The Great Masquerader

April 6, 2010 Tuesday

"Go slow today. Ease up on the demands you put on yourself. In time all will be revealed" KM

I should listen to this. I sometimes put too many demands on myself. This blog is demanding but I really enjoy it. I feel I am educating others.

Today I want to discuss the Great Masquerader. In the time of Sir William Osler (by now, you know he is my hero in Medicine), it was syphilis. Today it is Celiac Disease. We used to think that Celiac Disease is handled or treated by Gastroenterologists (stomach/colon doctors). These are the physicians that do endoscopes/colonoscopies. There are many atypical presentations of Celiac Disease when it appears as other autoimmune disorders, like diabetes and Hashimoto's Thyroiditis (inflammation of the thyroid gland). There sometimes are no gastrointestinal symptoms (bloating, flatulence and changes in bowel habits). There can be a neurological presentation as muscle weakness and peripheral neuropathy. It is my generation's great masquerader--not syphilis.

Because of the enigmatic presentation of Celiac, it is now handled by the general practitioner and internist to make the diagnosis. The challenge even falls on a cardiologist such as myself, who also practices integrative medicine.

Other presentations can be dermatological as vitiligo and psoriasis. It can present as a rheumatological disease like arthritis, and even Sjorgen's Syndrome.

I do not expect everyone to look up these diseases but remember that Celiac Disease (where you cannot have gluten) is also called colitis, irritable bowel and Crohn's disease and does not always have to be exclusive to gastrointestinal symptoms.

We will discuss gluten sensitivity throughout the blog.

Yesterday, I told you about gluten free grains and substitutes. I also gave the cooks in the audience a chance to bake/cook with different types of flours. Be creative!!

Because there is much controversy about soy, let's talk about it now. There is a book called The Whole Soy Story by Kayla Daniels. There are many doctors who recommend soy, and there are just as many who do not. Every person you talk to will have a story on soy. There are soy sauce substitutes: Bragg Liquid Aminos and Gluten Free Tamari sauce.

Want to know how to make a Soy-Free Soy Sauce? You must wait until Wednesday.

I adore the needlepoint above. I love animals, especially frogs, turtles and birds. I decided to frame this needlepoint after it was finished. Although I did frame it, it could also have been made into a pillow. I have never given it away nor do I hang it in our apartment. I decided to place it on our etsy store - www.etsy.com/shop/RickFratCreativeDuo

Until tomorrow...