I recently gave a talk on health to a group of about 50 men who are members of a Greek fraternal organization and I posed the question; How many of you know someone who is gluten sensitive? Probably two-thirds raised their hand. Had I posed the same question to a similar audience 10 years ago, I am guessing one person might have raised their hand.
I have had a few experiences recently that have strengthened my long held conviction that gluten is bad for many of us and can cause a lot of problems. The buzz in large part is being created by individuals who have chosen to go gluten-free (GF), feel better and become almost evangelical in their quest to spread the word. Also, their coworkers become curious when they notice the zealots have lost weight, seem in a better mood and “just look healthier”. Listen to me-this is not a fad. We will not be looking back twenty years from now saying “Can you believe all those gluten-free kooks have finally gone away?”. In fact, I see the ranks of the GF swelling as more people try it, feel better and never look back.
Before I tell you about my recent experiences that have transformed me into an evangelical, GF, zealot please allow me to digress for a moment. As many of you know, I have had a long-standing interest in irritable bowel syndrome (IBS), food intolerances, and food sensitivities. What struck me early on when working with patients that had digestive problems was, when you fix the gut many of their other medical problems go away. It was Hippocrates who said “all disease begins in the gut”. This is sage advice for modern times and I have to agree wholeheartedly. If you are one of the ever growing percentage of the population who is sensitive to gluten, you need to eliminate it from your diet.
Let me begin by defining gluten and explaining why gluten sensitivity is on the rise. Gluten is the protein found in certain grains such as wheat, barley, and rye. You may have heard of celiac disease which is a severe form of gluten sensitivity that is now found to affect one in 100 individuals. When I was in medical school in the 1980s we were taught that celiac disease was relatively rare, affecting about one in 3000 individuals. I thought at the time that I would have to look really hard to find someone so afflicted. More recently there has been a new group defined as “non-celiac gluten sensitive” individuals who experience an immune mediated reaction to gluten and by some estimates this group may represent up to 30% of the population.
You are going to hear more about this, as awareness of gluten sensitivity increases and new, more sensitive tests become available to diagnose individuals reacting to gluten. The incidence is also increasing because we are exposed to more gluten containing products as wheat is used in so many prepackaged and processed foods. Also, the modern day genetically modified (GMO) wheat has almost twice the gluten content as the ancestral pre-GMO wheat. As is often the case, the more you are exposed to something the more likely you are to develop an intolerance at some point.
Now on to the present.
In January 2013 I attended a functional medicine conference in Orlando, Florida. The keynote speaker was Dr. David Perlmutter, a well-respected neurologist who gave a talk entitled “Food and the Brain”. He received a standing ovation at the end of his presentation. A large part of the discussion centered around the many neurologic manifestations of gluten sensitivity. What struck me the most were his slides showing MRIs of patients with various neurologic disorders before and after going off gluten. There are what the radiologists often refer to as “unidentified white spots” in the brain which decreased or resolved completely on subsequent MRIs in these patients after going gluten-free. Also the varied neurologic symptoms which included things like seizures and tremor resolved in these same patients. There is definitely a brain, gut and gluten connection.
Recently, I had a very bright, fourth-year,, registered dietitian student in my office to shadow for a day. As is often the case in the course of a usual day at The Care Group we saw patients for follow-up whom we had previously recommended go gluten-free. The last patient on the schedule for that day was a delightful 80-year-old female who had rheumatoid arthritis for years. She was able to get off of her pain medications and rheumatoid meds after going gluten-free. She was now a GF convert and was showing the student how she could move her hands more freely. The dietitian student after the patient visit revealed to me her own personal experience with acne, fatigue and a variety of other symptoms which resolved when she discovered that she was gluten sensitive. I didn’t learn until the end of the day that she was also a GF. I asked her about the current nutritional teachings at her school and I learned they are still on the “healthy whole grains” kick. My advice to those of you reading this is-if a dietitian or nutritionist gives you nutritional advice which focuses on “healthy whole grains” fire them immediately.
Dr. Loren Cordain, who is on the faculty at CSU, is a nutrition researcher and big proponent of the Paleolithic diet. For those of you who haven’t heard of the Paleolithic diet, it’s the diet our ancient ancestors ate before we became an agricultural society. If you believe this theory, this is the diet we are genetically designed to consume. It basically consists of vegetables, fruit, nuts/seeds, and lean sources of quality protein. It does not include any grains, particularly not the modern day, gluten containing, genetically modified grains.
In the early 1990s when the scientific community began promoting a low-fat diet, which by nature leads to increased carbohydrate intake, the incidence of diabetes began to rise exponentially. Granted there are other factors like increased ingestion of high fructose corn syrup which have contributed to the obesity/diabetes epidemic. However, by now we should be realizing fats are not public enemy number one and indeed we need “good fats” like olive oil and omega-3 fatty acids. I think it was Dr. Atkins who first suggested something along the lines of “It’s the carbs that are bad stupid.”
I was watching a popular morning news program the other day and there was an author of yet another book on nutrition. She mentioned “healthy whole grains” and I almost barfed as I thought to myself here we go again with someone that really doesn’t get it. She should talk to Bill O’Reilly, who has been touting the book “Wheat Belly” by Dr. William Davis on his show. In his well-written book that has been on The New York Times bestseller list, Dr. Davis goes on to discuss the myriad of wheat/gluten adverse effects. It is important to point out that when we talk about wheat and whole grains, it is not to say that white bread is better for you than whole wheat bread. They both contain gluten and if you want to be a GF, both should be avoided. The Fox news, “nutrition expert” went on to say that you should avoid any diet that eliminates any major food group. Nobody seemed to take issue with this often cited advice when all fats were to be eliminated during the low-fat craze of the 90s.
So with this seemingly never ending conflicting advice, what are you to do? If you are a patient, listen to me, I am your doctor. I wouldn’t rant if I didn’t firmly believe that this is the best advice for you. Sometimes you have to take the Bill O’Reilly approach to get your point across. Try going gluten-free and see how you feel. As always, it is best to enlist the help of your healthcare practitioner, assuming of course they understand what you are trying to do and why.
You may be wondering by now how can something as seemingly innocuous as gluten in that delicious bread you love be so bad and cause all of these terrible problems? Why hasn’t your previous doctor, dermatologist or rheumatologist brought this up?
Let me try and simply explain what really is a complex issue. If you are genetically predisposed to react to gluten (genetic markers have been discovered) and you ingest gluten it can trigger an immune reaction in the intestine. Your immune system thinks that gluten is a foreign invader that should be destroyed. This reaction or overreaction can occur at any time in life in those who are genetically predisposed. Since there is a genetic predilection, if you have a relative who is gluten sensitive you are more likely to be gluten sensitive. You may do well for most of your life and have no reaction until a trigger causes your gluten sensitive gene to become expressed. This may include events such as an intestinal infection or taking an antibiotic, both of which can upset the delicate balance between good and bad bacteria in the gut.
During this battle that is being waged between your immune inflammatory cells and the gluten, the lining of the small intestine becomes damaged. This damage can lead to what commonly is referred to as “leaky gut” or more scientifically referred to as increased mucosal permeability. Imagine a coffee filter that has holes punched into it, pour in the water and now you have coffee grinds in your coffee. This is similar to what happens with “leaky gut”. Under normal circumstances your food is broken down in the small intestine and the lining of the small intestine acts as a selective filter allowing nutrients into the bloodstream and the remainder of the undigested material is eliminated with a bowel movement. With “leaky gut” you have seepage of this fecal sewage into the bloodstream. These larger particles percolate in the blood, causing distant inflammatory reactions wherever they land such as the joints, skin or the brain.
Here is a challenge. If you have a medical disorder, Google that disorder and gluten sensitivity. See what you come up with. I realize that the Internet can make you very smart or very dumb and that you really need to look closely at the credibility of the person giving the advice (like me for example). But you may be surprised what you find. Dr. Perlmutter, in his talk listed a range of neurologic conditions that have been associated with gluten sensitivity. To name a few, there has been an association suggested with conditions such as peripheral neuropathy, ADD, schizophrenia, brain fog and various mood disorders. In the past you would think of gluten sensitive individuals as having lots of digestive complaints, which they often do but it is important to realize that you may have another manifestation of gluten sensitivity and no digestive complaints at all. For example, I think of gluten sensitivity in any patient with chronic fatigue, frequent headaches, joint aches, or autoimmune disorders such as Hashimoto’s thyroiditis, rheumatoid arthritis, lupus, and psoriasis.
If you are currently a GF or become one feel free to share your experiences or favorite gluten-free recipes on this blog in the comments section. If you could talk to some of the patients we have seen over the years who are now GF you would be amazed to hear some of their stories. As I learn more and hear many of these stories it has made me more passionate about spreading the word regarding this important topic.
- Wheat Belly, by William Davis, M.D.
- Practical Paleo, by Diane Sanfilippo, BS, NC
- Paleo Comfort Foods, by Julie and Charles Mayfield.
After the Aurora Theater shooting, and just when you thought it couldn’t get any worse, we have this latest tragedy in Connecticut. Our office is less than two miles from the Aurora theater and we have patients and staff members who were affected by that incident. Our thoughts and prayers go out to the families and community in Newtown.
When will the next attack occur and what if anything can we do to try and prevent it? Surely the debate over gun control, TV violence and Internet violence will rage. Also, how do we recognize someone mentally deranged and on the verge of committing such a heinous act? As other practicing physicians, I deal with this question on a regular basis. This past summer we called the police twice on a former patient who had made some threatening remarks. Is this someone mentally deranged who is simply rambling, not a true threat or someone capable of following through?
What really bothers me is one factor which doesn’t seem to be garnering any attention, that may be contributing to this rise of mental illness and mayhem. That is the role of mental illness and nutrition. Is there a connection and if we addressed this could we possibly decrease the number of future tragedies? I believe from my experience practicing medicine and from what I have learned that the answer is yes. It is not a question of whether or not there is a connection but only the magnitude of that connection. We need to include a discussion of our diets and mental health in the debate.
What evidence do I have to support this contention? Let me cite a few examples.
A study published in 2011 showed that active-duty military personnel who had low levels of omega-3 fatty acids in their bloodstream were 60% more likely to commit suicide than those with the highest levels. The Department of Defense has now funded a prospective study in which our soldiers will be given omega-3 fatty acids and followed going forward to see if we can decrease the suicide risk. There is often a connection between suicide and homicide. Omega-3 fatty acids have been shown to help a variety of psychiatric and behavioral problems.
Our moods and emotions are controlled by a variety of factors. Unfortunately, there isn’t much we can do in most cases about the genetic factors that predispose one to mental illness. But that is not always true. As an example, there is a genetic enzyme deficiency (MTHFR) which leads to the build up of the amino acid homocysteine, which in turn can lead to a variety of neuropsychiatric disorders. Once diagnosed this can be easily treated with methylated folic acid.
The neurotransmitters or chemical messengers in the brain that control our emotions are in most cases derived from amino acids. Various minerals or vitamins serve as co-factors in the conversion of these amino acids to their respective neurotransmitters. For example, iron is required for the conversion of the amino acid tyrosine to the neurotransmitter dopamine. B. vitamins, particularly B6, are required for the conversion of the amino acid tryptophan to the neurotransmitter serotonin. As the brain requires a variety of nutrients to produce neurotransmitters, altered brain chemistry can result from deficiency of one or more of these nutrients.
Dr. Gerald Olarsch in an article entitled, “Why Are Kids Killing Kids?” states: “Diets lacking in nutrients especially trace minerals-lead not only to physical maladies and impaired learning, but also to antisocial behavior and even violence.” Some experts feel that our current agricultural practices lead to poor soil and nutrient deficient crops which is causing this escalation of mental illness and violence.
I’ve tried to point out just a few of the many nutritional factors that may contribute to mental illness. My hope is that as our current understanding of this relationship between nutrition and our psyche increases, maybe we can help prevent future tragedies.
Please feel free to comment below so we can discuss–I welcome your input.
Just last week, Neal D. Barnard M. D., Adjunct Associate Professor of Medicine at George Washington University School of Medicine and president of the Physician’s Committee for Responsible Medicine and a leading authority on gluten sensitivity appeared on the Dr. Oz show to discuss gluten sensitivity. Dr. Oz seems to be embracing the notion that a large percentage of the population reacts to gluten and in the program they point out the fact that about 50 different medical conditions now have been associated with gluten sensitivity. You can see part of the Dr. Oz show on his website.
Let me give you a personal, historical perspective. Many of you may know that I wrote one of the first books for patients with irritable bowel syndrome (IBS) in 1989 and have had a long-standing interest in food intolerances and food sensitivities. Back then we didn’t have many of the tests we now have to determine if someone might be reacting to gluten. Patients with IBS were asked to go on an “elimination diet”. This was a very arduous process as many different food groups were eliminated in the initial phases of the diet-one of which was gluten. [Gluten being the protein found in grains such as wheat, barley and rye.] What struck me was the fact that not only did many of these patient’s digestive symptoms clear up, but their joint aches and pains, mood disorders, skin rashes and other problems went away. Further research led me to conclude that gluten was the culprit. So I went to the library (unfortunately we didn’t have the Internet back then) where I found some studies suggesting there may be an association. Fast forward, today there has been a virtual explosion of research in this area.
Why does the incidence of gluten sensitivity seem to be exploding (pun intended)? I think there are several reasons for this observation. One is increased awareness but more importantly I think that the prevalence is actually increasing because we are exposed to more gluten in our modern day diet.
Wheat seems to be in just about everything and the problem is compounded by the fact that the today’s genetically modified (GMO) wheat we are consuming has a much higher gluten content. This fact is underscored when our patients who are gluten sensitive travel to Europe. One patient recently was in Italy and while at home she avoids gluten like the plague, she was tempted by the bread and pasta and she didn’t seem to react very much. Guess what? In Italy GMO wheat is not used.
I occasionally will hear healthcare pundits decry the gluten free diet as a fad. The point being missed here is that a gluten-free diet is not necessarily a weight reduction diet. In other words if you eat the same quantity of gluten-free bread or crackers you won’t necessarily lose weight as the calorie consumption often times is the same or more. The point is that in susceptible individuals the immune system is activated and the gluten protein is attacked in much the same way your body would fight a chronic infection. That in turn may lead to the whole range of symptoms one might have if gluten sensitive including such common conditions as fibromyalgia or chronic fatigue syndrome. Foot note: Many do lose weight on a gluten-free diet because they are eliminating many gluten containing prepackaged and processed foods they were previously consuming.
Unfortunately, even with more sophisticated tests to determine if someone is reacting to gluten, these tests may turn out negative and gluten sensitivity may still be part of the problem. Realize that celiac disease, the prototype and most severe form of gluten sensitivity, only affects a very small percentage of people who might be reacting to gluten to a lesser degree.
Although I can’t give specific advice to persons who are not patients of the practice and any dietary changes you might undertake should be run by your health care provider (the usual disclaimer), you might want to try going gluten-free for several weeks and see how you feel. What have you got to lose other than possibly a few pounds.
Some healthcare professionals will disagree with me suggesting that a gluten-free diet is unhealthy as you are eliminating “healthy whole grains”. You can still have healthy whole gluten-free grains such as brown rice, quinoa, buckwheat and others. Wheat Belly, by Dr. William Davis, M.D. is a good read on this topic. Foot note: Obesity and diabetes are two of the leading medical problems amongst the poor so I don’t think anyone is going to starve to death by going gluten- free on a trial basis.
Many of you reading this are patients of the practice and under our advice have gone gluten-free. I would encourage you to share your experience on our blog. I don’t have any exact figures, but after 27 years of practice I feel we could probably save enough medical costs to insure the uninsured if everyone were to try this. Below is a list of disorders and symptoms that might suggest gluten sensitivity.
Gluten sensitivity is often times genetic. So if you have a family member who is gluten sensitive you are more likely to be gluten sensitive.
- Frequent bloating or gas
- Diagnosed with IBS or acid reflux
- Daily diarrhea or chronic constipation
- Migraine or headaches
- Joint pains or aches
- Brain fog
- Depression or anxiety
- Ongoing fatigue
- Chronic eczema or acne
I want to talk about new recommendations regarding hepatitis C screening.
The Care Group, PC is pleased to announce the availability of a new audio CD
with Dr. Guillory entitled “Embrace Health: A Doctors Guide for Optimal
The CD offers listeners valuable information regarding the root cause of
many common health problems including autoimmune disorders, joint aches and
pains, chronic fatigue, hormonal imbalances, headaches, IBS and many other
In the CD you will learn about “leaky gut” and the four R’s approach to
achieving optimal wellness. Often times this approach can lead to
significant improvement and consists of Removing what might be making you
sick, Replacing what you are deficient in, Re-inoculating the gut with
probiotics and Repairing the intestine.
If you or someone you know is suffering from any of the above health
problems and would like to achieve optimal wellness
Click Here to listen or download from our website. We
also have free copies of this informative CD available through the office.
We also want to remind you Dr. Guillory is available for his
Corporate Wellness initiatives. If you own a company
or are part of a company and are interested in having Dr. Guillory come
speak please contact the office. Attendees will learn simple steps they can
take to achieve optimal wellness. These presentations often help companies
reduce absenteeism, increase productivity, lower healthcare costs and
improve worker health. If you have a small pool of workers, we can often
combine groups into one larger event.
Finally, please be sure to follow along for news, updates and events on our
social media portals. Please be sure to “Like” us on Facebook and/or
“Follow” us on Twitter @thecaregroup.
We have all done it, gone on that overindulgent vacation only to come home having gained a few pounds, feeling tired and bloated. After vacation might be a good time to consider a detox program. Although hard science may be lacking, Detox programs are designed to help the body rid itself of toxins. They have recently been popularized by many Hollywood celebrities.
The majority of our patients claim to feel much better while on a detox program and for some time after. It can help you appreciate how good you can feel and how bad much of the junk you were putting in your body previously was making you feel poorly. It is also sometimes a good way to jump start a weight loss program. Just remember that if you go back to your old eating habits you will lose any gains that you have made.
The problem is that there are many different “programs” out there and some are so restrictive that they might even be dangerous to your health if extended for a prolonged period of time. Try it for just 3 days initially and consider a supervised program for longer periods of time. Our staff has worked closely with many of our patients and the results have been overwhelmingly positive.
Ten tips for detox:
1. Drink plenty of water. Consider adding some fresh squeezed lemon juice. Drink green tea.
2. Eat lots of vegetables and fruit-preferably organic. Consider making a smoothie by blending the fruits and vegetables.
3. Limited amounts of raw nuts and seeds are a great snack and good source of protein and good fat. (No peanuts-which are actually a legume)
4. Limit protein intake to wild fish (salmon is a great choice) or boneless, skinless chicken breast. Do not grill or cook at a high temperature. Note-some prefer to eliminate protein altogether during the first few days of their program.
5. Eliminate all prepackaged, processed foods, caffeine, red meat, dairy, eggs, and limit grains to brown rice only (if you have grains at all).
6. Consider a meal replacement shake that is designed as part of a detoxification program.
7. Make certain that you take your vitamins-which may have been forgotten on your vacation. Taking omega-3 fish oil during this time is very important.
8. Allow extra time for exercise. Even if you just go on a meditative walk.
9. Reduce stress. Practice some simple breathing techniques.
10. Get organized and plan before you get started. This way you are less likely to get off track. This is a fun program to go through with a friend or your significant other.
It seems that in any given week you can find a new study that either confirms or contradicts previous research. It is our responsibility to filter through this information and help make some sense of at all. I will try and make a complex issue simple to understand.
The bottom line is that calcium and magnesium, two very important electrolytes must be taken in combination. Think yin and yang-nutrients don’t work alone. Calcium on the one hand increases contractility and is a component of atherosclerotic plaque. There are medications called “calcium channel blockers” that are prescribed to lower the blood pressure and regulate heart rate. Conversely, magnesium decreases contractility, relaxes blood vessels, and is a natural calcium channel blocker. We have known this for some time and have never offered a product that contains calcium without magnesium.
Many Americans are magnesium deficient and taking calcium supplements alone will compound the problem. Also, some purified drinking waters which have everything stripped from the water, including calcium and magnesium will lead to further deficiencies in these two vital nutrients.
You’ll be hearing more about the beneficial effects of vitamin K2, which is essential for helping the body incorporate calcium into the bones, while at the same time keeping excess calcium out of your arteries. There is compelling evidence that vitamin K2 can protect against cardiovascular disease.
So what should I do? If you have had a bone density test which reveals thinning of the bones (osteopenia, osteoporosis), or if you are at high risk for brittle bones, we recommend a food based calcium and magnesium supplement. The supplement also contains vitamin K2, vitamin D (to facilitate calcium absorption), and strontium (a chemical element shown to strengthen bones).
Think of your bones as a bank where calcium is being deposited until your early 20s. The calcium bank deposit remains relatively stable until later in life. In women, after the menopause, when the ovaries stop making sex hormones (estrogen, testosterone, progesterone) the body begins making withdrawals of calcium from the bones and the potential development of osteoporosis becomes accelerated. We often think of replacing calcium and magnesium in the postmenopausal woman. Men, particularly those with low testosterone are also at risk for osteoporosis. Also, it may make more sense, and many authorities feel, we should be recommending calcium and magnesium supplements earlier in life to build a strong bank account.
The announcement that New Chapter has been bought out by Procter and Gamble (a multinational fortune 500 corporation) was met with anger, uncertainty, and fear. Consumers are horrified that quality will suffer and the healing mission will become corrupt.
Trusted founders Paul and Barbi Schulick, who are nothing short of holistic pioneers, have a much different take on the circumstance. In an honest and strikingly candid YouTube video, the pair address the issue where Paul assures: “I am even more committed today toward the mission of healing that represents what New Chapter has stood for for the last 30 years”.
Most riveting about Paul and Barbi’s message is that they propose this decision will catapult them to new heights and, in turn, a larger level of healing. Where they have been seated at the “kids table” when it comes to decision making, they believe that their association with P&G will bring them to the “adult platform”. As Barbi explains, “If we get a force behind us… we can be at the big table where healthcare decisions are being made” and their dream to spread the healing mission will take flight.
New Chapter seems anything but ignorant when it comes to recognizing the iron fist of pessimism that greets them. Though there is little to be said for virtuous companies that have made similar choices in the past, Paul and Barbie are forcefully standing by their decision: “To the skeptics, imagine the possibility of millions of dollars going into studies, what we might be able to say about our healing herbs… the plethora of legal support helping us navigate through a complicated and complex regulatory environment… our dreams are coming true that we can bring healing to more people”.
“Over the years, I have seen many people, including myself, benefit from the use of New Chapter products. I am hopeful that the guiding principle created by the founders will persist with the new ownership.”- Gerard Guillory, M.D.
In an effort to help them cope with the drastic change in elevation, I suggested my family take rhodiola a week before they arrived in Colorado. Rhodiola is a natural herbal remedy also known as rhodiola rosea. As an adaptaptogen, rhodiola helps balance the body during physical stress by allowing it to use less oxygen on a cellular level. It has been studied extensively by the Russians and is utilized by many of their athletes to give them a competitive edge.
Fortunately, rhodiola worked wonders for my relatives. They were able to enjoy all that Colorado has to offer without incurring any of their previous symptoms. Acute mountain sickness can affect anyone, regardless of fitness level or age. If you have a trip planned to the mountains, be sure to bring your rhodiola. We suggest taking the herb before breakfast so it does not interfere with your sleep. If you know anyone who is heading to the mountains for a vacation, particularly if they are coming from a lower altitude , please share this tip with them. They will be sure to thank you for it!
I am delighted to share the story of a 77 year old patient of mine, Betty Lou. Betty has suffered from psoriasis (a common skin condition that causes redness and irritation) for the past three years. When the suggestions of her dermatologist and two holistic doctors failed, The Care Group was able to identify gluten as the source of Betty’s ailment. Within one week of adopting a gluten-free diet, her condition cleared.
Experts now estimate that 1 in 5 Americans have some form of gluten sensitivity and, as a result, we have seen countless other success stories similar to Betty’s. In eliminating gluten, patients have boosted their body’s immune system, decreased a variety of chronic gastrointestinal problems, decreased the severity of their anemia, and even increased bone density.
While the benefits of getting rid of gluten are now readily apparent, eliminating it from one’s diet can seem overwhelming, as it is found in: bread, candy, lunch meat, pasta, cereal, ketchup, pancakes, tortillas, and many other sources of processed foods.
The first step to overcoming gluten is being able to recognize which foods it is present in. Although the full list is exhausting, here are some common ingredients to help you spot gluten:
Flour (Enriched, Bleached, Durum, Bulgur, Semolina, etc.)
Malt (Flavoring, Syrup, Extract, Vinegar, etc.)
Food color, artificial flavors, seasonings, soy sauce, vitamins, etc. may or may not contain gluten. It is necessary to check with each manufacturer to determine if gluten is used.
In order to make the transition toward a gluten-free diet as painless as possible, we have provided this forum in which we encourage patients to share recipes, cooking tips, and other various information to help one another avoid the downfalls of gluten.