Tuesday, June 17, 2008

Gluten and gall bladders

Chris from Conditioning Research emailed this link to me, just before Troy asked about high fat eating after the surgical loss of your gall bladder. Many thanks Chris, immaculate timing. The main problem without a gall bladder is that there is no pulsatile release of bile acids to allow the formation of the lipid miceles needed for fat digestion and absorption. However, even without a gall bladder, there must be some on going bile secretion, even if there is no storage for a big release after a large meal. Is this enough? I commented that medium chain triglycerides might help, these are slowly absorbed without pancreatic lipase, but now I think about it, I'm not sure if this would work without bile acids to get the MCTs in to the enterocytes in the first place...

But there is a separate problem anyway. If you have coeliac disease you don't seem to produce cholecystokinin (CCK) when fat hits your small intestine. So under these circumstances, you may as well not have a gall bladder anyway!

There is obviously a trade off between the severity of the coeliac disease and the degree of cholestasis. The link above mentions active disease... I get the impression that villous atrophy is needed to get the blunted CCK response.

But then it's worth remembering that 1mg, that's one milligram, no typo, of gluten per day will sustain villous atrophy in unlucky individuals. They will be clinically and serologically normal under these conditions. I bet they don't make a lot of CCK though! Or get picked up by the average gastroenterologist.

So is subclinical coeliac disease any worse than having no gall bladder? Many many many people have sub clinical coeliac disease. Perhaps this is the wrong question. Maybe it would be better to ask whether THE reason you have had your gall bladder removed is that sub clinical coeliac disease was the underlying cause of your gall stone anyway. No CCK means no gall bladder contraction, which means no bile acid deposition, which means cholestasis, which means gall stones. Also means blunted fat absorption. Which means no CCK release... It's a chicken and egg situation.

Apart from coeliac disease and CCK, the other aspect which fascinates me is the effect of opioids on the sphincter of Oddi, at the end of the bile duct (includes the pancreatic duct in some individuals). Opioids spasm this sphincter. I know, I precipitated pancreatitis in a dog with a (big) dose of morphine once. It recovered.

So what does a continuous flow of gluten derived opioids through the gut do to the sphincter of Oddi? There's nothing I can find on pubmed directly related to this, but anyone with cholestasis problems or recurrent "idiopathic" pancreatitis wants to dump gluten big time. As if there weren't enough reasons to do this already.

So is anyone who is missing their gall bladder any worse off than someone eating to the food pyramid? Probably not. But who would want to be as dyspepsic as a food pyramid eater anyway???????? I guess the answer is dump the gluten, start with medium fat carried in real Food, dump the gluten, work up to higher fat loads, dump the gluten and try for 70% fat calories if any Olestra like effect allows, dumping the gluten. Whatever the outcome, sticking to Food and dumping gluten is the best you can do. Did I mention gluten?

Peter

PS at my time of peak gluten eating I was ultra sound scanned for gall stones. Negative, but that's just how it felt. Reading the celiac.com comments, it turns out you get that particular ache from gluten even after your gall bladder is removed! Maybe it's spasm in the sphincter of Oddi!

PPS When spell checking "Oddi" in google I found a host of support sites for people with dysfunction of this particular organ. Looks like it is coeliac disease rearing its head again.

And again, note the stupidity of ONLY biopsy sampling people who are anti endomysial antibody positive. Under diagnosis rules. As does 1mg per day of gluten induced, sero negative coeliac disease. Causing gall bladder disease. Or pancreatitis. You do not want pancreatitis. Honestly.

38 comments:

  1. Peter,

    I have friend who has digestive problems and specifically doesn't digest fat well. She eat a lot of whole-wheat bread. I've always wondered if there's a connection.

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  2. Hmmm, yes, I've met a number of people who tell me they are very clearly fat intolerant. I'm always suspicious that it's gluten. Initially by trashing the absorptive capacity of the brush border, now via CCK/gall bladder function. Fat intolerant, yes, fat triggered, I'm not so sure.

    Of course there may be people with defects in chylomicron assembly etc who really are fat intolerant per se. Probably single gene defects and rare, but possible of course.

    I remember when my wife's GI probs were severe and we had no idea of the trigger. Fat was the obvious explanation. Just look at the fat oozing out of that lasagna which caused so much gut pain and acid reflux.........

    Peter

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  3. Peter,

    You probably know this, but for some of your readers, gall bladder removal is one of the top operations in the US. With removal of the gall bladder not only is fat absorption messed up, but everything fat soluble, e.g. Vitamins A, D, E, K, also. I think that anyone with problems with fat absorption with or minus the gall bladder, should try to continue to eat fat but at each meal take some lipase supplement e.g. pancreatin.
    With impaired fat absorption all kinds of problems result down the road and the doctors will not ever understand it is because of poor fat metabolism in the body.

    Porter

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  4. I just had an idea!! It seems like the addition of wheat flour (+sugar) to pre-industrial diets had some of the same effects as deficiency of the fat-soluble vitamins: tooth decay, poor bone development, lowered immunity etc. Sometimes these people were eating wheat on top of their native diets.

    I wonder if it may have been more than simply the replacement of nutrient-dense foods with nutrient-poor ones, but also an active interference with the absorption of fat-soluble vitamins via gut damage? What do you think?

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  5. Just found this on Medline Plus:

    People at risk for developing vitamin K deficiency include those with chronic malnutrition (including those with alcohol dependency) or conditions that limit absorption of dietary vitamins such as biliary obstruction, celiac disease or sprue, ulcerative colitis, regional enteritis, cystic fibrosis, short bowel syndrome, or intestinal resection (particularly of the terminal ileum, where fat-soluble vitamins are absorbed). In addition, some drugs may reduce vitamin K levels by altering liver function or by killing intestinal flora (normal intestinal bacteria) that make vitamin K (for example, antibiotics, salicylates, anti-seizure medications, and some sulfa drugs).

    I'd love to see some data from wheat eaters who aren't diagnosed with Celiac.tknjpyv

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  6. Peter I think you are spot on with the gall bladder-pancreas-gluten link. For many years before her pancreatic cancer dx, my mother complained of "invisible cholecystitis" - various investigations always found nothing.

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  7. I had my gall bladder removed in January 2007. A few months before that I had an ERCP to place a stint in my collapsed Sphincter of Oddi. All this came on as par for the course with a bacterial overgrowth where there shouldn't have been one - the small intestines. My carb calories were being digested by the bacteria before I had a chance to digest them. Anyway, I was vegan to begin with; I ditched all fats, I juiced, I had the gall bladder out. I didn't get better until I began eating meat and put myself on Atkins induction. I've since had treatment for the bacteria (antibiotics oddly because once the small intestines are colonized you have little choice but to wipe the slate clean) and I have been easing into high fat (65 - 80% daily) since February of this year with no problems at all.

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  8. "I think that anyone with problems with fat absorption with or minus the gall bladder, should try to continue to eat fat but at each meal take some lipase supplement e.g. pancreatin."

    Porter, an alternative would be raw fat, which contains some lipase. It might digest easier for people with fat malabsorption. Obviously I mean animal fat. Oils don't have enzymes because they're water soluble. Even if they weren't, most vegetable oil is heavily cooked and processed, so the enzymes would be destroyed.

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  9. wow, this is so interesting. i was just asking about gall bladders on the Native Nutrition yahoo group b/c i have a friend who is having her gallbladder removed as soon as she gives birth in about 7 weeks. she was diagnosed with celiac at age 2 but has within the last 4 months or so resumed eating gluten--i don't remember who told her she was "cured" and could eat it again, but it's pretty sad that it has come to this.

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  10. Re Coconut Oil. The articles I have seen say medium chain triglycerides are "absorbed into the portal vein" and "transported directly into the liver without requiring lipase or bile salts for digestion."

    http://tinyurl.com/39l3r6
    http://tinyurl.com/72r8b

    Try virgin coconut oil - fermented or centrifuged kind. If that isn't tolerated, try the "76 degree melt white" coconut oil. Ray Peat found that many people tolerated the "76 degree melt" better than unrefined virgin oil. Spectrum has naturally refined coconut oil, you can order "76 degree melt" cheap online.

    http://www.efn.org/~raypeat/coconut.rtf
    http://raypeat.com/articles/articles/coconut-oil.shtml

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  11. My hairdresser has a myriad of health problems. She has had her gallbladder removed already, and she was sharing that she also has frequent GERD, "spinal arthritis" and lately signs of hypothyroidism. I immediately thought of your writings, the link between GERD, hypothyroidism, "spinal problems" and gluten, so I suggested that she might be intolerant of gluten because her list of problems are frequent complaints (and since she cannot eat a lot of fat, she tends to eat starches). I told her to google celiac disease. Next time I see her I'll get to see if she listened.

    Now that I know gallbladder disease is another symptom of celiac, I feel even more confident this is what her problem is.

    Also, I've noticed a lot of celiacs say fat give them no satiety and tend to promote high protein diets (which are far inferior to high fat diets in my experience, regarding satiety). Now that I know they don't make CCK normally, this can be expected. I've also noticed a subset of gluten intolerant people / celiacs don't experience hunger normally, in that they tend to have low appetites (which seems counterintuitive considering malabsorption). This gets better on low gluten, but seems to remain even when gluten free. I wonder if this is related to the damage from celiac disease to the gut, or perhaps the damage to the thyroid (which lowers metabolic rate thus hunger). Interesting, wish I knew.

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  12. Peter,

    THANKS!!!! and everyone else...these are amazing comments! The girl i just started seeing who has had her gallbladder removed has told me her only problem with her diet was that she loves bread!!! haha!!! Well...i will try and ease her into the fatty way of eating, and we can track how she feels...I am going to make her dinner thursday night!

    Funny thing is...i have not been diagnosed with celiac or gluten intolerance...but man...when i eat any of that crap i get bloated, i retain water, and i lose my lean look, and it makes me breath heavy. Same thing happens when i eat to many veggies, maybe its that damn fiber. I usually just eat animal fat and protien and stay away from anything else and get all my carbs for the day from something high in carbs and low in fiber, like peeled potatoes, or sushi rice, and maybe somekind of melon, or whatever berries that are in season. Hell...maybe i am gluten intolerant...Give Me The Animal FAT!

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  13. Sorry, a bit off topic, but I had to report the latest postings on Dr Briffa's blog (the gluten/listening to the patient post). Catherine Collins sorely needed a new one ripping and I did my best (as Cathy - my given name).

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  14. Hi Stephan, I'd buy in to that as a mechanism. There is always the work from Belfast showing that one association with gluten sensitivity in non coeliacs was increased overall mortality!

    Porter, yes, I can see this would mess up an awful lot of things! Ditto Belfast.

    Bruce, I'd be far more interested in adding bile acids as a supplement than lipase. Provided your pancreatic duct opens there should be no problem with lipase and there is a brush border lipase in the SI anyway. Of course, if you trash your brush border and pancreas with gluten you have a lot of health problems heading your way. But bile acids with a high fat meal was my leaning. Of course all of this is less relevant when we hear from people who have been there and done Atkins without GI distress.

    Knew about lipase but I never deal with bile acid deficient patients, so this one missed me.

    Team, this is shocking. No one is EVER cured of coeliac disease. You have the HLA white blood cell receptor, it really is in your genes, it ain't going to go away. The immunosupression of pregnancy will provide some protection against gut damage at the moment but giving the advice to eat gluten to a confirmed coeliac is criminal. The spasm of the sphincter of Oddi is not immune mediated. Gall bladders are not disposable organs. Grrrrrr. GRRRRRRR.

    Hi girrlock, that's very cool and it's great to hear from someone who's been there and done it. Thanks for commenting, As porter says, there's a lot of it about (gall bladder deficiency!). I can understand the SIBO aspect and treatment, and the easing in gently sounds very sensible. Obviously no need for bile salt supplementation for yourself... Oh no, another really interesting blog to read, arghhhhhh.

    Troy, hee hee you're gluten intolerant, congratulations. Join the club (not very exclusive I'm afraid)!

    Frank, guess I'd better go take a look. Haven't had chance to get around the blogs recently. First time CC posted on Dr Briffa's blog (some time ago) I drafted a comment berating him for making up a caricature idiot when his blog was quite interesting enough without such frivolity. Can't decide if I am glad or sad I failed to send it!!! Invisible cholecystitis, LMAO! We vets never see this (because it's invisible?). No gallstones equals no problem. The joy of non verbal patients!

    Peter

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  15. Peter and others: join

    http://health.groups.yahoo.com/group/SaturatedFatForHealth/

    more people, more to learn!

    Geoff's rawpaleo group is also high animal fat:

    http://health.groups.yahoo.com/group/rawpaleodiet/

    Peter, what is your view on "ketosis"? Dr. B. Groves claims to be fat addapted - but when you follow Mary (SaturatedFatForHealth) I am not so shore...

    Nicola

    Nicola

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  16. Peter,

    GREAT POST!! Yes no one wants pancreatitis -- they could be on insulin shots forever....

    'Silent' celiac disease is not only related to gallbladder (which more like 'fatty gallbladder') but also very interestingly associated with:
    --infertility
    --epilepsy (with cerebral calcifications)
    --primary biliary cirrhosis
    --fatty liver (nonalcoholic fatty liver disease NAFLD)
    --fatty heart (??)
    --fatty pancreas (??)

    Are we all to some degree silent celiac (or fullblown/nonsilent)?

    I think people find it hard to believe that BREAD can cause infertility! *ha*

    Here's the article:
    http://drbganimalpharm.blogspot.com/2008/05/wheat-would-you-give-your-kids-crack.html

    -G

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  17. Don't forget osteopenia and osteoporosis, both signs of deficiency of the fat-soluble vitamins!

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  18. Just found this study on "high-fiber diets" and vitamin D half-life. Looks like grains (bran) may have some nasty effects on D status

    http://www.ncbi.nlm.nih.gov/pubmed/6299329?dopt=Abstract

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  19. Hi Stephan,

    The D paper was 1983! The fiber fixation was on rocky ground from the time I was a relatively new graduate. Wow!

    Now back to gluten/coeliac. Rice comes with rice bran agglutinin. While this seems less toxic than gluten, could it still do the job of breaking the health of Eastern HGs who descended in to agriculture. Anything in corn to do the job in the New World?

    Peter

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  20. Nice post g,

    Here in the UK you have to get out of the ICU alive to worry about pancreatic failure after pancreatitis! None of the ICU nurses I've met looked forward to these patients...

    It amazes me how lightly I got off re withdrawl from the exorphins in wheat when I went gluten free. It seems very likely to me that the people who succeed best at LC long term are the ones who go gluten free at the same time.

    Love the man boobs comment! This is the commonest reason for male cosmetic surgery in the UK! Once, while I was hunting metabolic syndrome and prostate cancer, I found a protective effect in advanced prostate disease. Apparently the fall in testosterone from metabolic syndrome gives functional castration! Wonder how much gluten is to blame?

    Peter

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  21. Peter,

    Here's a little bit of info from the paper: adding 20g bran to the diet (Allinson's bran plus; they don't say what kind of bran) reduced the elimination half-life of 25(OH)D3 from 27.5 to 19.5 hours (significant), but had no significant effect on serum D half-life. The trial lasted 30 days, probably not long enough to show a difference in serum levels.

    I can only assume the bran comes from wheat, oats or rice. I'd say probably one of the first two. I couldn't find any more info about the product on the web.

    I don't know about rice, but corn definitely has some nasty anti-nutrients. It gives you pellagra if you don't nixtamalize it (soak it with lime, the mineral not the fruit), as many farmers in the Southern US found out early in the 20th century. Archaeological evidence also shows a reduction in stature, among other problems, upon the adoption of corn as a staple.

    It's funny how they had such a macronutrient-based approach when they published this paper. Fiber is fiber, no matter where it comes from so we don't even have to tell you what kind of bran we used. I'd be willing to bet vegetable fiber wouldn't have had the same effect...

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  22. I'm sorry, I misunderstood the results a bit. The numbers I listed in the previous comment were the serum half-life. What was not significant was the half-life during the initial "distribution phase" right after giving them the radioactive D.

    So serum half-life was affected pretty dramatically. They didn't look at changes in total serum levels before and after, unfortunately.

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  23. Never mind, I think I'll still give up the Allbran (heehee)

    Peter

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  24. Hi Nicola,

    I'm joined. Dunno how much time there will be for reading, got 4-6 weeks full time work, starts tomorrow...

    Thanks

    Peter

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  25. Peter, have you seen Fanatic Cook's recent post about how heart surgery is no better than a placebo? It's a $100 billion scam in the USA alone. Heart surgery does not prolong life or prevent the next heart attack. A bonus: it causes more than 50% rate of brain damage (some studies say a 100% rate of cognitive decline). It seems that clamping arteries and/or processing the patient's blood in a heart-lung machine releases bubbles of air and other debris, which then cause micro-strokes. Heart surgery: a waste of time and money. Here's a hint for heart attack victims: stop eating wheat, flour, refined sugar, and all PUFA vegetable oils. That's going to do a lot more than getting bypass or angioplasty. Exercise and sleep and sunlight and lower stress couldn't hurt, either.

    http://fanaticcook.blogspot.com/2008/06/heart-surgery-can-damage-brain-probably.html

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  26. "Rice comes with rice bran agglutinin. While this seems less toxic than gluten, could it still do the job of breaking the health of Eastern HGs who descended in to agriculture. Anything in corn to do the job in the New World?"

    Corn and oats are high in PUFAs (at 6% of calories). Wheat and rice are much lower (2-2.5%). Refining helps reduce PUFAs, esp in rice, but also reduces nutrients of course. I'd go with potatoes. If grains were used, organic or non-enriched white rice. No reason to enrich something, when you are not eating much of it. They take out more than is put back, any way. Better to get nutrients by way of food, not synthetics.

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  27. Believe it or not I had never considered fat soluble vitimins to be an issue after having a cholecystectonmy 15 years odd years ago. Duh. I tolerate fat quite well (75-80%) of daily calorie intake, but how do I get my fat solubles? From recently tested vit D levels its obvious that my dietary fat intake plus sunshine is not cutting it. Would super dosing with fs vitamins make up for the poor of absorption? Interesting too about the diminished satiety from fats without a gallbladder. Certainly something I have noticed.

    L

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  28. Hi Bruce,

    Skimmed FCs article. I'm well aware that there has never been a placebo controlled trial of coronary artery grafting. This would require, at an absolute minimum, a full thoracotomy. Ideally a period of asystole on bypass too. There may be slight ethics approval problems with such a study. The same problem applies to most surgery. But an anaesthetist would say that.

    Pity FC demonstrates such intense stupidity re saturated fat and meat. Her tendency to eat Food is her sole redeeming feature.

    Peter

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  29. Hi L,

    You're way ahead of the rest of us if you're looking at blood D levels 15 years down the road. But my thoughts do drift towards bile salts as a supplement, ie substitute the gall bladder secretions and maybe then add supplements when they can be absorbed. I've not had chance to see if bile salts are available... Or if they involve horrible cruelty to animals to obtain them!

    I assume you're taking 10,000 iu oil based D3? Dr Davis doesn't rate other forms of vitD and perhaps you would need generous doses...

    Peter

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  30. Dr B G – your blogspot has the same title as my (unfinished) book – Animal Pharm. Great article too – crack! Really brings it home doesn’t it.
    It explains much too – I have a very dear friend with very severe rheumatoid arthritis who just cannot give up her bread and cake habit. I’ve done my best to provide her with information on Jasniewski’s diet but she says she’d rather die than give them up.
    It’s also nice to hear I’m not the only one lapsing occasionally – it’s also to do with inadequate planning and not due to craving.

    Bruce it’s very true that CABG and other heart surgery does not provide any mortality benefit (read Charles McGee’s Heart Frauds). The only apparent benefit is angina pain reduction – most likely due to nerves being cut rather than improved perfusion.

    Peter thanks for the input – CC is a hack, and a dangerous hack at that. Have you ever entered a dietician’s lair? The desk and shelves are festooned with boxes of “low-fat” processed foods, margarine pots and sorbitol-laden jams and jellies. Advising sorbitol for diabetics is also criminal; they already have too much tissue accumulation of sorbitol. In insulin-independent tissues (vascular endothelial cells in retina, kidney and nervous tissue), hyperglycaemia saturates the hexokinase pathway and the excess glucose is converted to sorbitol by aldose reductase. Having high aldose reductase activity depresses immune function in diabetics but go ahead, slather that sorbitol jam on your margarined whole wheat bread. "No, we’d rather add to the ever-growing list of drugs now being foisted on people with type 2 diabetes like so many guinea pigs, because it’s high-tech and it makes us look important." Okay now you know why I get so mad with dieticians. Preventive medicine my butt!

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  31. "Bruce it’s very true that CABG and other heart surgery does not provide any mortality benefit (read Charles McGee’s Heart Frauds). The only apparent benefit is angina pain reduction – most likely due to nerves being cut rather than improved perfusion."

    The stunning thing is that placebo also reduces angina pain. It gives physiological benefits like better blood flow. So much for the flawed studies of Dean Ornish and others. They change all sorts of variables (like smoking, stress, meditation) that are either known to provide a benefit or can be assumed to cause placebo effect. Maybe we should be reconsidering treatments that have never been proven to give benefits in double-blind placebo controlled trials, like heart surgery.

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  32. Hi Nicole,

    Forgot the comment re ketones. I drift in and out of mild ketosis. If I exercise without eating I get deep ketosis. Dairy gives post prandial ketosis, presumably from the MCTs, dripping doesn't seem to. As far as I can tell I am as fat adapted as I'm going to get and don't notice the limitations I used to. O2 delivery through my lungs appears to be limiting factor on high level exercise, but I don't do a huge amount of this. I need about a week of adaptation to do really hard stuff because I'm not doing much currently. I'm five years in to 70-85% calories from fat. I'd agree with comments on Mary's group that about a year to adapt is reasonble. Lutz suggest younger people adapt quicker, oldies slower.

    I don't know re Barry Groves. He's been playing this game a lot longer than the rest of us, so I tend to give him a lot of credence. I doubt he is in ketosis on the basis of Eat Fat, Get Thin. He also doesn't seem keen on BMIs below 20...

    None of the old timers seem to aim for continuous ketosis, but I found that I cannot avoid ketosis completely unless I increase carbs well above the 40-50g/day I normally eat.

    The old chestnut of ketones, good or bad is difficult and I don't really have a hard view. Some are nice as a fall back on, FFAs rule and some glucose is nice when you need it....

    Peter

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  33. Peter, if you find time I am shore Mary, Lex (he has been eating his mix of raw beef and dog&cat plus suet for 3 years) and other members would approve of your "Hyperlipid" input...
    I have spoken to Lutz personally (he spends part of the year in Austria).

    Nicola
    Switzerland

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  34. This comment has been removed by the author.

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  35. I find Mary's comments on Saturated Fat For Health to be unreliable. In one post, she claimed that Aajonus Vonderplanitz ate 3-4 pounds of raw butter a day, but his book actually said 1-2 sticks a day (4-8 ounces). That's a lot, but it's nowhere near 3-4 pounds. She exaggerated by 6-16 times what he actually ate.
    http://www.wewant2live.com/site/811618/page/370805

    At one time, AV claimed to eat 4-8 sticks of raw butter per day while allegedly recovering from a poison mushroom. That's 1-2 lbs, and he's no longer eating that much, AFAIK. Even that is less than she said he was eating, so what gives?
    http://www.buildfreedom.com/dietanc.htm

    She has said other things that were ridiculous, like getting rid of her cancer with grape juice. She claims cancer cannot live without glucose, but grape sugar is 45% glucose. She said she had to lose all of her fat and muscle to get rid of the cancer and this is also absurd. If you get rid of all your fat or muscle, you would die. In short, I find it very hard to trust the information which she presents. A lot of it is wrong, arbitrary, dubious, or misleading.

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  36. Frankie(Cathy?)

    You are a GEM!

    Yes, what a wonderful title for a book! Well, since I deduce you don't have a blog... your BOOK will be a popular hit ;) Can't wait to read your thoughts on pharma secrets... hhhmmmm is that the subject matter?? Orwell always did a fantastic job conveying politics beneath a 'fairy story.'

    I think that you are correct about atherosclerosis (does not) = AMI

    Your ideas about 'calcium derangements' and immunity/cancer/infection are fabulous... Lp(a) is part of the immune system -- thus an unsolved ENIGMA... (but not really -- fix the immune system, then you'll probably fix Lp(a)). Why can't researchers spend time/$$/resources on this??

    in fact did you know several studies are showing significantly increased aortic calcifications and even calcified brain lesions in vitamin D deficient people (esp when they are taking calcium supplements -- per 'conventional' MD advice)?

    Didn't know about sorbitol in diabetics!!

    -G

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  37. Hi, I have been up all might with gallbladder attacks. I have all the symptoms, have been to several doctors, late night walk in clinics, Er twice, along with an MRI and ultrasound. I was put on antibiotics because my blood count was 18,000(regardless that they didn't know where the infection was.....just that there was one). And that the intense burning i felt in my stomach was ulcers and put me Sulcralfate. I originally 3 months ago thot i had hurt my back, so i saw the chiropractor. She said my SEVERE SEVERE SEVERE RADIATING pain was from a misplaced rib. Slowly, i began describing to my chiropractor the symptoms and she said i sounded like i had gallbladder problems. She did an xray and it showed a small circle. I told my doctor, so he sent me to have the ultrasound-it showed no stones. So my chiropractor said maybe its a pinched nerve and the pain was making me throw up....ect. So i had an MRI, it showed nothing. So i began researching gallbladder stones, symptoms, ect. I made an appt with a ND, nutritional doctor (because i do not want surgery) and she gave me A-F Beta food tablets to take 4 times daily our to chew 3 at a time/onset of an attack. I changed my diet to zero fats, oils, sugars, butter... I'm not better at all!!! My rib is a pain all its own, but i have the attacks on top of it. I can not work, go anywhere, barely can shower due to no energy and absolutely can not sleep. Therefore i research, in hopes of finding help. The one thing i didn't take out of my diet was gluten. I don't know at this point if i have any faith left and am so wore out from constant severe pain. But I'm a believer in nutrition and diet cutting people of many things. So, I'm going to cut out all gluten as well beginning today and pray to God for relief, and my life back.

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  38. At least no one dies of gluten deficiency, but be careful you don't miss a specific problem. Also be very careful of low fat diets in general...

    Good luck

    Peter

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