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As millions of Americans gather round tables with family and friends to give thanks, it is a special reminder of just how good it is to be grateful…not just one day, but every day. How good for our emotional health, our relational health, our spiritual health, and our physical health. Being grateful is so good. […]

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This bread can cause any number of symptoms of gluten intolerance in people with a sensitivity to the food.

You just don’t feel good. You’re tired and get frequent headaches, have ongoing skin issues, or struggle with depression—or all of the above. Maybe you’ve wondered if gluten could be the culprit, but because you don’t experience gastrointestinal upset, you’ve since put the thought out of your mind and haven’t mentioned anything to your doctor. Or perhaps you’ve shared your suspicion, but conventional testing ruled out celiac disease (CD) and thus, supposedly, any issues with gluten. In either case, your diet has likely stayed the same … and so have these often-overlooked symptoms of gluten intolerance.

Yes, all of the symptoms mentioned here—and many others you may not have heard about—can be signs that you have a significant degree of gluten intolerance. Even if you don’t run to the bathroom right after enjoying a plate of pasta, and even if standard lab work says otherwise, your body (and brain) may be having serious problems with gluten. Let’s explore these lesser-known symptoms and discuss if going gluten free is right for you.

You’ve heard of the havoc gluten can wreak on your digestive tract, but did you know that gluten intolerance can cause skin problems, depression, and frequent headaches? Check out this article for more symptoms of gluten intolerance you’ve never heard of. #nutrition #chriskresser

Undiagnosed Intolerance Is More Common than You May Think

First off, I want you to know that if you eat gluten and you feel lousy but you don’t have digestive issues—and you have tested negative for CD and been told it’s all in your head—you are not alone. In fact, undiagnosed cases of gluten intolerance are incredibly widespread. Here’s why.

As I’ve written before, wheat contains several different classes of proteins: gliadins (of which there are four different types, including one called alpha-gliadin); glutenins; agglutinins; and prodynorphins. Once wheat is consumed, enzymes in the digestive tract called tissue transglutaminases (or tTGs) help break down the wheat compound. During this process, additional proteins are formed, such as deamidated gliadins and gliadorphins (also called gluteomorphins). Stick with me here—these terms are worth knowing so that you can understand the pitfalls of conventional testing for CD.

CD is a serious form of gluten intolerance, one that can do real damage to the tissues in the small intestine (though its symptoms aren’t merely gut related). CD is characterized by an immune response to one specific gliadin (the aforementioned alpha-gliadin) and one specific type of transglutaminase (tTG-2). But people can—and very much do—react to several other components of wheat and gluten.

Therein lies the problem, because conventional lab testing for CD and gluten intolerance only screens for antibodies to alpha-gliadin and tTG-2.

If your body reacts to any other wheat protein or type of transglutaminase, even severely, you’ll still test negative for CD and intolerance.

Statistics suggest that for every one case of CD that is diagnosed, 6.4 cases remain undiagnosed—the majority of which are atypical forms without gastrointestinal symptoms; even many patients who are eventually diagnosed don’t experience an upset stomach after consuming gluten. (1)

What’s more, the distinct autoimmune response to wheat proteins and transglutaminase enzymes in the gut that defines CD is just one possible expression of gluten intolerance. The many other ways a sensitivity to gluten can affect the body are collectively referred to as non-celiac gluten sensitivity, or NCGS. Cases of gluten intolerance classified as NCGS involve both intestinal and non-digestive reactions to gluten that are not autoimmune or allergic in nature and that resolve when gluten is eliminated from the diet.

There is no definitive diagnostic test for NCGS, making it difficult to put a number on its prevalence. By some estimates, it may occur in as many as one in 20 Americans. (2) And although your doctor and plenty of others out there might still insist that NCGS doesn’t truly exist, several studies have validated it as a distinct clinical condition. (3) As I’ve explained previously, gluten sensitivity is very real. Stories painting NCGS as a collective delusion have gotten it wrong.

Decoding Your (Real) Symptoms

Gluten intolerance can affect nearly every tissue in the body, including the brain, skin, endocrine system, liver, blood vessels, smooth muscles (found in hollow organs such as the intestines), and, yes, stomach.

That’s why it can manifest either in the classic presentation of digestive distress—abdominal pain, bloating, gas, and diarrhea or constipation—or in any of the following, likely surprising, non-digestive symptoms.

Anemia

Although it’s discussed infrequently in popular articles, iron-deficiency anemia is well documented as a symptom of gluten intolerance in scientific studies. (4, 5) In fact, research suggests that it may often be the first noticeable symptom of CD and that up to 75 percent of those with an anemia diagnosis may be gluten intolerant. (6, 7) Gluten intolerance can interfere with the uptake of iron from food, causing malabsorption of this important nutrient. (8) What’s more, because anemia generally saps one’s energy, it can trigger or worsen the next non-digestive sign of gluten intolerance on this list.

Fatigue

Many gluten-intolerant individuals report feeling tired and fatigued, especially right after eating, you guessed it, gluten. (9) Research has linked NCGS to chronic fatigue symptoms in some people. (10) As with chronic fatigue syndrome, symptoms of gluten intolerance can also include muscle fatigue and muscle and joint pain.

Brain Fog

This type of cognitive dysfunction can be a sign of gluten sensitivity. Those affected often describe experiencing “foggy mind” symptoms such as an inability to focus and concentrate; some also describe feeling mentally fatigued. (11, 12)

Headaches

Headache is a frequent finding in NCGS, with one recent study reporting the symptom in more than half of its participants. (13, 14, 15) Migraine in particular is an associated symptom. (16, 17)

Eczema and Other Skin Disorders

As with fatigue, brain fog, and headaches, people with NCGS may notice a worsening of skin symptoms such as eczema, rash, and undefined dermatitis after ingesting gluten-containing foods. The most commonly reported skin lesions include those similar to subacute eczema, as well as the bumps and blisters indicative of dermatitis herpetiformis, or Duhring’s disease—to which CD is closely linked. Those who are gluten intolerant may also experience scaly patches resembling psoriasis. Lesions are typically found on the muscles of the upper limbs. (18, 19, 20)

Depression and Anxiety

One of the main reasons gluten sensitivity often goes unrecognized and untreated, researchers theorize, is because mental health issues can be a hallmark of this condition.  Data suggests that up to 22 percent of patients with CD develop such dysfunctions, with anxiety and depression occurring most commonly. One study found that CD patients were more likely than others to feel anxious in the face of threatening situations, while additional research has linked conditions such as panic disorder and social phobia to gluten response. Depression and related mood disorders appear to occur with both NCGS and CD. (21, 22)

Here’s the good news: The majority of studies cited here not only investigated whether or not these symptoms are signs of gluten intolerance, but also whether or not they can be addressed by going gluten free. And it turns out, these problems improved or completely resolved with adherence to a gluten-free diet.

But more on that in a minute.

Beware These Surprising Consequences of Intolerance

While the symptoms mentioned above are what will most likely clue you in to your body’s negative response to gluten, they aren’t the only effects of intolerance to be aware of. In fact, a variety of chronic diseases may develop due to long-term CD or NCGS, including: (23, 24)

  • Epilepsy
  • Attention-deficit hyperactivity disorder, or ADHD
  • Autism spectrum disorders
  • Schizophrenia
  • Type 1 diabetes
  • Osteoporosis
  • Multiple sclerosis
  • Hashimoto’s
  • Peripheral neuropathy
  • Amyotrophic lateral sclerosis, or ALS

In one study, researchers found a strong link between gluten sensitivity and neurological complications—especially those in which the cause was unknown. (25) Research has even shown that, for some people with gluten sensitivity, the primary symptom they experience is a neurological dysfunction. (26) The data suggests that nearly 60 percent of people with neurological dysfunction of unknown origin test positive for anti-gliadin antibodies. (27)

Challenge Yourself: Do You Feel Better On a Gluten-Free Diet?

If you’re currently experiencing any of the symptoms of gluten intolerance I shared in this article and can’t seem to find relief, or if you have received a diagnosis of any of the above linked diseases or disorders and you and your doctor have not found a probable cause or resolution, gluten could very well be a trigger for you.

Because of the limitations of current testing for CD and the lack of diagnostic options for NCGS, the most reliable test for gluten intolerance is a “gluten challenge.”

This involves removing gluten from your diet completely for a period of at least 30 days—60 days is best—then adding it back in after that time has elapsed. If your symptoms and/or diagnosis improve during the elimination period and return when gluten is reintroduced, let your healthcare provider know. You have NCGS or atypical CD.

Though I consider this to be the gold-standard test for gluten intolerance, Cyrex Laboratories does offer a comprehensive blood panel that screens for all of the wheat and gluten proteins and transglutaminase enzymes discussed earlier. It can be a helpful diagnostic tool, but it shouldn’t replace a gluten challenge. (Note: It must be ordered by your physician or another healthcare provider.)

How Will You Deal with Your Symptoms of Gluten Intolerance?

If you experience improvement on a gluten-free diet and plan to continue eating this way, you can feel confident that there is no risk in terms of nutrient deficiencies to removing gluten from your diet. (28) If anything, my experience has shown me that people who eat gluten-free are more likely to increase their intake of essential nutrients, especially if they replace breads and other flour products with whole foods.

Have you experienced any of these symptoms? Are you planning a gluten challenge to determine once and for all if gluten is the culprit? Let me know below in the comments!

The post The Symptoms of Gluten Intolerance You Haven’t Heard About appeared first on Chris Kresser.

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Drinking alcohol is common. In the United States, for example, the 2015 National Survey on Drug Use and Health (NSDUH) reported that more than 86 percent of people 18 and older have drank alcohol at least once in their lifetime, and over 50 percent reported they drank some in the last month [1].

Many people can enjoy alcohol without negative physical, psychological, or social consequences. In other words, these individuals can “drink in safety.” Others, however, can drink too much, too fast, or too often, and these patterns of alcohol consumption can lead to negative consequences.

It can sometimes be hard to know for certain if a friend’s or family member’s relationship with alcohol is safe, or if it might be problematic. Even more confusing is knowing how — or even if — to talk about alcohol with someone you care about, if you’ve been concerned about their drinking.

If your interest was piqued by the title of this article, the short answer is yes, you should talk to your loved one. This is an easy answer, because alcohol can be extremely detrimental to both physical and psychological health, as well as careers and relationships. To put it bluntly, alcohol can cause death.

For example, more than 88,000 people die from alcohol-related causes every year, and it is the third leading cause of preventable death, just behind smoking and sedentary lifestyles [2].

Despite this easy affirmative answer, it may not feel easy for those of you who are uncomfortable bringing up friend’s or a family member’s drinking. If your aunt or best friend had a nasty cough, would you ask about it? No problem! It would be normal to express concern and wonder if they had seen their doctor. If your workout buddy or office mate was walking with a limp, or kept rubbing their knee, would you ask if they were in pain? Of course!

But talking about alcohol use often feels “different” for those of us who worry about a loved one’s drinking. This is because much like mental illness, problematic behavior around alcohol is stigmatized, and talking about it can sometimes evoke feelings of guilt and discomfort in both yourself and the person you care about. As a result, you may feel hesitant to speak up.

Please, say something anyway! Regardless of what kind of evidence you have to support your worries, your feelings of unease and your desire to check in about it is evidence enough that you should talk with the person you’re concerned about. Not their significant other, not their roommate, not even the other friends in your circle of friends — the loved one themselves.

Here are some ideas for how to talk to someone you love when you think that alcohol might be a problem.

1. Call a Spade a Spade

You do not need fancy words, research, or anything other than your own experiences to bring up your loved one’s drinking. With empathy and compassion, you can speak directly to the observations you’ve made. For example:

Cindy, I just want to check in with you, because the last three times we’ve gone out, I noticed you had so much to drink that you started slurring your words, and you had to go home early. Then, the next morning you’ve told me you were blacked out on all of those nights. I feel worried that you are drinking too much.

When someone is having trouble with their drinking, they are not objective and will not be able to see their drinking clearly. It may feel confrontational, but if you speak with empathy, your honesty and clarity can help your friend or family member put things into perspective.

In addition, it is common for people who have a problem with alcohol to minimize their drinking, or the effects of their drinking. When you can describe your observations in a black-and-white way, you leave no room for minimization and are helping the person you care about see their drinking more clearly.

2. Have an Idea of What to Do Next

You do not need to solve this problem for your loved one, but if they are open to your feedback, they may respond with “What should I do?” They may not be ready, or willing to make any changes, but if the question gets asked, it will help you to have one or two suggestions for how they can find out more. So here are a few thoughts:

Encourage Your Loved One to Find Out More

It can be helpful to learn about the signs and symptoms of problematic drinking, what constitutes heavy or high-risk drinking, and when someone should seek help. You can be part of the process, or provide a link to information, but either way, encourage them to be an informed consumer.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) offers a free screening tool to assess your pattern of drinking, identify signs of an alcohol problem, and answers common questions about alcohol and alcohol problems.

Recommend Getting Help

The NIAAA offers a free Alcohol Treatment Navigator and lists options for finding help. Your friend or family member should talk to a professional about their drinking. They could see their primary care doctor, but they could also talk with someone who has expertise in alcohol and problems with alcohol.

Some therapists have specialties, or even special credentials in alcohol and drug abuse counseling. These professionals will offer the most expertise, and they often work with people who are questioning their relationship with alcohol.

Suggest Going to Check Out an AA Meeting

Free, anonymous, and often open to the public, Alcoholics Anonymous (AA) meetings are widely available in many parts of the world. You can go to AA.org to find local meetings, both online and in person, in addition to loads of free information and literature about alcohol and alcoholism.

If your loved one is open to checking out a meeting, you will want to select a meeting that is “open,” which means open to people who do not necessarily identify as having a problem with alcohol. This will make it more approachable for the person you’re concerned about, and also open to you, if you do not identify as having a problem with alcohol yourself.

In order to find an open meeting, search for meetings in your area, examine the initials listed next to a meeting you’d like to attend, and look for an “O” next to that meeting. This means the meeting is open to all. In addition, there are meetings specifically for women (W), young people (YP), newcomers, and other special groups.

3. Repeat As Needed

Minimization, rationalization, and denial are symptoms of the disease of addiction. If your loved one has a problem with alcohol, count on them responding with these three defenses, and do not back down.

Express your concern each time you feel it. Alcoholism does not only impact the individual drinking, but the people around them. Often, the loved ones of someone with a drinking problem will feel they “shouldn’t harp on it,” or “feel bad” bringing it up repeatedly. These are also symptoms, sometimes referred to as the second-hand effects of alcoholism.

When in doubt, remember that the only reason you’re concerned, reading the article, and planning to talk to a friend or family member, is that you love them! There is no place for feelings of guilt or reluctance. Those hesitancies are the second-hand effects of your loved one’s drinking, and all the more evidence that you should talk to them.

If you need more encouragement, go to any of the links provided in this article, and educate yourself more. Alcoholism is a disease that is chronic, progressive, and fatal; the sooner and more directly you address your concerns about a loved one’s drinking, the better.

Speaking to a friend or family member honestly about their drinking can intervene with alcohol problems that are just developing and curtail the extent of the consequences for alcoholic drinking.

References

  1. Substance Abuse and Mental Health Services Administration (SAMHSA), 2015. National Survey on Drug Use and Health (NSDUH). https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab2-41b
  2. Centers for Disease Control and Prevention (CDC), 2006-2010. Alcohol and Public Health: Alcohol-Related Disease Impact, Alcohol Attributable Deaths. https://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=8E1C5233-5640-4EE8-9247-1ECA7DA325B9&F=&D

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It’s time to give some thanks. Certainly if you’re in the U.S. today—but, honestly, there’s never a bad time to do it.

Think about everything for which you have to be thankful…because there’s a lot.

Think back to the purported first Thanksgiving—the best elements of that story, which is a complicated one, I know. Think back a thousand years before that. Realize that everyone who lived and everything that transpired did so to lead up to this moment—to your existence and your life. We know all the the great shifts and great figures that show up in history books, but what of the faceless millions that trudged alongside, working and living and laughing and suffering? Most people who lived never made it very far. Most human lineages trail off and die. You are the chosen few who can trace their history through wars and famine and pestilence and genocides and environmental catastrophe, all the way back to the primordial soup.  Your ancestral line has survived hundreds of millions of years. And now you’re here, taking it all in. If that isn’t humbling, I’m not sure what is.

But we can be humble. And we can be thankful for the opportunities we all have. When you think about it on a cosmic scale, it’s remarkable that we’re even here.

Give thanks and love to your family, friends, neighbors, and pets. Give thanks and love for your food, for the land around you, your gym, your barbells, your hobbies, your favorite park, your favorite coffee mug. Give thanks for the memories of another year—the joys and triumphs amid difficulty, the love and friendship that gets you through the weeks. And when it’s time for everyone to go around the table giving “thanks,” be ready with your answer and ready to be grateful to hear others’.

Happy Thanksgiving, everyone. Take care and have a great rest of the holiday week.

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It’s the morning of Thanksgiving. Your turkey is still a solid brick of ice. Your entire extended family is arriving in less than three hours. Quick, what do you do? First of all, don’t panic — you have some options.

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Amazon continues to roll out their early bird Black Friday savings, and we especially love today’s 45% off sale on the Instant Pot DUO Plus 3 Quart 9-in-1 Multi-Use Programmable Pressure Cooker. For the rest of today, you can pick one up for $55, normally $100.

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We’re gonna make a bold statement here. Ready? Here goes: Vitamix makes the best blenders in the biz. These kitchen workhorses blend perfect smoothies, sauces, nut milks, (hot!) soups, and more, and boast a five-year full warranty.

If you’ve been a reader of our site for any length of time, you already know that we think they’re worth the splurge. And actually, if you buy one today, it won’t cost you nearly as much. Because Amazon is slashing prices on Vitamix blenders just for today — yes, on Turkey Day! — as an early Black Friday deal.

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Black Friday, Cyber Monday, and basically everything between Thanksgiving and Christmas seem to be about spending money — even the best of sales requires a little bit of cash on hand. But there’s a saving grace hidden among the spend, spend, spend mentality, and it’s the thing that will keep you sane as you rush from store to store looking for the cheapest stand mixer and the best deal on an Instant Pot: free food.

Plenty of places offer gift card deals — buy $25 or $50 in gift cards and get a little more to spend on yourself (BurgerFi, Carraba’s Italian Grill, Bonefish Grill, The Cheesecake Factory), but there are better deals to be had, especially if you weren’t already planning to gift restaurant gift cards (but if you were, definitely look for deals).

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Growing up, nearly all Thanksgiving dinners were spent at my grandma’s house, and in classic potluck style; everyone brought the sides and desserts so her only duty in the kitchen was the turkey and gravy. For me, this meant a morning making several dishes we could easily pack up and that would handle the drive to our holiday dinner.

This year I’m drawing on all those helpful tips I’ve picked up throughout the years as I ready to prep some of these delicious dishes. No matter what your schedule or how far you’re traveling, these five make-ahead Thanksgiving sides are sure to wow the crowd around the table.

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We asked Marge to tackle one of Kitchn’s most divisive questions we’ve ever received: Is it OK to ask your friend for money for Thanksgiving?

Dear Marge,

A friend just invited me to his home for Thanksgiving dinner — and asked me to pay $50 upfront. I understand that hosting can be expensive, and I wouldn’t mind being asked to bring a dish, but asking guests for cash seems incredibly rude. Am I crazy to be a bit miffed? Has anyone else experienced this? If so, how do you handle it?

Should I tell my friend that this is not the norm?

Pay to Play

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