FREQUENTLY ASKED QUESTIONS

A. The symptoms of coeliac disease can vary widely from person to person. Some people can experience more unpleasant symptoms than others, some may only have mild and non-specific coeliac disease symptoms such as iron-deficiency anemia, general fatigue etc and some people may not experience any symptoms at all!

Possible coeliac disease symptoms may include:

Diarrhea, excessive wind and/or constipation

Persistent or unexplained gastrointestinal symptoms such as nausea and vomiting

Regular stomach pain, cramping or bloating

Iron, vitamin B12 or folic acid deficiency

Tiredness and/or headaches

Weight loss (in some cases)

Hair loss

Skin rash (dermatitis herpetiformis)

Tooth enamel problems

Osteoporosis

Depression

Infertility

Join and/or bone pain

Neurological (nerve) problems such as ataxia (poor muscle co-ordination) and neuropathy (numbness and tingling in the hands and feet)

Some of these coeliac?disease symptoms are commonly mistaken as symptoms of Irritable Bowel Syndrome (IBS) but the National Institute for Health and Clinical Excellence (NICE) guideline on IBS states that GPs have to exclude a diagnosis of coeliac disease before they diagnose IBS.

If you are having a test for coeliac disease you must make sure you have eaten gluten products such as bread in your diet for at least 6 weeks or the results will be affected.

A. If you feel that you have some coeliac disease symptoms, we recommend that you book an appointment with your doctor and get tested.

Steps to getting diagnosed with?coeliac?disease:

1. It is important to stick to a gluten containing diet prior to getting tested. This is because gluten needs to be present in your body for the test result?to be accurate.?Before you take the blood test at the doctors it is essential to of been eating gluten for the last 6 weeks. This is because the gluten is causing a reaction in the body which produces antibodies. This is what the blood test that screens for coeliac disease detects- the presence of these specific coeliac antibodies. If somebody is already on a gluten free diet then the body won’t be producing these antibodies and they will test negative even though they may have coeliac disease. This is because they are already following a gluten free diet.

2. If this test is positive then you will be referred onto a consultant at the hospital for a further test which is a biopsy of the small intestine. The blood test is only a screening and you need to have a biopsy to confirm the suspected diagnosis.

3. If the result from the initial blood test is negative but the symptoms continue it may be that you are referred on for a biopsy to eliminate coeliac disease. Speak to your GP more about this.

A. Coeliac disease can affect men and women of all ages, and can sometimes start in infancy, during weaning. However, coeliac?disease is most frequently diagnosed in adults between the ages of 30 and 70.

Coeliac disease can also run in families and is more likely to occur in people who have other autoimmune conditions such as Type 1 diabetes, thyroid disease or liver disease.

• It is thought that only 1 in 8 individuals with coeliac disease are actually diagnosed.
• There are specific groups who have an increased risk of developing coeliac disease

These groups include:

If you have a close family member (e.g. parents, siblings or children) who has coeliac disease the risk increases to 1 in 10

People with Type 1 diabetes

People who have Irritable Bowel Syndrome

People who have autoimmune thyroid disease

People who have anaemia

People with neurological disorders

Associated chromosomal disorders e.g. Down’s Syndrome

A. We talk to so many people?who are gluten free for many different reasons. Some have Coeliac disease, some are Gluten intolerant and a large number of people choose not to involve gluten in thier diet as it simply makes them feel better.

A. Gluten is a protein composite found in wheat, barley and rye. It is what gives baking it’s fluffy texture, and aids in the rising of dough. These qualities are why it can be found in a wide range of foods.

It is also extracted from grains and used as a pure ‘gluten, which is commonly used in vegetarian imitation meats. About 1 in 10 people have an intolerance to gluten, and 1 in 100 people are Coeliac, or have a gluten allergy.

A. There are a number of arguments out there and people make a lot of claims about removing gluten being bad for you with no evidence to support this. The reality is that a healthy diet is made up of a balance of various foods, and if removing gluten from your diet is so terrible than we should all be rather concerned for most of Asia.

On any restricted diet it is important to try and balance your diet as much as possible. Some people on a gluten free diet will not get enough fiber, and for many women, iron. The easy way to avoid this is to replace glutinous grains with a wide range of high fiber, high iron grains, like buckwheat and quinoa.

What you choose to eat is your choice and no one else, and you are the only one who will suffer the consequences if it is not right. So follow how you feel, eat what makes you feel healthy, happy and at your best and if that involves limiting or removing gluten than we would love to help.

A. Unfortunately, this is partly a result of being in a small market (NZ is a tiny, isolated island), and partly to do with ingredient prices. Suppliers usually have to make their products in smaller quantities and often cannot bulk buy ingredients like their counterparts in regular mass-production based companies. To ensure the ingredients are gluten free, they often cannot buy cheaper versions of gluten free products because of the risk of cross contamination.

For the distributors, (like us) the turnover is smaller as a much smaller percentage of the population require our products. Because of this, higher mark-ups than at regular grocery stores are needed to cover overheads.

A. Now you have coeliac disease you will be managed by a health team such as your GP, pharmacist and dietitian. If your child has been diagnosed with coeliac disease a pediatric dietitian must be involved also.

The only clinically proven management of coeliac disease is a strict lifelong adherence to a gluten free diet. If a gluten free diet is not adhered to then there are many associated health risks such as osteoporosis, infertility, and gastrointestinal cancer. So sticking to a gluten free diet is essential!

Once you start cutting out gluten foods, the lining of your small intestine will be able to get back to normal. This means food will start to be absorbed properly, improving your energy and nutrient levels  believe us, you’ll soon feel the difference!

Just make sure you keep up your new gluten free diet; if you fall back to eating foods that contain gluten, your previous symptoms could return and there may be ongoing damage to the villi if there is continued gluten ingestion.

Clinical guidelines recommend follow up at 3, 6 & 12 month intervals following diagnosis. An annual review is important, particularly at times of stress or pregnancy. The reviews also monitor symptom improvement, nutritional state, dietary compliance and check routine blood tests.

Being diagnosed with coeliac disease doesn’t mean you have to put up with a more complicated and less exciting approach to food.You may have to tread carefully to start off with but you’ll be an expert in browsing labels and planning meals before you know it.

A. Don’t get bored or worried about not being able to eat your favourite foods.

Taste and flavor isn’t missed as you can liven up your breakfast, lunch and dinner by trying our gluten free recipes. We have lots of recipes that will help you bake what you already like. Keep our “Gluten free Grocer” baking flour mix in your cupboard so you don’t miss out on home baking, also our mix can be used to replace almost any standard recipe, you may just need to add a bit more moisture to your recipe.

As a coeliac it is important to know about gluten cross contamination in and out of the home. Cross contamination is when gluten comes into contact with your gluten free meal and this can happen without even realizing. There are many ways this can occur for example when toasting your gluten free bread it may come in to contact with gluten crumbs left in the toaster. Even tiny amounts of gluten like gluten breadcrumbs may cause gut symptoms in the short term and gut damage in the longer term.

The safety of oats is often of great concern for Coeliacs and although pure oats are often safe for most coeliacs to eat contaminated oats are still a big issue. Oats do not contain any gluten but avenin, a protein very similar to gluten. Research has shown that the majority of Coeliacs can safely eat this protein and only a very small number of people with coeliac disease are sensitive to pure uncontaminated oats. If oats are produced or stored in the same place as wheat, barley or rye then gluten can get mixed up with the oats. This is called cross contamination.

Oats can give great benefits to a gluten free diet, they provide further variety and nutritionally provide a good source of soluble fiber which helps to keep a healthy gut, can help to treat high cholesterol and can keep blood sugars stable for those with diabetes.

Our advice is if you want to add oats into your diet is to speak to your local healthcare team, GP or dietitian, they can give you specific advice and monitor your symptoms. However if you are newly diagnosed you may be advised to avoid oats to start with, usually for at least six months to allow your gut to heal.

The labeling of oats can sometime be confusing. You may see Oat products labelled as 100% oats, pure oats or organic oats none of these claims guarantee an uncontaminated product. We only recommend “Bobs Red Mill” oat products, as these are grown in wheat free fields, and are grown far away from any other wheat producing fields. They are also processed and packed in a Gluten free facility, and are regularly checked for any presence of wheat.

It is a legal obligation for grains which contain gluten to be listed in an ingredient list if they have been used as a deliberate ingredient, regardless to the amount used. Currently oats are considered a cereal which contains gluten. However in the future this may change so that pure, uncontaminated oats may be labelled gluten free.

A. Allergies are an auto-immune reaction to substances generally considered to be harmless to people.? An auto-immune reaction can include:
Skin rashes, like eczema, hives or swelling
Nasal or sinus congestion
Asthma
Inability of the body to process essential minerals resulting in chronic tiredness
Constantly getting minor illnesses
Acute digestive complaints and/or weight loss or gain
Anaphylaxis
If you have an allergy to a food, even if you don’t have an immediate or serious reaction to it, you should avoid it as this can have long term effects on your health. For people with Coeliac disease (an autoimmune disorder affected by eating gluten) the long term possible side effects of continuing to eat gluten include depression, infertility, osteoporosis and increased cancer rates.

A. An intolerance does not result in an auto-immune reaction. In-tolerances occur when an enzyme required to digest something does not exist in the body. For example: those with a lactose intolerance don’t have lactose (or have very little lactose), the chemical which naturally breaks down lactose, in their body. A reaction from an intolerance can include:
Nausea
Gastric discomfort (bloating, flatulence, cramps)
Headaches
Tiredness

A. You should see your doctor. They have a range of tests they can run to determine whether you have an allergy. If you are a New Zealand citizen, and your doctor shares your concerns, these can be done for free through the public health system. If you are still having problems and nothing has shown up in the tests, the next place to go to is an allergy specialist.

A. If you think it is more likely you have an intolerance, and want to try and get a handle on it yourself  remove the food /chemical you’re concerned about from your diet for 3 – 4 weeks. See if you feel any different. Keep a food diary to monitor your progress as you may find you have an intolerance to something else. Often responses can be delayed, so a food diary is important. A naturopath, a dietitian or nutritionist will be a great help with this. If you have any worrying gastro symptoms though you should definitely see your doctor, as these can be caused by a number of things.

A. These 8 foods account for about 90% of all food allergies:
Dairy
Egg
Peanut
Wheat or Gluten
Tree nuts
Fish
Shellfish
Soy