Should Those With Long Covid Be Checked For Coeliac Disease?
One of my Google Alerts picked up this interesting page on the British Medical Journal.
In response to this paper on the journal, which was entitled Long Covid—An Update For Primary Care, a retired GP named Andrew Brown had said this.
The update reminds us that alternative diagnoses should be considered in patients presenting with long covid symptoms. I suggest that screening for coeliac disease should be added to the list of conditions to look for. Coeliac disease occurs in more than 1% of the population, with many more cases undiagnosed. Typical symptoms of fatigue and GI problems are the similar to those of long covid.
As a non-medical person, I would agree, as after the Asian flu of 1057-58, I was off school for a long time with long covid-like symptoms and my excellent GP; Dr. Egerton White was very worried.
But at the time, it is now known, I was an undiagnosed coeliac.
So was my coeliac disease meaning that I couldn’t fight the flu?
I cover the link between coeliac disease and long covid in more detail in Covid Leaves Wave Of Wearied Souls In Pandemic’s Wake.
High Risk Of Coeliac Disease In Punjabis. Epidemiological Study In The South Asian And European Populations Of Leicestershire
The title of this post, is the same as that of this peer-reviewed paper on PubMed.gov.
This is the abstract of the paper.
The purpose of this study was to measure the incidence of coeliac disease in different ethnic communities and investigate the hypothesis that the incidence is decreasing in most European countries and the role incomplete retrieval of data may play. In a retrospective study of histologically confirmed cases of coeliac disease between 1975 and 1989 in the City of Leicester, 106 patients with coeliac disease were identified. Of these 86 were European and 20 Asian. The overall incidence of coeliac disease in Europeans was 2.5/10(5)/year (95% CI 2-3.2), in Gujaratis 0.9/10(5)/year (95% CI 0.4-1.8), and in Punjabis 6.9 (95% CI 3.2-12.3). These differences were independent of religious belief. The relative risk to Punjabis compared with Europeans is 2.9 (95% CI 1.5-5.3; chi 2 = 12.5, p < 0.01) and to Gujaratis 8.1 (95% CI 3-22.4; chi 2 = 25; p < 0.001). Gujaratis were at 0.4 risk of Europeans (90% CI 0.2-0.8; chi 2 = 6.7; p < 0.01). The incidence in the urban populations of Leicester was 6/10(5)/year (95% CI 1.3-1.9) which was significantly lower than the 3.2/10(5)/year (95% CI 2.7-3.8; chi 2 = 5.6; p < 0.001) in surrounding rural areas. This study shows that the incidence of coeliac disease in Punjabis (Sikhs, Hindus and Muslims) is 8 times higher than in Gujaratis (Hindus and Muslims) and 4 times higher than in Europeans in Leicester.
I find the last sentence in particular very significant.
I’m no medic, but I think it is reasonable to assume, that in a particular community for every diagnosed coeliac, there will be several undiagnosed coeliacs out there.
In this overview of coeliac disease on the NHS web site, this is said about the incidence of coeliac disease.
Coeliac disease is a condition that affects at least 1 in every 100 people in the UK.
But some experts think this may be underestimated because milder cases may go undiagnosed or be misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS).
Reported cases of coeliac disease are around 3 times higher in women than men.
The one-in-100 figure is often used in web pages in European countries or Australia, Canada and the United States, so I’ll go along with that.
So does that mean that Punjabis living in Leicester, have a one-in-twenty-five likelihood of being coeliac?
Whether you have been diagnosed though, is a matter of pure luck.
I had been having gut problems for years and then one Autumn, I didn’t see my GP, but a very elderly locum, who as I had recently had my fiftieth birthday, gave me a present of my first blood test.
It turned out my B12 levels were very low and after several months of B12 injections, which made little difference to my B12, my GP decided to send me to a consultant at Addenbrooke’s Hospital in Cambridge.
My appointment was on a Monday morning and consultant took about ten minutes to ask a few questions, after which he said they would take a few bloods.
On the Wednesday morning, I received a letter that said, that I was probably suffering from coeliac disease and this would be confirmed by endoscopy.
Was I diagnosed solely by analysis of my blood? This was in 1997, which is after the date of the Leicester study.
Two endoscopies without sedative or anaesthetic were performed and I was confirmed as coeliac.
The first was performed by Dr. Richard Hardwick and the second by Dr. Rebecca Fitzgerald.
Both doctors feature in this story on the Cambridge University Hospitals web site, which is entitled Familial Gastric Cancer – Case Study.
My problems have been minor compared to the two sisters in the story.
My luck had been good and I recommend that everyone who feels they could be coeliac should get themselves tested.
Cases Of Covid-19 In Leicestershire
This article on the Leicester Mercury is entitled 11 Areas Of Leicestershire Have Among Worst Infection Rates in the UK.
In Coeliac Disease: Can We Avert The Impending Epidemic In India?, I started like this.
The title of this post, is the same as that of this article on the Indian Journal Of Research Medicine.
With the high levels of COVID-19 in Leicester and an Indian population who make up 28.3 % of the population of the city, I was searching the internet to see if there was any connection between those of Indian heritage and coeliac disease.
I know you should not try to prove a theory. But as a coeliac, I’m very interested to see how the millions of diagnosed coeliacs on a gluten-free diet like me, are faring in this pandemic.
I then talk about some extracts from the Indian research.
In a section entitled, which is entitled All Wheats Are Not Equal, I say this.
The other dimension to this problem is that not all wheat is alike when it comes to inducing celiac disease. The ancient or diploid wheats (e.g. Triticum monococcum) are poorly antigenic, while the modern hexaploid wheats e.g. Triticum aestivum) have highly antigenic glutens, more capable of inducing celiac disease in India, for centuries, grew diploid and later tetraploid wheat which is less antigenic, while hexaploid wheat used in making bread is recently introduced. Thus a change back to older varieties of wheat may have public health consequences.
So did all these factors come together to create the high levels of Covid-19 in Leicestershire?
Conclusion
I am getting bored with saying this. More research needs to be done!
Coeliacs On A Gluten-Free Diet And The AstraZeneca COVID-19 Vaccine
I am coeliac and I am on a strict gluten-free diet.
I have not had a serious dose of Covid-19, but I may have had a very mild dose, after a meeting with about twenty Chinese students, that I described in Did I Have A Close Brush With Covid-19?
That would not be possible to check now, but I did have a bad reaction after my AstraZeneca vaccine, which I wrote about in July 2021 in Hay Fever, Coeliac Disease And The AstraZeneca Covid-19 Vaccine. I also told my GP about it and he said he’d heard similar tales.
I had no reaction to my second AstraZeneca vaccine.
This year my hay fever was even worse. Is this due to my immune system being boosted by the vaccines?
Yesterday, at a funeral, I met an old friend, who is on a strict gluten-free diet and she had not had a serious dose of Covid-19. But like me, she did have a serious reaction to her first dose of the AstraZeneca vaccine.
I’d like to hear any experiences of coeliacs on a gluten-free diet during the pandemic.
Why Do More Elderly Men Die Of The Covids Than Women?
I asked this question of the Internet and found this article from The Times, which is entitled Why Are Men more Likely To Die From Covid Than Women?.
These are the first two paragraphs.
On Valentine’s Day last year, researchers at China’s Centre for Disease Control and Prevention submitted one of the first studies into who was dying of the new coronavirus that was spreading through Wuhan.
Two clear findings jumped out. Firstly, the virus appeared to hit the elderly hardest. Secondly, if you were a man, you were much more likely to die.
The article goes on to say, that men are 24 percent more likely to die.
I am coeliac and here are some facts about coeliac disease.
This page on the NHS web site is an overview of coeliac disease.
There is a sub-section called Who’s Affected?, where this is said.
Coeliac disease is a condition that affects at least 1 in every 100 people in the UK.
But some experts think this may be underestimated because milder cases may go undiagnosed or be misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS).
Reported cases of coeliac disease are around 3 times higher in women than men.
It can develop at any age, although symptoms are most likely to develop:
during early childhood – between 8 and 12 months old, although it may take several years before a correct diagnosis is made
in later adulthood – between 40 and 60 years of age
People with certain conditions, including type 1 diabetes, autoimmune thyroid disease, Down’s syndrome and Turner syndrome, have an increased risk of getting coeliac disease.First-degree relatives (parents, brothers, sisters and children) of people with coeliac disease are also at increased risk of developing the condition.
The three most important facts in this are.
- The condition affects 1 in every 100 people in the UK.
- Reported cases are three times higher in women than men.
- First degree relatives of coeliacs are at increased risk of developing the condition.
I am sure my father was an undiagnosed coeliac.
When I was born in 1947, there was no test for coeliac disease in children, as one wasn’t developed until 1960.
Testing for many years was by the Gold Standard of endoscopy, which for a child is not an easy procedure.
I’m certain, that in 1997, I was one of the first to be diagnosed in a General Hospital by genetic testing.
At fifty, a locum had given me a blood test and I had been found to be very low on B12. Despite a course of injections, it refused to rise so I was sent to Addenbrooke’s Hospital, where I saw a consultant, who gave me a short chat and then got a nurse to take some blood samples.
Two days later, I received a letter, saying I was probably coeliac and it would be confirmed by endoscopy.
I can’t think how else it was done so quickly, unless they were using a genetic test.
I went gluten-free and the rest as they say is history.
In some ways there’s been two of me.
- BC – Before Coeliac – Frequently unwell, lots of aches and pains and weak mentally.
- AD – After Diagnosis – Healthier, few aches and pains and much stronger mentally.
My immune system appears to be much stronger now!
I believe my son was also coeliac.
Undiagnosed coeliacs tend to have poor immune systems and he died of pancreatic cancer at just 37, because he refused to get himself tested.
As there was no test for coeliac disease in children until 1960, anybody over sixty has a higher chance of being coeliac with a poor immune system and be at higher risks from both the covids and cancer.
It should be noted that according to the NHS, there are three times more female coeliacs than male.
Could this be explained by the fact that undiagnosed coeliac disease can be a cause of female infertility? So when a lady has difficulty conceiving, doctors test for it. So perhaps, by the time they get to 70 a higher proportion of female coeliacs have been diagnosed, compared to male ones, which may explain why more elderly men than women die of the covids.
More research needs to be done.
AstraZeneca May Explain Britain’s Lower Death Rate
The title for this post, is the same as that of this article on the The Times.
These are the second and third paragraph of the article.
Dr Clive Dix said he believed that the jab could help to stave off serious Covid-19 illness for longer than RNA-based alternatives made by Pfizer and Moderna. “If you look across Europe, with the rise in cases, there’s also a corresponding lagged rise in deaths, but not in the UK,” he told The Daily Telegraph. “I personally believe that’s because most of our vulnerable people were given the AstraZeneca vaccine.”
Dix suggested that the T cell response to the AstraZeneca jab may explain the lower level of hospital admissions and deaths.
Dr, Clive Dix is a former Deputy Chair of the Vaccines Taskforce.
I think that Dr. Dix may have a point.
I am coeliac and I know I have a strong immune system.
When I had my dose of AstraZeneca vaccine, I was fairly sure that my immune system gave the viral vector vaccine a good kicking, as it thought the chimpanzee adenovirus on which it is based could be a dangerous intruder.
But with the second dose, I got no reaction. Had my immune system decided that the vaccine was a friend?
I have mentioned this reaction to people and I have found some coeliacs, who had a similar reaction to the one that I had with the AstraZeneca vaccine.
But more significantly, this summer, I suffered badly from hay fever. My GP told me that the high level could have been because the AstraZeneca vaccine had boosted my immune system.
I’ve only had it as bad once before and I suspect that was a couple of years after I went gluten-free, after being diagnosed as a coeliac. I suspect that that would have boosted my immune system.
I can do a small calculation.
I suspect, that there are about 40,000,000 in the UK who have been vaccinated with two doses of the AstraZeneca vaccine.
If we assume coeliacs are 1-in-100 of the population and most have been vaccinated, as they tend to be cautious about their food and health, that equates to 400,000 people who could be fully vaccinated and have an immune system with all the defensive strength of a whole regiment of special forces soldiers on steroids.
For some time now, various sources have been saying the models of the pandemic aren’t right.
I do wonder, if coeliacs with the AstraZeneca vaccine are super-immune and they are skewing the models. After all 400,000 with a super-immunity is a large number in comparison to the total number of deaths from the Covids in the UK, which stood at 171,801 with the Covids on their death certificate tonight.
Conclusion
I am drawn to one big conclusion and that is more research needs to be done.
It would be a great help, if we knew how many coeliacs on long-term gluten-free diets had ended up in hospital.
I wouldn’t ask the doctors, but the catering departments, who would be providing the gluten-free food, that the coeliacs will be demanding.
Infection, Mortality And Severity Of Covid-19 In Coeliac Disease – Prof Jonas Ludvigsson
The title of this post is the same as that of this presentation on the Coeliac UK web site.
If you are coeliac and worried about catching the Covids, I suggest you watch the presentation.
The presentation is about eighteen minutes long and this is the last-but-one screen.
Coeliac Disease and Covid-19
- No increased risk of death from Covid-19
- No increased risk of ICU for Covid-19
- No increased risk of any (!) Covid-19
THEN: Coeliac patients with Covid-19, have no increased risk of death compared to other patients with Covid-19.
Conclusion
The professor concludes it is good news and there is no need for coeliac patients to get the jab earlier than other people.
I would also like to add my fourpennyworth!
The professor was only analysing diagnosed coeliacs, who were probably on a long-term gluten-free diet.
My son was an undiagnosed coeliac, who lived the rock and roll lifestyle, generally living on ciggies, high-strength cannabis and Subways. His immune system, probably gave him all the protection of a plastic colander.
He died at just 37 from pancreatic cancer.
Who Stole All The M & S Gluten-Free Food?
Over the last few weeks, certain gluten-free lines in Marks and Spencer have started getting difficult to find.
Some of the things, I like that have been difficult have included.
- Ginger snap biscuits.
- Gluten-free pies
- Scones
- Bloomer slices
- Gluten-free muesli
Note that my supper is usually something I cook myself from scratch or one of the many M & S ready meals, that contain no gluten. It is usually washed down by a bottle of Adnams low-alcohol beer and followed by some fruit. Tonight, the fruit will be one of my favourites, which are strawberries and bananas.
I did think that the shortage of the lines I mentioned was due to a supply problem.
But then, there have not been shortages of other lines, that I buy, that are not specifically gluten-free.
So is it some gluten-free suppliers are having problems? Possibly.
But!
Regular readers of this blog will know that I believe that those coeliacs on a long-term gluten free diet seem to be unlikely to suffer a severe dose of the dreaded covids. There was no battle with the second dose!
I know for a start that my immune system gives short shift to any viral invaders, as it did with the AstraZeneca vaccine before they came to a truce.
So have others, including some with more medical knowledge than myself, come to the same conclusion about coeliac disease, the immune system, gluten and the covids and have gone gluten-free for safety?
For example, I’ve heard that those suffering from long covid have been tested for coeliac disease.
I’d love to be able to analyse the sales of gluten-free food.
Brutal Third Wave Or Harmless Ripple? The Scientists Aren’t Yet Sure
The title of this post, is the same as that is the same as that of this article on The Times.
The scientists nay not be sure, whether with two jabs, you are safe from the Indian or Delta variant.
But how about me?
- I have had my two AstraZeneca jabs.
- I am also coeliac and have stuck tightly to my long-term gluten-free diet.
- Despite possibly being challenged by a group of Chinese students, that I wrote about in Did I Have A Close Brush With Covid-19?, I have not knowingly had the covids.
- I’ve only had one test for the virus and that was negative.
For various reasons, I believe that coeliacs on a long-term gluten-free diet have a very strong immune system, that could help to protect them from the covids.
- Personally, my health was transformed, when I went gluten-free in 1997.
- I am sure, my immune system gave the first dose of the vaccine a good kicking.
- I rarely, suffer from colds and sniffles, although I do have flu jabs.
- Research by Joe West at Nottingham University, has shown that as a group, we’re 25 % less likely to suffer from cancer.
So could these points prove my hypothesis?
In addition, I ask people, if they have any coeliac friends. These personal tales have yet to reveal any coeliacs on long-term gluten-free diets, who’ve had a serious dose of the covids.
I’ve also talked to intensive care doctors, who have said they can’t remember caring for a coeliac with a serious dose of the covids.
So I shall be Keeping Calm And Carrying On!
What Does Novak Djorkovic Tell Us About The Covids?
If you search the Internet for “coeliac disease and Novac Djokovic, you get a lot of posts linking to gluten-free diet and some to coeliac disease.
Some say he is coeliac and others say he is just gluten-free.
There are also reports on the Internet of Novac Djokovic having Covid-19.
So does that tell us anything about gluten-free diets, coeliac disease and Covid-19?
As there are no reports of him spending a long time in hospital, it doesn’t disprove my theory, that coeliacs on a gluten-free diet don’t get serious doses of the Covids!
I’d love to hear more stories of coeliacs on a gluten-free diet, who have caught Covid-19.
Covid-19, Coeliac Disease And Budesonide
I am coeliac and whenever a drug is shown to have positive effects against the Covids, I type its name into Dr. Google with coeliac disease.
With dexamethasone, I found it is used in some countries. as an alternative to a gluten-free diet.
Typically, these countries appear to be one with a Pop-A-Pill-For-Everything habit.
Budesonide appears to be used for Crohn’s disease, which is associated medically with coeliac disease.
As we keep hearing that the best way to fight the covids is with your immune system and coeliac disease is an autoimmune disease, is enough research being done as to the role of undiagnosed coeliac disease in this pandemic?
Coeliac UK are just advising Keep Calm and Carry On with the gluten-free diet!
The Anonymous Widower 