What I want to do in this follow-up article, is give you some tools to assess whether your doctor is up on the subject of food intolerances and celiac disease.
My recommendation is that you ask your doctor some or all of the following questions and you'll know fairly quickly how well-versed he or she is in this area.
If you suspect that you may be suffering from gluten intolerance or may have celiac disease you should ask your doctor some of these questions:
- Can you explain gluten intolerance and its symptoms?
- How many patients have you seen with celiac disease or gluten intolerance? (It doesn't matter if the answer here is zero, that's fine, as long as you think your doctor truly understands the situation, and-this is important-stays up-to-date with the recent research)
- What is your understanding of celiac disease? (This is an intentionally loaded question. If you're going to ask just one this is it, sit back and let your doctor talk.)
- You should also ask a few questions that you already know the answer to, not to be challenging or cute, but to see how knowledgeable your doctor is on the subject. My experience is that doctors who are intimidated by patients who know more than they do on the specific issue tend not to be open-minded enough to help with issues such as this.
- Is and celiac disease a childhood condition? (The answer to this should be no)
- If a person is gluten intolerant or have celiac disease, is it okay for them to have some gluten from time to time? (The right answer is no)
If you find that your doctor won't or doesn't want to learn about the condition, I suggest that you find a new physician immediately.
And if you are reluctant to believe that your doctor isn't the right doctor, or you have trouble accepting the fact that you may need to change consider the following reasons why your doctor will not test you for celiac disease:
Most doctors are heavily influenced by their training in medical school and residency, if your doctor is not exposed to celiac disease during this training it's been my experience it's very unlikely they will ever look for it once they graduate from medical school and residency.
Many physicians think the people who are complaining of multiple symptoms affecting different parts of the body at the same time are either hypochondriacs or exaggerating.
Celiac disease and gluten intolerance can present itself with symptoms that are very often outside of the digestive system-and they can also be silent: as I've mentioned in other videos, celiac disease is a multisystem condition, which affects many different organs, not just the gastrointestinal tract. And the result is that it's rare one physician will recognize that all of these symptoms, such as joint pain skin conditions and depression, can all be due to a single disorder. Doctors are trained in medical school to find the simplest explanation for their patients symptoms.
Common or routine blood tests will not make the diagnosis of celiac disease confirmed. Routine blood tests that are performed during your annual checkup or even when you are sick rarely if ever include a test specifically for celiac. Usually they will include the usual chemistry panel and a complete blood cell count among other things. In a patient that has untreated celiac disease the complete blood count panel may reveal things like anemia or a low red blood count. If the red blood cells are small, this is often due to an iron deficiency. If the red blood cells are large, this might be due to a vitamin B12 or folate deficiency.
All of these are examples of malabsorption that happen in patients with gluten intolerance and celiac disease. Usually what happens is the doctors just suggest you increase your vitamin supplements, without looking for the cause-and this is why it's so important to understand the cause of this situation and get to the root of it.
Cost containment is another issue in our era of managed medical care. I see this more often in the United States where there is a two-tier health system than here in Canada. As I mention in the testing options video the only true way to know if you have celiac disease or a gluten intolerance is to have a biopsy of your small intestine.
I hear many of my website visitors tell me that their health plan will not pay for a biopsy because it's not cost effective, even if they have blood tests and symptoms that are consistent with celiac disease. What is so sad about this situation is that these health plan providers just don't get it-they don't understand that early diagnosis of celiac disease is actually cost effective, and preventative medicine.
This is because patients with untreated celiac disease have been proven to have twice the mortality rate at any given age of those who do not have the disease. This is due entirely to the increase of other disorders as well as extremely high rates of bowel cancer. Lastly treating celiac disease early has been proven to prevent osteoporosis-another huge burden on our health care system.
The reality for people who are suffering from a toxic body resulting from wheat consumption, is that the best therapy is dietary. The big pharmaceutical companies don't have any way too make a profit from people who are suffering from wheat intolerance symptoms. That plus the fact that there's very little nutritional knowledge built into the typical general practitioner's training means most means doctors really won't have much ability to help you with this journey.
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