Did Your Lab or Hospital Misread Your Celiac Biopsy?

villi

When you first head down the road of defining a possible issue with gluten, it’s like entering a new dimension. And you also need to learn a new vocabulary to navigate that world. You’ve been lucky enough to find a doctor who is associating your potentially varied symptoms with celiac disease, and now you need to be concerned about how your lab results are being analyzed, or you may be given a mistakenly clean bill of health.

In order to achieve what physicians call the “gold standard” of a celiac disease diagnosis, an endoscopy must be done that shows histological changes, or damage, to the small bowel. The villi that line the small intestine are like what you would think of as a deep, thick, dense-pile carpet. Each of the villi can be compared to a carpet thread, contributing it’s surface area (imagine going  up one side of the thread, across the tip and down the other side) to the absorption of nutrients during digestion. However, when the villi encounter something that they cannot absorb, such as the gliadin protein in the case of celiac disease, they become damaged and show signs of decreased length, referred to as villous atrophy. Additionally, there are cellular changes, such as increased lymphocytes in the tips of the villi, that indicate inflammation. See these photos from TheFoodDoc.com to gain a better understanding of what this looks like under a microscope. So now your beautiful thick carpet of villi has worn down patches and ratty areas that make your intestinal lining look like crackled dried out mud. You may think, “Why should I care what it looks like in there, the doctor and the lab guy know what they’re doing.” But is that really the truth?

From the Journal of Clinical Pathology, 2011 we learn that biopsies, or tissue samples taken during the endoscopy procedure, are subject to “interobserver variability”, meaning that different pathology practices may be reading biopsies differently.

Biopsies from community hospitals, university hospitals and commercial laboratories were blindly assessed by a pathologist at our institution for differences in histopathology reporting and agreement in diagnosis of CD [celiac disease] and degree of villous atrophy (VA) by κ analysis.

The results were that the agreement for primary diagnosis was very good at the university hospitals, but not nearly so good at community hospitals and commercial laboratories. Actual diagnosis differed in 25% of cases, which meant that after the cases were reviewed, there was a 20% increase in celiac disease diagnosis! Even the degree of villous atrophy, damage or blunting of the villi, was upgraded in 27% of cases. And when it came to the really subtle early stages of damage that are categorized as Marsh scores, there were complete misses at the community hospitals and commercial labs, where they only began to pick up on the details when the damage became more significant. Some labs used only basic descriptions like blunting or marked atrophy when referring to damage as opposed to providing degree of villous atrophy and IEL’s (intraepitheilial lymphocytosis) counts, or even left the information out altogether.

The intraepithelial lymphocytes are white blood cells that are part of the immune response to the proteins in food that are causing the damage. The lymphocytes rise to the surface of the lining, displacing enterocytes which are usually there, absorbing your nutrients. The IEL count may need to be analyzed in the lab through the use of a special immune chemistry stain that can make normal looking tissue reveal higher counts of lymphocytes. This can be extremely beneficial to diagnose the earliest signs of injury to the intestine, for people who already might have, with the best intentions, restricted gluten in their diets, and family members of people who have celiac disease.  Catching the disease at this early stage can greatly reduce the amount of damage to the gut.

So when you’re dealing with a celiac disease diagnosis, a university lab might be your best setting. If that’s not possible, ask your doctor about what lab he will be sending your biopsies to, and what type of standards they are using to analyze the tissue. It could make the difference between a correct diagnosis, and living with the ongoing damage of celiac disease that they are now “sure” you don’t have because the lab said so.

 

Synchronicity: You Have the Amazing Ability to Create Coincidence

Synchronicity

By Dr. Kirby Surprise

Rethinking Synchronicity:

You Have the Amazing Ability to Create Coincidence Synchronistic events (SE) are those uncanny coincidences in which the environment seems to be speaking directly to us through events. In my work as a psychologist, I have clients who report radio and television broadcasts, random events of all sorts, comment on what they are thinking as if something was reading their minds. Psychologists call this experience “Thought of Reference.” Events seem to reference the thoughts of the client. Many clients with psychotic disorders experience thoughts of reference. But what if they were not reporting a symptom of mental illness, but an experience everyone has in some form? What if televisions really do seem to comment on what we are thinking?

There is a measure of self‐awareness called “The Mirror Test” developed by biopsychologist Gordon Gallup. Animals are shown their own reflection in a mirror. If they recognize the reflection in the glass as their own, it is taken as an indication it is a self‐aware being. Humans, some great apes, elephants, and dolphins generally recognize their own reflections; a few birds do as well. Interestingly, some birds and dogs that can’t initially recognize their own reflections can be trained to do so. Synchronicity is a form of mirror test. People see in the mirror of events around them the image of their own inner life. They see what they think, feel and believe. They even see their fantasies about what causes these reflections. For some clients who report thoughts of reference, it is the stories they tell themselves about the causes of the SE, not the SE themselves, that label 2 them as symptomatic.

Everyone has experienced meaningful coincidences. They are explained by supernatural and religious beliefs, archetypal influences, or more exotic personal mythologies. SE mirrors these beliefs back to the observer. SE sometimes become mistaken for confirmations of the objective reality of personal beliefs. Most people are looking into the mirror of SE every day. They don’t realize the images they see are their

own thoughts. You have an amazing ability. Your thoughts and feelings, your memories and experiences, are reproduced in the events around you as coincidences. The world shapes itself around your thoughts, presenting you with meaningful coincidences based on your inner life. Everyone creates their own SE, constantly. The ability is innate to the way our brains process information into meaning. This seemingly magical ability goes largely unnoticed, unexplained and misunderstood until it presents itself in spectacular form.

Consider the following SE: “One cool autumn day I was sitting in my car waiting to pick up a friend. I was listening to the radio to pass the time. During a commercial break an ad for the movie ʺCarrieʺ was played. The movie is about a teenager who discovers she has the ability to move objects at a distance. I started having fantasies about what it would actually be like to experience moving an object this way. I had seen the film; during its climax Carrie uses her power to crush her family home. I looked across the street and saw an old cottage. Focusing on the house, I fantasized about what being able to move an object that large would be like. I was remembering a National Inquirer headline about a house that supposedly was turned over on its side by some psychic force. I was wondering what effect such a power would have on a person, how it might feel to move a house.

As I stared at the house the entire cottage shuddered violently. The house started to move. It rolled over onto its side. The roof was now facing me. I was astonished and felt panicky. I stared at the overturned house and asked ʺCould I have really done this?ʺ ʺNoʺ, I answered. I wondered if this was just a vivid dream. I decided I was awake and the event was real. “OK” I said to myself. “If I just did that, then I want to see the house crushed like in the movie.” As I stared awestruck the house again began to shudder. The roof started to collapse inward as if the center of the house were slowly imploding. Beams burst through walls, windows shattered, as the house began to tear itself apart. A moment later I saw a flash of yellow paint above the house, then the largest bulldozer Iʹd ever seen climbed lazily over the center of the house crushing the structure into rubble in a few moments. It then started to load the debris into waiting dump trucks. The house had obscured the demolition equipment from sight. With the radio on and windows up, I couldnʹt hear the tractor engine. My fantasy had come to pass, my wish fulfilled through a series of synchronistic events.ʺ

SE defies the way we usually think about cause and effect. In the SE of the moving house there was a connection between the observer and the event, but finding the cause seems impossible. The house moved, but there was no physical force exerted by the observer. Radio commercials, memories and patterns of thought and physical events became coordinated, but there was no obvious force doing so. Yet, there is a pattern

evident in the events. The pattern is in the person’s thoughts. People have always reported seeing SE. They are the basis for many superstitions and religious beliefs. The 4 difficulty in finding the cause of SE has always been the mirror effect. Some of my clients seem delusional when they are referred to me. They report SE that tell them God has special and grandiose plans for them. They may believe the government is reading their minds and talking to them through broadcasts on the evening news. I have a version of the mirror test for these clients. I tell them they have the amazing ability to reflect their thoughts and emotions off the environment. If they believe they had been communicating with secret government agencies, I tell them to look for messages from Mickey Mouse. If they believe they were in communication with God, I tell them to talk to Bugs Bunny. The SE often responds in the pattern the clients look for. If they stop believing what they think is real, just because the world reflects their thought back to them, they are no longer delusional.

The evidence for SE being created by our thought is fairly strong. In science the best experiments are done with the “Double Blind” method. Neither the experimenter, nor the subjects, know what the expected outcome of the experiment is. This is because the act of observing an experiment changes the outcome. Just expecting to find a significant result, will alter what happens in the direction the researcher is looking for. Although the causes of this phenomenon remain a mystery, it must be accounted for in any good experiential design.

Most explanations for synchronicity have done more harm than good. Carl Jung, who created the term, speculated that SE were created by patterns he called archetypes. These universal patterns of creation existed somewhere outside of time and space, and caused events to cluster around them in patterns. He did the world a great service in acknowledging that SE were real, not just disturbed minds misinterpreting reality. But, 5 he placed the cause of SE in imaginary archetypes, not in the people who actually create and observe them. In Jung’s writings he describes several series of SE that he ascribes to archetypes he was formulating at the time. He seems to miss the fact that he created these thought forms, and that SE always reflected his thoughts. When people look for SE based on one of Jung’s archetypes, they find them, because their thoughts create them.

Many SE can be explained by the way the brain processes information. The human evolutionary niche is to excel at matching and remembering patterns. Each moment our senses present the brain with billions of bits of information that it must organize into patterns. The brain deletes most information before it reaches consciousness, and often substantially alters our sensory information, filling in gaps and highlighting patterns it believes are important. As a result of this process we all live in a highly modified

representation of the world. Our reality is literally a massively simplified construction of the patterns our brain thinks most important at any given moment. Finding meaning between patterns, between events, is what we do best.

For SE, there are no physical limitations. Rolling over a house is no more of a coincidence than rolling over a pair of dice. Our mirror test is the entire universe, and it reflects the meanings your mind creates. SE will appear to be caused by whatever the observer believes causes them. Looking for SE consciously, knowing SE are a mirror of your thoughts, reveals your astonishing ability to shape your experience of the universe according to the thoughts you choose.

Dr. Kirby Surprise is the author of “Synchronicity”, published by New Page and due out December 15, 2011. ISBN: 978‐1‐60163‐183‐1 List Price: US $16.99, Canada $18.95

ColoVantage Blood Test for Colorectal Cancer

by Cynthia Henrich

test tubes

ASCO, the American Society of Clinical Oncology, released the results of a “large, multinational prospective screening study of nearly 8,000 individuals called PRESEPT”. Pre-SEPT because the study explored a DNA biomarker for colorectal cancer known as Septin 9. The test is both sensitive, 90%, meaning it picks up almost all cases, and specific, 89%, meaning it weeds out false positives. For more on sensitivity and specificity, which are very important for determining whether a test should be considered a valid way to check for disease, read more here.

From ASCO clinical applications of biomarkers:

Importantly, the majority of the patients used in the study were of early stage; 87% of stage I and II specimens demonstrated methylated SEPT9. SEPT9 methylated DNA was detected in blood specimens taken from individuals with tumors arising in all locations of the colon and rectum, including right-sided tumors which have proven difficult to detect by endoscopic methods. SEPT9 methylation was analyzed using adenoma and polyp tissue specimens; methylation was shown to occur early in the progression of CRC and could be a useful tool for evaluating biopsies.

This is very important news for over 40 million Americans who do not comply with colonoscopy recommendations. The outcome of detecting early stage tumors is excellent! My research indicates that one very commonly used lab carries this test, Quest Diagnostics, here is the link: ColoVantage. It seems that Quest charges $355, but I found a lab called eStatLab that charges $260 for the same test.

All of the different components of a colonoscopy typically total about $1,400, so this could be a significant help for people who have no insurance. When combined with other tests, such as the fecal occult blood test and the CEA, carcinoembryonic antigen, the results can paint a very good picture of the potential for colorectal cancer.

Tea for Healing Yeast, Cancer, Ulcers and Parasites

healing soothing tea

by Cynthia Henrich

I am lovin’ me some mulling this winter! Enjoying the comforting fragrance of spices simmering and imbuing the house with a cozy expectant feeling. The best news is that instead of the calories of a baked muffin or gingerbread, which I have been stuffed to bursting with this past month or so, this delightful little tea has no calories and a plethora of healing properties. It also tastes so incredibly sweet and tasty that it’s hard to believe there is not a drop of sweetener or sugar in it!

I found a great little brewing teapot, with a stainless steel strainer that holds whatever tea leaves or spices that I’m using, right within the hot water. It’s about 3 cups and is the perfect amount to fill my mug twice in the morning. Make sure that the “basket” for holding the tea or mulling spices is made of either glass or stainless, so that you are not leaching plastic compounds into your hot tea.

The spices that I used in brewing the tea have many healing properties:

Cinnamon is great for relieving nausea, gas, bloating, indigestion, vomiting and diarrhea. It has been shown in studies to reduce blood pressure, and to just about double insulin’s ability to metabolize blood sugar. Doses of cinnamon tincture have been used historically to control uterine bleeding. Cinnamon has been shown to be useful against liver cancer and melanoma. A fungus that grows on the bark has been found effective against leukemia cells in animal testing. Cinnamon is also a potent antifungal, especially useful when yeast medications, such as Diflucan, have failed. It works wonders for fungus-induced sinus infections caused by Aspergillus niger, and combats gingivitis and thrush. Propanoic acid, a compound found in cinnamon, stops the formation of stomach ulcers without interfering with the production of gastric acid, necessary for the breakdown of foods to ensure proper nutritional absorption. Additionally, compounds in cinnamon upregulate glutathione production and protect the epithelial cells of the colon. The myristicin that cinnamon contains has been found to be anti-inflammatory.

Cloves are protective against stomach cancer, are antifungal, antibacterial and analgesic. Clove oil has literally saved my life when it comes to exposure to food poisoning bacteria, along with oregano oil. Cloves are antiparasitical, interrupting the egg cycle of many parasites. Cloves can reduce the feeling of bloating for people with peptic ulcers.

Anise is an herb that stimulates the body to secrete fluids to clear out congestion and normalize digestion. Anise is useful for taming bad breath, stimulating the production of breast milk in nursing mothers, increasing libido, reducing colic and spasmodic gas pain, calming asthma and unproductive coughs. Anise seeds are chewed traditionally after meals in India, and bottles of anisette, such as sambuca, are typically put on the table after a large dinner as a digestif.

Nutmeg‘s distinctive flavor and fragrance are derived from myristicin. Nutmeg as a functional food, has been found to reduce dental caries, reduce gas, aid digestion, improve appetite, treat nausea, vomiting and diarrhea, and reduce inflammation. Nutmeg is also anti-bacterial, anti-viral and anti-cancer.

So enjoy a spot of tea yourself this afternoon, or serve it when your family comes in the door from work or school for an extra boost of health and comfort!

Sources:

The Epicentre Encyclopedia of Spices

Prescription for Dietary Wellness, by Phyllis A. Balch

Prescription for Herbal Healing, by Phyllis A. Balch

Molecules, 2010, The cinnamon-derived dietary factor cinnamic aldehyde activates the Nrf2-dependent antioxidant response in human epithelial colon cells.

Current Opinion in Biotechnology, 2011, Food components with anticaries activity.

Molecules, 2011, Anti-inflammatory effect of myristicin on RAW 264.7 macrophages stimulated with polyinosinic-polycytidylic acid.

Journal of the Medical Association of Thailand, 2007, Myristica fragrans Houtt. methanolic extract induces apoptosis in a human leukemia cell line through SIRT1 mRNA downregulation.