Autoimmune Disease | The Paleo Mom

Teaser Excerpt from The Paleo Approach: Probiotic Supplements

February 18, 2013 in Gut Health, Supplements, The Paleo Approach Excerpts

Last week I posted a teaser excerpt from The Paleo Approach about the importance of including probiotics (while the book is written from the perspective of autoimmune disease, the benefits of probiotics extend to all health conditions and human health in general). However, there are many people who don’t do well with fermented foods (reasons might include a yeast sensitivity, which is common in people with gluten intolerance, or a histamine sensitivity) or who just plain old don’t like them. So, it’s no surprise that that post prompted a series of questions about probiotic supplements. I have decided to share another excerpt from the book with you to help answer the question of probiotic supplements.

I should probably mention that both of the specific brands of probiotics mentioned in this section are ones that I take myself (and chose after a great deal of research). I’ve been taking these for 4 or 5 months and really like both of them. I also heard Chris Kresser rave about Prescript-Assist in his most recent podcast (just in case you were looking for a second opinion!).

This excerpt is from Chapter 8 (the supplements chapter).

As mentioned in Chapter 6,different strains of probiotics confer different effects on your body. However, from the vast array of different probiotic bacteria (approximately 35,000 species), only a handful have been characterized.

As previously mentioned, probiotic supplementation was shown to be beneficial for the management of every autoimmune disease in which it has been tested, including: inflammatory bowel disease, autoimmune myasthenia gravis, celiac disease, rheumatoid arthritis, multiple sclerosis, and autoimmune thyroid disease. However, it is important to note that there is also some conflicting information. In fact, there is convincing evidence that both bifidobacterium and lactobacillus probiotic bacteria (the two most common bacterial genera in probiotic supplements) are a source of autoantibody formation through molecular mimicry in autoimmune thyroid disease (discussed in Chapter 2). Furthermore, there have been reports of severe eosinophilic syndrome—a condition characterized by elevated eosinophils (a type of white blood cell important for the innate immune system) in the blood with damage to cardiovascular system, nervous system, and/or bone marrow—directly attributable to the use of probiotics (both in people with a history of autoimmune disease but also in completely healthy individuals).

What does this mean? If you do not tolerate fermented foods, probiotics are definitely worth trying. The majority of the evidence in the scientific literature supports their potential benefits; however, some caution is advisable. Just as in the case of fermented foods, probiotic supplements can be added after following The Paleo Approach for several weeks (at least 3) in the case of people with severe gastrointestinal symptoms or known bacterial overgrowth.

Which probiotics should you take? Probiotic supplements fall into two categories:

Lactobacillus/Bifidus: Lactobacillus and bifidobacterium are the two most heavily studied genera of probiotic bacteria. They are also the most commonly found in supplement form. It is important to note that even though the majority of scientific studies show health benefits of these strains, these are also the strains that may contribute to autoantibody formation and to severe eosinophilic syndrome in some people.

If you choose to take a lactobacillus and bifidobacterium supplement, look for a brand with as many different strains as possible (for greater probiotic diversity). However, be cautious: dairy ingredients are common in these types of supplements. Look for a bottle that specifically brands itself as dairy-free, gluten-free, soy-free, corn-free, wheat-free, egg-free, peanut-free, and tree nut-free. Also look for one that is yeast-free if the reason you are taking a probiotic supplement instead of eating fermented foods is yeast sensitivity concerns. One high-quality brand to look for is Kirkman.

Start with a low dose, even breaking open a capsule and sprinkling a small amount in your food or in a small cup of water. Alternatively, you can take your probiotic supplement every 2 or 3 days. Over the course of several weeks, work your way up to the suggested dose on the bottle, taken daily. Some probiotic supplements recommend taking with food while other recommend taking them on an empty stomach. It is typically best to follow the specific recommendation of the brand you are using. If your probiotic supplement does not have directions regarding whether or not to take it with food, first try taking it on an empty stomach. After several weeks, switch to taking with food and see if you notice any improvement.

Soil-Based Organisms: While not as extensively studied as probiotics from the lactobacillus and bifidobacterium genera, soil-based organisms hold extreme promise for modulating the immune system and correcting gut dysbiosis. They have been shown to have extreme therapeutic potential in Irritable Bowel Syndrome and provide probiotic organisms that are routinely missing from our modern, over-hygienic lifestyles yet are normal residents of a healthy gut.

One brand to look for is Prescript-Assist which contains 29 different strains of soil-based organisms and is also dairy-free, gluten-free, soy-free, corn-free, wheat-free, egg-free, peanut-free, tree nut-free and yeast-free (also none of the strains included in Prescript-Assist come from the lactobacillus or bifidobacterium genera, or indeed any of the strains typically found in fermented foods). Prescript-Assist has one of the best diversity of any probiotic supplements available. Soil-based organisms seem to be better tolerated than lactobacillus and bifidobacterium, although extensive comparisons have not been made.

It is typically recommended to take two capsules daily (divided into two doses) for thirty days, followed by one capsule once or twice per week as a maintenance dose. Because the strains in soil-based organism probiotics are different from the probiotic strains typically found in fermented foods, it is worth strongly considering taking a soil-based probiotic even if you are eating fermented food or taking a lactobacillus and bifidobacterium-based probiotic supplement.

Bittner AC, Croffut RM & Stranahan MC, Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome: a methodologically oriented, 2-week, randomized, placebo-controlled, double-blind clinical study, Clin Ther. 2005 Jun;27(6):755-61.

Bittner AC, et al., Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial, Clin Ther. 2007 Jun;29(6):1153-60

Jirillo E, Jirillo F & Magrone T, Healthy effects exerted by prebiotics, probiotics, and symbiotics with special reference to their impact on the immune system, Int J Vitam Nutr Res. 2012 Jun;82(3):200-8

Kiseleva EP, et al., The role of components of Bifidobacterium and Lactobacillus in pathogenesis and serologic diagnosis of autoimmune thyroid diseases, Benef Microbes. 2011 Jun;2(2):139-54.

Klaenhammer TR, et al., The impact of probiotics and prebiotics on the immune system, Nat Rev Immunol. 2012 Oct;12(10):728-34

Kverka M & Tlaskalova-Hogenova H, Two faces of microbiota in inflammatory and autoimmune diseases: triggers and drugs, APMIS. 2012 Oct 24.

Mendoza FA, et al., Severe eosinophilic syndrome associated with the use of probiotic supplements: a new entity?, Case Report Rheumatol. 2012;2012:934324

Veerappan GR, Betteridge J &Young PE., Probiotics for the treatment of inflammatory bowel disease, Curr Gastroenterol Rep. 2012 Aug;14(4):324-33.

Vyas U & Ranganathan N., Probiotics, prebiotics, and synbiotics: gut and beyond, Gastroenterol Res Pract. 2012;2012:872716.

Tags: Autoimmune Disease, bacteria, benefit, bifidobacterium, bifidus, biogold, celiac, crohn's, disease, fermented foods, Gluten, Gluten-Free, Grain-free, gut, healing, health, IBD, IBS, illness, Irritable Bowel Syndrome, kirkman, lactobacillus, organism, paleo, Paleolithic, prescript-assist, probiotic, probiotics, repairing, soil-based, strain, supplement, supplements
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Guest Post by Angie Alt: Accepting My Paleo Imperfection

January 5, 2013 in Living with Autoimmune Disease

Angie Alt is wife, mother, world traveler & blogger. She’s also a warrior in the autoimmunity war. Angie confronts three autoimmune disorders each day, including Celiac Disease, with powerful management techniques like AIPaleo & the Paleolithic lifestyle. She blogs regularly about the emotional side of tackling autoimmunity, adopting Paleo, and how it impacts her, her family, & their way of life. You can read more by Angela Alt at her blog and connect with her on Facebook.

I’m a perfectionist. Sigh . . . I wish it weren’t so, but it is. I have always, always wanted all the details of everything I do to be flawless. It doesn’t stop with just the things I do though, it is also who I am . . . I want that to be perfect too.

In part, I happily ran down the Paleo path, because Paleo is aiming for ideals. Ideal digestion, ideal blood sugar regulation, ideal vitamins and minerals from ideal foods, ideal body weight, ideal strength, ideal rest . . . and for people like me taking it that extra-step with Autoimmune Protocol, ideal disease management. To begin with, it was a very complicated internal process for me to even wrap my mind around my autoimmunity. “You mean my body is not functioning perfectly?” I felt like I had done something wrong. I’d made a mistake and naturally I had to make a major correction. I knew immediately that the less than ideal standards of typical western medicine were not going to cut it for my perfectionist personality.

Although I still have four months to go before I reach my first “paleoversary,” we are rapidly nearing the end of the calendar year. Just like millions of other people I have been thinking recently about what I achieved in the past year and what I want to achieve in the new year. The more I thought, the more I dwelled on all I have not yet accomplished on my Paleo journey. I don’t eat organic, grass-fed meat or wild-caught fish 100% of the time yet. I am coming from a starting point of extreme illness, including Celiac Disease, so I know I need supplementation, but I still haven’t worked out exactly what supplements to take and the best sources. I don’t have a good routine put together yet for getting outside and using my body. I haven’t mastered my sleep patterns. I don’t have a good stress management process down.

I have the terrible perfectionist habit of focusing on the areas that I think might be substandard. As I contemplated the past year and tried to begin mentally planning the new one, I didn’t take any time to focus on the remarkable successes. I had finally gotten a name for what was wrong for over a decade, Celiac Disease. I had discovered a path to healing through Paleo and jumped head first into the Autoimmune Protocol. Through careful AIP discipline I brought my gluten antibodies from 161 to only 1 point outside the normal range. I learned literally volumes about real nutrition and almost without trying put together an awesome support network. Most importantly, I started using my blog to write about the emotional side of tackling autoimmunity and adopting Paleo as a way to connect with and offer support to others in similar situations.

Learning about Paleolithic nutrition and spreading the word from the basics all the way to the emotional triumphs and challenges culminated for me this week. My co-workers asked me to give a presentation on Paleo. I prepared everything meticulously (ugh, perfectionism) and then passionately gave them my pitch. At the end of it, every single one of them decided to start the new year with Paleo. I was so excited and will totally be cheering for them in their personal health resolutions. And then it occurred to me . . . over and over during the course of my talk, I had emphasized to them that this was a process, that they should not get bogged down in rules, that they should take their time adapting to this new template for living . . . that it was not important to be perfect. I was encouraging them to go easy on themselves, while I was silently running myself down about all the ways I have not yet achieved the Paleo ideal. (I think those of us using Paleo to manage disease are particularly at risk for being too hard on ourselves about achieving perfection, since it can mean profound differences in our physical health and emotional well-being to get it all down just right.)

The truth is, given the time and budget I have to work within, I am doing the absolute best I can in terms of food quality. Long-term undiagnosed Celiac Disease means sorting out proper supplementation and finding high-quality, affordable sources is a larger work in progress, but I continue to work at it diligently. I’m working hard to find the time between working full-time, being a wife and mother, and taking time for my passion, writing, to get outside and move my body. I’ve had the sleep rhythms down a few times over the course of my Paleo adaptation and I am sure I will find my way back again.

But then there is still that lacking stress management plan? Maybe it should start with acceptance of my Paleo imperfection? I, as a human being, am by nature one long work in progress. How did we get here from our primal ancestors anyway, if it isn’t all about building one piece at a time to reach an ideal? I am moving in the right direction. I can feel it in my cells. I am getting closer to the ideal and that is what counts.

I owe Angie an apology for not posting this post before New Years. I hope this post will resonate with all of you the way it does for me and still seem timely as we contemplate and tackle our own New Years resolutions.

Tags: acceptance, attitude, Autoimmune Disease, imperfection, new, optimism, paleo, Paleolithic, perfect, perfection, perfectionism, positive, primal, resolutions, transition, year, year's
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The Great Dairy Debate

October 13, 2012 in FAQ, Foods in Moderation, The WHYs of the AIP

The value (or lack thereof) of dairy products is the second most fiercely debated topic within the paleo community (after carbohydrate intake). Opinions vary dramatically from consumption of no dairy whatsoever, to only consuming dairy fat (such as ghee, butter and heavy cream), to only consuming raw grass-fed dairy, to only consuming fermented dairy or aged cheeses, to including any dairy on a regular basis.

The reason for this diversity of opinions is that the science is not clear cut. There are strong arguments to be made both for and against.

Let’s start with the arguments against dairy. Prof. Loren Cordain dedicates an entire well-cited chapter in his most recent book The Paleo Answer (a fantastic book for describing the nitty gritty scientific details behind the paleo diet) to the many reasons why milk should not be consumed in any form. To summarize, what I view the strongest parts of this argument:

Milk is not as nutrient-dense as meat, fruits and vegetables.
Milk is highly insulinogenic, meaning it causes a large spike in blood insulin levels, disproportional to the amount of sugar and protein in milk. This may contribute to the development on insulin resistance, at least in the context of a high carbohydrate diet. Insulin is also pro-inflammatory.
Milk contains active bovine (cow) hormones which have the potential to alter our hormone levels. The effects of dietary intake of most of these hormones have not been studied. However, other hormones have been studied. For example, the milk hormone Insulin-like Growth Factor-1 (IGF-1) has been linked to risk of breast, colorectal and prostate cancer, with the strong indication that consumption of dairy protein is a large contributor to blood IGF-1 levels ¹.
Milk contains protease inhibitors which may contribute to the development of a leaky gut (see this post for a more in depth explanation as to why)
Milk increases mucus production. This may aggravate conditions such as asthma but also creates excess mucus in the gastrointestinal tract which may irritate the gut lining and inhibit nutrient and mineral absorption.
Lactose is poorly tolerated by adults. Approximately 25% of Caucasians (American and European) are lactose intolerant. 97% of Native Americans are lactose intolerant. This argument does not apply to drinking raw milk since raw milk contains enzymes to help digest lactose.
Dairy is highly allergenic. This is where I believe the chief argument against dairy lies and I will discuss this further below.

There are also some very compelling arguments for including dairy products in our diets. Studies have shown that consumption of dairy, especially full-fat dairy products and fermented dairy products, can protect against Metabolic Syndrome (cheese, full-fat dairy, and fermented dairy), Type II Diabetes (fermented dairy only) and Cardiovasular Disease (cheese, full-fat dairy, and fermented dairy) ^2-6.

Grass-fed dairy, especially the fat from grass-fed dairy, is an excellent source of fat-soluble vitamins and Conjugated Linoleic Acid, an anti-inflammatory and healing fat. Fermented dairy is an excellent source of probiotics. There are also some valuable proteins in dairy, such as glutathione (very important for reducing inflammation and protecting against oxidative stress) and whey (which may help prevent cancer).

There is also evidence that dairy proteins are beneficial for children due to their growth-promoting effects. Traditionally, children would have received some breast milk until approximately 5 years of age. In our current society, most children are weaned by age 1. The current scientific view is that, provided cow’s milk is not introduced too early, it is a good substitute for human milk in terms of its growth promotion ⁷.

Yes, the science is not clear, although there seems to be a good case for including dairy fat in our diets. This is why the standard paleo diet allows for ghee and butter, and in many cases heavy cream and full-fat sour cream. Many people also include fermented dairy in their diets with great success.

However, one thing that is abundantly clear is that milk allergy is common. Beyond lactose-intolerance, which can be treated with the aid of digestive enzymes or consumption of raw milk, allergy to milk proteins is very common. Epidemiological reports of cow’s milk allergy (IgE antibody reactions to cow’s milk proteins) range between 1 and 17.5% in preschoolers, 1 and 13.5% in children ages 5 to 16 years, and 1 to 4% in adults ⁸. It is not known how prevalent cow’s milk sensitivities are (IgA and IgG antibody reactions to cow’s milk proteins). It’s important to note that goat’s milk is not as allergenic as cow’s milk.

Cow’s milk proteins are also known gluten cross-reactors, which means that those with gluten intolerance may produce antibodies against gluten that also recognize dairy proteins. For these people, eating dairy is the same as eating gluten (more information in this post). Very importantly, for people with allergy, intolerance or gluten cross-reactions to dairy proteins, even the trace dairy proteins in ghee can be a problem.

So, what do I recommend? Caution. I believe that dairy is probably okay for many healthy adults, especially full-fat, grass-fed dairy. In fact, for healthy individuals, the benefits likely outweigh the risks. However, for those battling autoimmune disease or other conditions where a leaky gut is a potential contributing factor, it makes the most sense to omit dairy from your diet for now. As is my standard recommendation for all of the gray-area foods, I suggest leaving it out of your diet for at least 1 month, then try reintroducing it and see if you notice any obvious symptoms (this is the best way to determine if you are allergic or sensitive).

I am still trying to gauge my own tolerance for grass-fed butter. My daughters both seem to do better without cow’s dairy in their diets (except grass-fed butter, which seems okay), but I have reintroduced grass-fed goat mineral whey protein powder into their diets and they seem to do really well with that (especially my oldest). I also have intentions to try them with some grass-fed goat’s whole milk. This is another highly individual aspect of a paleo diet and you really don’t know whether or not milk is good for you until you try living without and then try living with.

1. Crowe FL et al “The association between diet and serum concentrations of IGF-I, IGFBP-1, IGFBP-2, and IGFBP-3 in the European Prospective Investigation into Cancer and Nutrition.” Cancer Epidemiol Biomarkers Prev. 2009 May;18(5):1333-40.

2. Louie JC et al “Higher regular fat dairy consumption is associated with lower incidence of metabolic syndrome but not type 2 diabetes.” Nutr Metab Cardiovasc Dis. 2012 Sep 26. pii: S0939-4753(12)00193-7. doi: 10.1016/j.numecd.2012.08.004. [Epub ahead of print]

3. Warensjö E, et al. “Biomarkers of milk fat and the risk of myocardial infarction in men and women: a prospective, matched case-control study.” Am J Clin Nutr. 2010 Jul;92(1):194-202. Epub 2010 May 19.

4. Sonestedt E et al. “Dairy products and its association with incidence of cardiovascular disease: the Malmö diet and cancer cohort.” Eur J Epidemiol. 2011 Aug;26(8):609-18. doi: 10.1007/s10654-011-9589-y. Epub 2011 Jun 10.

5. Sluijs I et al “The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study.” Am J Clin Nutr. 2012 Aug;96(2):382-90. Epub 2012 Jul 3.

6. Bonthuis M et al. “Dairy consumption and patterns of mortality of Australian adults” European Journal of Clinical Nutrition (2010) 64, 569–577; doi:10.1038/ejcn.2010.45; published online 7 April 2010

7. Agostoni C and Turck D. “Is cow’s milk harmful to a child’s health?” J Pediatr Gastroenterol Nutr. 2011 Dec;53(6):594-600.

8. http://www.worldallergy.org/publications/WAO_DRACMA_guidelines.pdf

Chris Kresser has a terrific post Dairy: food of the Gods or neolithic agent of disease?

The Paleo Answer by Prof. Loren Cordain is an excellent resource.

Tags: ancestral, Autoimmune Disease, babies, bad, benefit, blood, butter, cancer, children, con, cream, dairy, detriment, Diet, Fat, fermented, ghee, good, inflammation, insulin, kefir, kids, leaky gut, metabolic syndrome, milk, okay, paleo, Paleolithic, primal, pro, protect, Protein, Sugar, yogurt
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Gluten Cross-Reactivity: How your body can still think you’re eating gluten even after giving it up.

October 4, 2012 in FAQ, FAQ, Foods in Moderation, Gut Health, The Autoimmune Protocol, The WHYs of the AIP

NOTE: An updated version of this post can be found here.

For those 20% of us with celiac disease or gluten-intolerance/sensitivity (whether diagnosed or not), it is critical to understand the concept of gluten cross-reactivity. Essentially, when your body creates antibodies against gluten, those same antibodies also recognize proteins in other foods. When you eat those foods, even though they don’t contain gluten, your body reacts as though they do. You can do a fantastic job of remaining completely gluten-free but still suffer all of the symptoms of gluten consumption—because your body still thinks you are eating gluten. This is a very important piece of information that I was missing until recently.

Proteins are made of long chains of amino acids (small proteins may only be 50 amino acids long whereas large proteins may be 2000 amino acids long) and it is the specific sequence of these amino acids that determines what kind of protein is formed. These amino acid chains are folded, kinked and buckled in extremely complex ways, which gives a protein its ‘structure’. This folding/structure is integral to the function of the protein.

An antibody is a Y shaped protein produced by immune cells in your body. Each tip of the Y contains the region of the antibody (called the paratope) that can bind to a specific sequence of amino acids (called the epitope) that are a part of the protein that the antibody recognizes/binds to (called the antigen). The classic analogy is that the antibody is like a lock and a 15-20 amino acid section of a protein/antigen is the key. There are 5 classes (or isotypes) of antibodies, each with distinctive functions in the body. The IgE class of antibodies are responsible for allergic reactions; for example, when someone goes into anaphylaxis after eating shellfish. The two classes IgG and IgA are critical for protecting us from invading pathogens but are also responsible for food sensitivities/intolerances. Both IgA and IgG antibodies are secreted by immune cells into the circulation, lymph, various fluids of the body (like saliva!) and tissues themselves. And both IgG and IgA antibodies are found in high concentrations in the tissues and fluids surrounding the gut (this is part of why the gut is considered our primary defense against infection).

The formation of antibodies against an antigen (whether this is an invading pathogen or a food) is an extremely complex process. When antibodies are being formed against a protein, the antibodies recognize specific (and short) sequences of amino acids in that protein. Depending on how the antigenic protein is folded, certain amino acid sequences in that protein are more likely to be the target of new antibody formation than others, simply because of the location of that sequence in the structure of the protein. Certain sequences of amino acids are more antigenic than others as well (i.e., more likely to stimulate antibody formation). This is also part of why certain foods have a higher potential to cause allergies and sensitivities.

Understanding that antibodies recognize short sequences of amino acids and not an entire protein is key to understanding the concept of cross-reactivity (and molecular mimicry, but that’s a topic for another post). It also is the reason why many different antibodies can be formed against one protein (this redundancy is important for protecting us from pathogens). Many different antibodies can also be formed against one pathogen or, more relevant to this discussion, one specific food.

So what happens in cross-reactivity? In this case the amino acid sequence that an antibody recognizes is also present in another protein from another food (in the case of molecular mimicry, that sequence is also present is a protein in the human body). There are only 20 different amino acids, so while there are millions of possible ways to link various amount of each amino acid together to form a protein, there are certain amino acid sequences that do tend to repeat in biology.

The take home message: depending on exactly what antibody or antibodies your body forms against gluten, it/they may or may not cross-react with other foods. So, not only are you sensitive to gluten, but your body now recognizes non-gluten containing foods as one and the same. Who needs to worry about this? Any of the estimated 20% of people who are gluten sensitive/intolerant or have celiac disease, i.e., have formed antibodies against gluten.

Cyrex Labs offers a simple blood test that tests for cross-reactivity to the most common culprits (Chris Kresser vouches for the high quality tests done by this company, which is good enough for me!). Here is the full list (some of these are obviously not paleo, but you might consider them cheat foods, which is why I mention them):

Rye
Barley
Spelt
Polish Wheat
Oats
Buckwheat
Sorghum
Millet
Amaranth
Quinoa
Corn
Rice
Potato
Hemp
Teff
Soy
Milk (Alpha-Casein, Beta-Casein, Casomorphin, Butyrophilin, Whey Protein)
Chocolate
Yeast
Coffee
Sesame
Tapioca (a.k.a. cassava or yucca)
Egg

Just like trace amounts of gluten can cause a reaction in at least those with celiac disease (the threshold for a reaction has not been tested in non-celiac gluten sensitivity), even a small amount of these foods can perpetuate inflammation and immune responses. This is important when you think of the small amounts of soy used in so many foods and even the trace milk proteins that can be found in ghee.

If you have autoimmune disease (which has a very high correlation with gluten-sensitivity), celiac disease, gluten-sensitivity, or are simply not seeing the improvements you were hoping for by following a standard paleo diet, one or all of these foods may be the culprit. You have the choice of either cutting these foods out of your diet and seeing if you improve or get tested to see if your body produces antibodies against these foods. For me, it’s a no brainer (because it just all makes so much sense now!): I have to stop eating chocolate (sniff), fermented foods like sauerkraut and kombucha (because of the yeast content), eggs, and tapioca. I am very happy to report dramatic improvement in my lichen planus lesions in just four days! (and as much as I miss chocolate and kombucha, it’s worth it!)

A great overview of proteins and antibodies (and source of protein folding image): http://publications.nigms.nih.gov/structlife/chapter1.html

A fairly technical review of food IgG-mediated food sensitivities: http://www.usbiotek.com/Downloads/information/criticalReview.pdf

Cyrex Labs Array 4: http://www.cyrexlabs.com/CyrexTestsArrays/tabid/136/Default.aspx

Image of antibody binding taken from http://classes.midlandstech.edu/carterp/Courses/bio225/chap17/ss2.htm

Tags: antibody, Autoimmune Disease, celiac, cross-reaction, cross-reactivity, Diet, disease, foods, Gluten, gluten intolerance, gluten sensitivity, inflammation, other foods to avoid, paleo, Paleolithic, primal
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