I'm finishing a jar of "dry" (not oil suspended) Vitamin D3 capsules and taking them with enteric coated fish oil. Might the enteric coating prevent the fish oil from helping the "dry" D3 absorption?

Really interesting post. I think I'm sensitive to wheat, but can't seem to stop eating it right now. Once I gave it up for about two months and lost 20 pounds. I should probably try to eliminate it again. Thanks for the insight.

Interesting.  I have just the opposite experience though.  My very rare (maybe once every 6 months or so) consumption of wheat causes no obvious symptoms whatsoever though I have in the past had severe sinus allergy response to wheat/gluten

When I first went gluten-free, I was not as careful as I am now and had several incidences of acute joint pain (with incredible heat) upon exposure to minute amounts of gluten.  The last time I knowingly ate gluten (crumbs from a crouton on a salad) I woke up the next day with the most intense back pain I have ever had.  My usual response to gluten is in the form of migraines. This pain was definitely not muscle pain but neurological with squeezing pains from my spine to the front.  That was the last time I had any gluten - I am extremely careful now and I have been GF 3 years and feel so much better.   I think gluten is a poison, plain and simple, and everyone would be better off not consuming it in any way.

I'm one of the lucky ones.  I caved during the silly season and stole a couple of my sisters' delicious homemade double chocolate cookies.  Alas, no mad dashes to the procelean apparatus.

Wheat breeding sounds to be at fault for the way it's protein folds into an antigen trigger for a lot of people. Granny gave me jam with bread, pie and sugar cookies which didn't provoke malaise, but that was older breed of wheat.  

Now-a-days professional diet advice is to avoid sugar, substitue sweetener. So, many don't get that sugar binding to  the gluten protein fragments. For people with metabolic syndrome adding back in sugar doesn't make sense; they can't use it to "goop-up" the gluten. Cutting out the wheat for them solves the dilema.

Gluten are metabolized into opioids. Both the digestive system and the immune system have lots of neurons AFAIK. Is a nice system to protect the brain, I would guess. Evolution and natures way to say: Don't eat that, it'll mess you up.

Why diarrhea with wheat rechallenge etc.?
Perhaps because your bacterial intestinal flora has changed since wheat/grain elimination.

I have suffered from gastroparesis for 20+ years. Some medication has helped, but nothing has worked better than a carb/wheat free diet. If I avoid them my digestion seems fine. One cookie and within a few hours the rumbling and belching begins . . .

There's this Ethiopian restaurant here in LA. They serve a flat bread called Injera.

I must have it once or twice a year, I tell you, I must! Even though it causes sores in my mouth by the next morning. It never did that when I was eating wheat regularly. Now that I've given up wheat, BAM! Sores!

Otherwise, I'm a sore-free, wheat-free good boy the rest of the year.

Dr. Davis,

Great post.  I believe I have experienced exactly what you described.  I gave up drinking beer (my only grain) last summer and recent grain encounters led to stomach pain and quick trips to the bathroom.  One time I felt really sick for hours.

There are never a shortage of reasons to avoid grains.

@ Anonymous,
I did some work in Ethiopia in 1970 & ate a lot of Injera;
fermented Teff grain with a soaking phase. This increases the % of Arginine amino acids in Injera. People with cold sores are often agravated by arginine foods. Your sensitive mouth tissue is probably reacting to the high level of arginine. (Your individual sensitivity would likely extend to Indian Idli, soaked/fermented rice with dhall bean puff; it's bio-converted a lot of arginine too.)

For those of us that are cutting way back on wheat in our diets, but not eliminating it - what are our best options?  I'm finding heirloom wheat flour available on the internet.  And here's an interesting article I found on Heirloom wheats:
'Are Heirloom Wheat Varieties the Next Big Baking Trend?"
http://www.seriouseats.com/2010/01/is-heirloom-wheat-the-next-big-baking-trend-jim-lahey.html

And what about Kamut?  Any comments?  Here's a write-up on it - it has some very nice features.
http://www.suite101.com/content/kamut-ancient-grain-in-modern-times-a89648

I try to avoid wheat all the time.

However, I found one bread here, that is made without Flour but uses wheat sprouts instead. The recipe is made by Russian academic scientist.
You have some English language info at

http://www.zernohleb.ru/health_eng.html

What do you think about it ?

Thx

My digestion was always lousy (but I didn't know it) until I cut out wheat.

Now if I reintroduce the reaction varies depending on the form of poison. Pasta is worst, sending the gi tract into the red zone for a week, plus migraines and sinus.

other forms (cookies, pizza) the reaction is less volcanic, but still noticeable. The baseline reaction is the sensation that the lining of my stomach has been scrubbed with a brillo pad, and sometimes joint and back pain, with a touch of sinus fun.

All this I used to think of as"normal".

Anyone have any success with enzyme products (like "Gluten Ease“) to help deal with occasional exposure?

"The majority of people who experience a wheat re-exposure syndrome will have diarrhea and cramps..."

This seems to say that of those who DO have symptoms ("experience a ... syndrome"), a majority will have diarrhea and cramps and a minority will have other symptoms.  But what proportion experience any symptoms?  Like Geoffrey above, I don't.

Wow... that just happened to me.  But only after being wheat free for like a week.  I was experimenting with a gluten free paleo diet but went out with some friends to the mall to see a movie.  I drank one beer ate 4 slices of pizza and a big cookie.  I ended up screaming at a friend over a stupid comment, nothing serious, but I felt SO angry .  Something that is not usual for me.  Then that night I woke up in the middle of the night with stomach pain and diarrhea.  
This was after just 1 week with no wheat.

I forgot to add that I had bad headaches just 30 minutes or so after eating the pizza slices too..

Don't you think this could also have something to do with the 1 in 133 statistic for celiac disease? Alot more are gluten intolerant and on down the spectrum to gluten sensitive.  

That adds up to a whole lot of people out there who are on the continuum of mere sensitivity --->celiac

That's me in a nutshell. Re-exposed to wheat and it was two days of unspeakable nastiness... I lapsed into this silliness as an experiment with the 4HB which necessitates a weekly wild day. It was wild alright...

Great post. I would love it if someone could explain the mechanism by which this re-exposure horror happens.

Since cutting out gluten, even tiny exposures have sent my stomach into paroxysms of pain. This is accompanied by nausea and an all over sick feeling, like I have been poisoned.

My bloods tested negative for coeliac though so I don't understand why I have such a bad reaction.

I am one of those people prone to headaches, migraine and colds. Usually, my first recourse is White Flower Embrocation (embrocation.50webs.com), also called White Flower Oil

Why so many lipid panels?

Doesn't cholesterol naturally ebb and flow?  Or does it only ebb and flow when we feed it?

For my taste the second panel is better, other than the HDL.  I'd say she did a good job getting her Cholesterol up over the holidays....

One of the highlighted lines in my Taubes book is the piece about the lower the cholesterol the higher the incidence of cancer.  Correlation I know but wasnt all the science about cholesterol a well choreographed dance around correlation.

My father was a cancer patient and a heart patient.  He "naturally" had cholesterol in the 150-160 range and was sick his whole life.  

IMHO that womans cholesterol is doing what it does to save her life.  Rising to wrangle up the garbage she's dumping down her throat.  

My fathers never rose to combat the garbage he was dumping down his throat.  What are your thoughts on that?

If this stuff happens as you say, a fairly simple pattern, then why the differences?

Dr. Davis - This is off topic for this particular post, but I want to suggest the next blog post for you.  

First, cudos for keeping this blog informational only, without a hint of commercialism in in.  However, I and perhaps others who read it have seriously considered contacting your office for an appointment to become patients, even though we live in other parts of the country.

Would you consider posting a topic on the blog of how this could work?  My thoughts are to have necessary tests done in advance of a visit, so that things which normally take 2-3 visits could be accomplished in one. Is a list of these things something that could be determined by a phone interview with your office staff when the appointment is being made?  Can your office arrange for heart scans to be done in Milwaukee in the AM for a PM appointment with you?

Important question: Is a heart scan at a closer facility (Still 3 hours away) & track your plaque membership (not yet done because I've not had a scan yet) just as good as a visit to your office once a year or would I get additional benefits becoming a patient? i.e., can you rely on scan scoring done by others if I wanted your opinion on the results?

Two other things all those carbs will do to susceptible people is give them bloating and acid reflux. The posts on that subject have been my two most popular over the past month.

Re: cholesterol, mine is 140. The total didn't change much when I cut way back on the carbs, but the ratio of HDL:LDL improved. If I'm sick or riddled with cancer, I'm afraid it's escaped my notice. My liver must be making all I need.

I don't miss the cookies, overly sweet eggnog, and Christmas candy at all, since I revised my diet in early 2004.  I don't gain holiday weight anymore; in fact, some years I lose a couple pounds between Thanksgiving and New Years.

When I celebrate during the holidays with food, I do indulge (if you can call it, that because my indulgences tend to be nutrient-dense and very satisfying, too) with rich paté, lovely artisan cheeses, fish roe (caviar) and deviled eggs, fresh veggie slices, and bacon-wrapped scallops and shrimp, etc.  I make egg nog that isn't nearly so sweet as well as super easy homemade truffles with very dark chocolate, which has just a small amount of sugar.

I eat a high carb diet (60% typically, lots of oats, beans, potatoes) and just got back my first test result:

Cholesterol, Total   152
Triglycerides         39
HDL Cholesterol       70
VLDL Cholesterol calc  8
LDL Cholesterol calc  74

I'm lean (16% body fat according to my electronic scale, 12% according to a formula I found on the internet) and get plenty of moderate exercise (yoga and walking). So it appears all those carbs are NOT turning to Triglycerides in me.

Rather, when I eat carbs, the glucose goes into the muscles. After I finish my last meal for for the day, the body gradually burns off this stored glucose so that the muscles are mostly depleted by the next morning, when I break my nightly fast. Isn't this how the body is supposed to work? I have to disagree with this notion that the muscles can only store a couple of hundred grams of glucose. I think that amount of glucose that can be stored increases in lean people who exercise and routinely eat large amounts of carbs.

Brent, You have been reading my mind! Yes, Dr Davis please tell us how best this could best be accomplished as per Brent's comment!

I've been looking more into de novo lipogenesis. The key conclusion I see is the following:

Hepatic de novo lipogenesis in normoinsulinemic and hyperinsulinemic subjects consuming high-fat, low-carbohydrate and low-fat, high-carbohydrate isoenergetic diets by Jean-Marc Schwarz, Peter Linfoot, Doris Dare, and Karmen Aghajanian (2003)

...
In the present study, this higher proportion of simple sugars (54%) led to elevated fractional hepatic DNL, whereas when only 40% of the carbohydrate consisted of simple sugars, hepatic DNL was minimal (11). Overall, these findings confirm and extend previous results from Hudgins et al (8), who found that the proportion of simple sugars in very-low-fat, high-
carbohydrate diets was the determining factor for hepatic DNL in healthy subjects.

In other words, if you are healthy to begin with (lean and exercise daily) AND you eat mostly complex carbs AND you don't overeat, then de novo lipogenesis is NOT a problem.

Bit over simplified; unless holiday indulgences (prior to patient's Jan. lab test) were made rich tasting without using any fat &/or cholesterol content
(and wasn't over eating, nor lazing around).

Clinic patients are presumably often already suffering with metabolic syndrome. An absolute admonishment is going to become rote patient visit after patient visit.

Is a prevention strategy for everyone, or just the sedentary and geneticly pre-disposed? One's adult health may be doing well with a contrary diet. By middle age Doc's restrictions might be a pre-emptive strategy for countering metabolic changes to come.

So if Jeanne returns to restricting sugar and flour from her diet in January, her profile improves.  Did she leave lasting damage?  Is the risk only that disease will develop during her holiday relapse?

Anna--

I love the gourmet-bent you've taken with your diet. That's a great direction to go.


Brent and Michael--

You can call my office at 414-456-1123 to arrange an out-of-town visit. Alternatively, call the same number to arrange a video teleconference to review lipoproteins or your coronary prevention program. (Video teleconference is not covered by insurance, however.)

I treat so much cholesterol in my patients with bio-identical hormone therapy in addition to nutritional biochemistry / blood test to help rebuild the adrenals and help the body convert the excess cholesterol into the LDL and then into the next hormone called pregnenolone. Most people who have high cholesterol have silent adrenal dysfunctions/ burn out / PTSD whereby the cholesterol does'nt convert into the next hormone.
Most MD's won't look to check the adrenal and sex hormones in conjunction with and cholesterol test.
What an oversight eh !

I used to have very lows trigs (35-45 range), I start eating high fat low carb & 6 month later my trig went up to 79.

Carbs = elevated trigs??
Not for me.

  My lowest trigs were in my vegetarian days eating whole wheat, oats, beans etc...when I started upping the fats & meat my trigs went up (even when cutting down wheat, which I dont eat it anymore)

Could you provide an answer to this mr Davis?

I agree that holidays is a season to increase weight gain. Uncontrollable eating can risk our health. There is no any guarantee how long can our body take the cholesterol we're feeding. So proper self-discipline is needed. Low carbohydrate diet is the best diet for those who want to lose weight especially for diabetic people.