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The information contained in this section has been procured from the Mayo Clinic and John Hopkins Medicine. It is all for educational purposes and not intended to be taken as medical advice . What is Lactose Intolerance? ​ Lactose intolerance is when your body can't break down or digest lactose. Lactose is a sugar found in milk and milk products. ​ Lactose intolerance happens when your small intestine does not make enough of a digestive enzyme called lactase. Lactase breaks down the lactose in food so your body can absorb it. People who are lactose intolerant have unpleasant symptoms after eating or drinking milk or milk products. These symptoms include bloating, diarrhea, and gas. ​ Lactose intolerance is not the same thing as having a food allergy to milk. ​ Lactose intolerance is most common in Asian Americans, African Americans, Mexican Americans, and Native Americans. Cooking Blog Source: John Hopkins Medicine HOME Recipes All About Gluten Autoimmune Disorders Support Groups Cheesecakes About Joe Contact Joe Gastritis What causes Lactose Intolerance? ​ Lactose intolerance occurs when your small intestine doesn't produce enough of an enzyme (lactase) to digest milk sugar (lactose). ​ Normally, lactase turns milk sugar into two simple sugars — glucose and galactose — which are absorbed into the bloodstream through the intestinal lining. ​ If you're lactase deficient, lactose in your food moves into the colon instead of being processed and absorbed. In the colon, normal bacteria interact with undigested lactose, causing the signs and symptoms of lactose intolerance. ​ Source: Mayo Clinic ​ ​ Types of Lactose Intolerance ​ There are three types of lactose intolerance. Different factors cause the lactase deficiency underlying each type. ​ 1. Primary lactose intolerance People who develop primary lactose intolerance — the most common type — start life producing enough lactase. Infants, who get all their nutrition from milk, need lactase. ​ As children replace milk with other foods, the amount of lactase they produce normally drops, but usually remains high enough to digest the amount of dairy in a typical adult diet. In primary lactose intolerance, lactase production falls off sharply by adulthood, making milk products difficult to digest. ​ 2. Secondary lactose intolerance This form of lactose intolerance occurs when your small intestine decreases lactase production after an illness, injury or surgery involving your small intestine. Diseases associated with secondary lactose intolerance include intestinal infection, celiac disease, bacterial overgrowth and Crohn's disease. ​ Treatment of the underlying disorder might restore lactase levels and improve signs and symptoms, though it can take time. ​ 3. Congenital or developmental lactose intolerance It's possible, but rare, for babies to be born with lactose intolerance caused by a lack of lactase. This disorder is passed from generation to generation in a pattern of inheritance called autosomal recessive, meaning that both the mother and the father must pass on the same gene variant for a child to be affected. Premature infants can also have lactose intolerance because of an insufficient lactase level. ​ Source : Mayo Clinic ​ Who is at risk for Lactose Intolerance? ​ Factors that can make you or your child more prone to lactose intolerance include: ​ Increasing age. Lactose intolerance usually appears in adulthood. The condition is uncommon in babies and young children. Ethnicity. Lactose intolerance is most common in people of African, Asian, Hispanic and American Indian descent. Premature birth. Infants born prematurely might have reduced levels of lactase because the small intestine doesn't develop lactase-producing cells until late in the third trimester. Diseases affecting the small intestine. Small intestine problems that can cause lactose intolerance include bacterial overgrowth, celiac disease and Crohn's disease. Certain cancer treatments. If you've had radiation therapy for cancer in your stomach or you have intestinal complications from chemotherapy, your risk of developing lactose intolerance increases. Source : Mayo Clinic ​ What are the symptoms of Lactose Intolerance? ​ Each person’s symptoms may vary. Symptoms often start about 30 minutes to 2 hours after you have food or drinks that have lactose. ​ Symptoms may include: ​ Belly (abdominal) cramps and pain Bloating Gas Diarrhea Nausea, and sometimes, vomiting How severe your symptoms are will depend on how much lactose you have had. It will also depend on how much lactase your body makes. ​ The symptoms of lactose intolerance may look like other health problems. Always see your healthcare provider to be sure. Source : John Hopkins Medicine Source : Mayo Clinic ​ How is Lactose Intolerance diagnosed and tested for? ​ Your doctor might suspect lactose intolerance based on your symptoms and your response to reducing the amount of dairy foods in your diet. Your doctor can confirm the diagnosis by conducting one or more of the following tests: ​ Hydrogen breath test. After you drink a liquid that contains high levels of lactose, your doctor measures the amount of hydrogen in your breath at regular intervals. Breathing out too much hydrogen indicates that you aren't fully digesting and absorbing lactose. Lactose tolerance test. Two hours after drinking a liquid that contains high levels of lactose, you'll undergo blood tests to measure the amount of glucose in your bloodstream. If your glucose level doesn't rise, it means your body isn't properly digesting and absorbing the lactose-filled drink. Stool acidity test. This test is used for infants and young children. It checks how much acid is in the stool. If someone is not digesting lactose, their stool will have lactic acid, glucose, and other fatty acids. ​ Source : John Hopkins Medicine Source : Mayo Clinic ​ How is Lactose Intolerance treated? ​ There is no treatment that can help your body make more lactase. But you can manage your symptoms by changing your diet. In the past, people who were lactose intolerant were told to stop taking dairy products. Today, health experts suggest you try different dairy foods and see which ones cause fewer symptoms. That way you can still get enough calcium and other important nutrients. ​ Lactose intolerance symptoms can be unpleasant, but they won’t hurt you. So try to find dairy foods that don’t cause severe symptoms. ​ Here are some tips for managing lactose in your diet: ​ Start slowly. Try adding small amounts of milk or milk products and see how your body reacts. Have milk and milk products with other foods. You may find you have fewer symptoms if you take milk or milk products with your meals. Try eating cheese with crackers or having milk with cereal. Eat dairy products with naturally lower levels of lactose. These include hard cheeses and yogurt. Look for lactose-free and lactose-reduced milk and milk products. These can be found at many food stores. They are the same as regular milk and milk products. But they have the lactase enzyme added to them. Ask about lactase products. Ask your healthcare provider if you should take a lactase pill or lactase drops when you eat or drink milk products. ​ Children with lactose intolerance should be seen by a healthcare provider. Children and teenagers need dairy foods. They are a major source of calcium for bone growth and health. They also have other nutrients that children need for growth. Source : John Hopkins Medicine ​ ​ Living with Lactose Intolerance ​ With some trial and error, you might be able to predict your body's response to foods containing lactose and figure out how much you can eat or drink without discomfort. Few people have such severe lactose intolerance that they have to cut out all milk products and be wary of nondairy foods or medications that contain lactose. ​ It’s important to read food labels. Lactose is often added to some boxed, canned, frozen, and prepared foods such as: Bread Cereal Lunch meats Salad dressings Cake and cookie mixes Coffee creamers Check food labels for words that may mean a food has lactose in it, such as: Butter Cheese Cream Dried milk Milk solids Powdered milk Whey ​ Source : John Hopkins Medicine ​ ​ Maintaining a Good Dietary Plan ​ Reducing the dairy products doesn't mean you can't get enough calcium. Calcium is found in many other foods, such as: ​ Broccoli and leafy green vegetables Calcium-fortified products, such as cereals and juices Canned salmon or sardines Milk substitutes, such as soy milk and rice milk Oranges Almonds, Brazil nuts and dried beans Also make sure you get enough vitamin D, which is typically supplied in fortified milk. Eggs, liver and yogurt also contain vitamin D, and your body makes vitamin D when you spend time in the sun. ​ Even without restricting dairy foods, though, many adults don't get enough vitamin D. Talk to your doctor about taking vitamin D and calcium supplements to be sure. ​ Source: Mayo Clinic ​ Limit Dairy Products ​ Most people with lactose intolerance can enjoy some milk products without symptoms. You might tolerate low-fat milk products, such as skim milk, better than whole-milk products. It also might be possible to increase your tolerance to dairy products by gradually introducing them into your diet. ​ Ways to change your diet to minimize symptoms of lactose intolerance include: ​ Choosing smaller servings of dairy. Sip small servings of milk — up to 4 ounces (118 milliliters) at a time. The smaller the serving, the less likely it is to cause gastrointestinal problems. Saving milk for mealtimes. Drink milk with other foods. This slows the digestive process and may lessen symptoms of lactose intolerance. Experimenting with an assortment of dairy products. Not all dairy products have the same amount of lactose. For example, hard cheeses, such as Swiss or cheddar, have small amounts of lactose and generally cause no symptoms. Ice cream and milk contain the most lactose, but the high fat content in ice cream might allow you to eat it without symptoms. You might tolerate cultured milk products such as yogurt because the bacteria used in the culturing process naturally produce the enzyme that breaks down lactose. Buying lactose-reduced or lactose-free products. You can find these products at most supermarkets in the dairy section. Using lactase enzyme tablets or drops. Over-the-counter tablets or drops containing the lactase enzyme (Lactaid, others) might help you digest dairy products. You can take tablets just before a meal or snack. Or the drops can be added to a carton of milk. These products don't help everyone who has lactose intolerance. ​ Source: Mayo Clinic ​ Alternative Medicine ​ Probiotics. Probiotics are living organisms present in your intestines that help maintain a healthy digestive system. Probiotics are also available as active or "live" cultures in some yogurts and as supplements in capsule form. They are sometimes used for gastrointestinal conditions, such as diarrhea and irritable bowel syndrome. They might also help your body digest lactose. Probiotics are generally considered safe and might be worth a try if other methods don't help. ​ Source: Mayo Clinic

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The information contained in this section has been procured from HealthyEating.SFgate.com, CentrespringMD.com, VeryWellFit.com, BMCMedicine, Journals.LWW.com, BeyondCeliac.com, and my own personal experience. It is all for educational purposes and not intended to be taken as medical advice . Consult your physician before making changes to your diet What to Expect When Going Gluten Free ​ As you have finally made the decision to start a gluten free diet for medical or personal reasons, you find yourself wondering what to expect or do next. It can be frustrating and intimidating. ​ Your body will undergo through a process that will leave you wondering if that is normal or worth it. Yes it is. However, you most be aware that it will be quite an adjustment, physically, emotionally, and financially. And yes it will be difficult at times for weeks or even months. The two most important things to know and remember are that (1) is a normal part of the process of adjusting to a gluten free diet and (2) you can make it through without breaking the bank in doing so. ​ So let's discuss what to expect when going gluten free: the good, the bad, and the ugly. Cooking Blog HOME Recipes All About Gluten Autoimmune Disease Support Groups Mental Side Effects ​ Starting a gluten free diet will promote changes in your body that will affect your brain... just like any other diet. Just be aware that at first, you might experience some changes in your behavior, that could get to you unless you are aware that this is part of the process. If gluten was a big part of your every day life, your brain is going to miss it. Just remember: it gets better as time passes. Just as your body adjusts to the new diet, your brain also needs to adjust to the changes. You could experience the following: ​ Mood swings Irritability Brain Fog Confusion Here a couple of things you can do to get you through this: Exercise. Be active and get those endorphins naturally flowing. That always helps improve your mental well-being. Educate yourself about the gluten free lifestyle. The more you know the more you will understand what to expect and how to deal with the changes without getting overwhelmed by them. Learn about cross-contact: Cross-contact is when a gluten-free food or food product is exposed to a gluten-containing ingredient or food – making it unsafe for people with celiac disease to eat. There are many obvious (and not-so-obvious) sources of cross-contact at home and in restaurants and other foodservice locations. There is even a risk of cross-contact before ingredients make it to the kitchen, such as during the growing, processing, and manufacturing processes. While it may seem like a challenge to remember and be proactive about all of the possible sources of cross-contact at first, your improved health will make the effort worth it. Read on to better understand some of these sources and what you can do to prevent cross-contact for more information about cross-contact click here. Eat the right things. Very important you supply your brain with the right foods it needs throughout this adjustment period. But what are the right things you need? Fresh fruits and vegetables, lean meats, plenty of fluids, multivitamins, probiotics to aid your digestion, etc. All these things are discussed in more detail below. During these first few days, try to fill your plate with plenty of gluten-free foods you enjoy to avoid feeling overwhelmed. Understand that each person will experience side effects differently. There is not a set time period to adjust to these changes. It could be days, weeks or even months...and that's normal. ​ Source: Healthy Eating Source: BeyondCeliac.org ​ Physical Side Effects ​ The first few days on a gluten-free diet, you might experience a number of physical side effects. Some of this side effects could be debilitating and downright annoying, yet it's normal. Your body is detoxing from the gluten, adjusting to the new diet... and it will sometimes fight back. Here are some of the things you might experience : ​ Headaches Bloating Constipation Diarrhea Skin outbreaks Nausea Fatigue Hair loss Joint pain Muscle aches ​ Here are some things you can do to help with these side effects: Understand that each person will experience side effects differently. There is not a set time period to adjust to these changes. It could be days, weeks or even months...and that's normal. Eat fresh fruits and vegetables. Eating fresh fruits and vegetables will help supply your body with fiber that will aid digestion and help settle your GI system. Consume lean meats. Avoid red meats for a while. Let your gut adjust to the new diet. Be aware of diets that might increase your risk of disease. Aside from being diagnosed with celiac disease, gluten allergy or intolerance, or having been diagnosed with an autoimmune disorder that requires a strict dietary restriction, one reason many people are going gluten-free is because they're following the "Paleo Diet "or another "Low-carb Diet"... which advocates going grain-free (and therefore gluten-free). This caveman style of eating also encourages eating more meat. Research shows that following a low-carb diet and increasing your protein intake can put you at risk for heart disease, diabetes, and other diseases. Moreover, a 2018 study from Circulation showed that higher intake of animal protein has been associated with increased cardiovascular risk. But by balancing your diet with more plant-based protein, gluten-free whole grains, and plenty of veggies and fruits, you can reduce your risk for disease. Drink plenty of water. Doing this will help to avoid constipation. Find a good probiotic and multivitamins to prevent a nutritional deficiency. Your body will need some help in getting nutrients that due to the change in diet and beginner's confusion you might not be getting anymore or not in the recommended daily amounts as you normally would. When you eliminate wheat, barley, and rye from your meals, you're not just getting rid of gluten, you're lowering your intake of a wide range of other nutrients that tend to come in those foods, including iron, fiber, folic acid, zinc, vitamin D, and more. Prevent Folate Deficiency. This is very important and will be discussed in length below. Learn about cross-contact: Cross-contact is when a gluten-free food or food product is exposed to a gluten-containing ingredient or food – making it unsafe for people with celiac disease to eat. There are many obvious (and not-so-obvious) sources of cross-contact at home and in restaurants and other foodservice locations. There is even a risk of cross-contact before ingredients make it to the kitchen, such as during the growing, processing, and manufacturing processes. While it may seem like a challenge to remember and be proactive about all of the possible sources of cross-contact at first, your improved health will make the effort worth it. Read on to better understand some of these sources and what you can do to prevent cross-contact for more information about cross-contact click here. Do not re-introduce gluten into your diet. If you reintroduce gluten back into your diet, you will never be able to overcome the beginning stages of adjustment. When you were eating gluten every day, you may not have had reactions to individual instances of accidental gluten ingestion. However, once you remove it from your diet, you may find your body is more sensitive to trace amounts of gluten found in cross-contact in your food. You could also find that you're more sensitive to that single bite of glutenous cake that you just couldn't resist. Sensitivity to trace gluten and cross-contact is a common side effect of the gluten-free diet, and the level and severity of sensitivity can vary from person to person. A reaction to gluten in your food may come quickly within an hour or less in some cases, or may not appear until the next day or even later. Your digestive symptoms may come in the form of the following: ​ Constipation Diarrhea Gas Reflux Vomiting You may also experience other symptoms, including: Brain fog Bouts of depression Fatigue Joint pain Abdominal pain ​ Source: Healthy Eating Source: Prevention.com Source: VeryWellFit.com ​ Folate Deficiency While this change is health-promoting for so many people, there’s one thing you need to be mindful when you cut out processed breads and other enriched flours from your life: Folate Deficiency. Folate is a naturally occurring B-vitamin found in many foods. Due to its importance for our own health and for the health of developing fetuses in pregnant women, many foods have been fortified with folic acid (a synthetic version of folate). These include bread, cereal, flour, cornmeal, pasta, rice, and other grain products. However, just because you choose not to eat foods from those categories doesn’t mean you have to decrease your intake of folate. The hope is that you are replacing those foods with healthy, whole fruits and vegetables. If that’s the case, you should be in the clear! Some examples of folate-rich foods are: ​ Dark leafy greens like spinach and kale Cruciferous vegetables like broccoli, cauliflower and Brussels sprouts Other green vegetables like asparagus and okra Legumes like beans and lentils Colorful fruits like papaya, oranges and strawberries Avocado Nuts and seeds If you include at least a couple servings per day from the foods listed above, your folate intake will be just fine. Many people also choose to take a folate supplement. This can come in the form of: ​ A multivitamin for kids A B-complex vitamin for adults Or folate alone ​ f you do chose to supplement, Dr. Jamilet Alegria , M.D. recommends that you consider taking the active form of folate (5-methyltetrahydrofolate) as some people are unable to process and effectively use the inactive folic acid. ​ Taking on a gluten-free diet can be a great step towards better health for you or your child. Don’t let concerns over folate deficiency stop you from enjoying the benefits of this new lifestyle! ​ Source: CentreSpringMD ​ Body Weight Fluctuation ​ At first, at gluten free diet could seems as a balancing act. During my early days of adjusting to the lifestyle, my own experience was marked with a sudden weight lost of almost 20 pounds in two months. Once I understood what my body needed and how to provide or eliminate certain things from my diet, my weight became healthy and stable. However every person reacts to the weight fluctuation differently. If you have celiac disease and experienced malabsorption of nutrients that led to weight loss and/or other health issues, a 2019 review published in BMC Medicine found that a gluten-free diet can lead to weight gain, since many gluten-free foods tend to be higher in vegetable fats, sugars, and carbs ​ But not all people with celiac disease are underweight prior to their medical diagnosis. A 2010 study published in Journal of Clinical Gastroenterology observed the effects of a gluten-free diet on 61% of newly diagnosed celiacs who were considered normal weight, 17% percent who were underweight, 15% percent who were overweight, and 7% who were obese. ​ The researchers noted that a gluten-free diet helped to regulate body weight to normal levels in the subjects who were either underweight or overweight. ​ Therefore, your weight could normalize as a side effect of the gluten-free diet. Many people also mistakenly believe a gluten-free diet will automatically lead to weight loss. If you indulge in too many gluten-free snack foods (which tend to be high in calories and low in nutrition, just like their conventional counterparts), you could find yourself packing on a few extra pounds. ​ Some of the things recommended to help with weigh fluctuation are: ​ Consult your physician. Nobody will know you medical history better than you and your physician. Not every single dietary plan works for everyone... specially if you are struggling with multiple autoimmune disorders or medical conditions as well as starting your gluten free journey. Always and foremost ask for advice to a professional primary care physician. Bloggers like myself can provide you with educational tools to help you through this adjustment process but are not supposed to give medical advice. That's your physician's job. Exercise. Be active and get those endorphins naturally flowing. That always helps improve your mental well-being and your overall health. Educate yourself about the gluten free lifestyle. The more you know the more you will understand what to expect and how to deal with the changes without getting overwhelmed by them. Eat the right things. Very important you supply your body with the right foods it needs throughout this adjustment period. But what are the right things you need? Fresh fruits and vegetables, lean meats, plenty of fluids, multivitamins, probiotics to aid your digestion, etc. Research products. Read labels and ingredients. You need to familiarize yourself with the products that actually will work best for you on your gluten free journey. Keep in mind that gluten free processed foods are still processed foods and will contain the fats, carbs, sugars, preservatives and additives like regular processed foods. ​ Source: VeryWellFit.com Source: BMCMedicine Source: Journals.lww.com ​ Be Aware of Hidden Gluten in Medications ​ Gluten can be used in the excipients of medication. Excipients are the binders that hold medicine together. It is important that people with celiac disease work with their doctor or pharmacist to make sure their medications are gluten-free. The manufacturer should also be able to help you determine if the medication you will be taking is gluten-free or if it is not safe for people with celiac disease. ​ Source: BeyondCeliac.org ​ The Problem with Gluten in Medication ​ There are currently no requirements for labeling gluten or common allergens found in drug ingredients There are no specific precautions for individuals with celiac disease in labeling Potential sources of gluten in medications are not well-recognized by healthcare professionals Generic drugs may use different binders than name brand drugs ​ Source: BeyondCeliac.org ​ Starches Found in Medications ​ The following inactive ingredients are considered “red flags,” as they may be sourced from wheat, barley or rye. If you see a red flag ingredient, it means that more information is needed to find out if the drug’s ingredients contain gluten. Some ingredients are more obvious than others. ​ Wheat Modified starch (if source is not specified) Pregelatinized starch (if source is not specified) Pregelatinized modified starch (if source is not specified) Dextrates (if source is not specified) Dextrin (if source is not specified; the source is usually corn or potato which is acceptable) Dextrimaltose (when barley malt is used) Caramel coloring (when barley malt is used) ​ Source: BeyondCeliac.org How to Get Answers ​ Getting answers about gluten in your medication can be challenging. Your best sources of information are your physician, pharmacist and the drug manufacturer. There are some lists available online, however, it is extremely important that you double check any claims found on the internet with those mentioned above to be sure that your medication is truly gluten-free. ​ For help getting started, you can access a free drug list at GlutenFreeDrugs.com . ​ Source: BeyondCeliac.org Shopping Gluten Free and Relieving Financial Stress ​ Going gluten free at first is going to feel like is hitting your wallet hard. That's because (a) we tend to panic and go on a shopping spree and buy whatever gluten free item we see at the store, trying to substitute what we can't have anymore with gluten free alternatives; (b) in our confusion we buy expensive items that are truly not worth the money, are bad for your health, and are overall just horrible products; or (c) we don't realize that gluten-free products, such as breads, pretzels, pasta, cookies, pastries, and crackers cost 139 percent more, on average, than their wheat-based counterpart of the same product. ​ I think the greatest and most important thing I have found since beginning this journey a decade ago is that the majority of the edible products geared to the gluten free community are either overpriced, unhealthy, or have terrible taste or texture. Not all of them but a great number of things. And the truth is that some corporations are just trying to cash out on the gluten-free bandwagon while others are truly trying to provide the gluten free community with good healthy and delicious products... at a price, of course. ​ Going gluten free doesn't have to be a financial burden if you do your research first. Yes, there are some things you will need to buy that are necessary for your everyday life, which may be a little more expensive from what you normally budget and pay for. But these are things that if you are celiac, have a wheat allergy, or are gluten sensitive, you will need to get the gluten free version no matter what. Why? Because the original products do contain hidden gluten. Shocking, no? Some of these products are: ​ Oral Products and Oral Care (tooth paste, mouthwash, oral cleansers, dental strips, and lip balms, breath sprays). Scroll below to Cosmetics, Medications & Toys for more information. Cosmetics & Hygiene Products (lipsticks, lip gloss, foundations, facial moisturizers, mascara, powders, makeup removers, soaps, shampoos, conditioners, and some lotions). Scroll below to Cosmetics, Medications & Toys for more information. Condiments & Spices . Gluten is used for flavor, thickening agent or as an additive to prevent "caking' in powders and spices. Scroll below to "Where Gluten Is Found" , Hidden Gluten" and Is it Gluten Free Or Not?" for more information. ​ There are a couple of things you can do to avoid the pit fall of expending a lot of money when going gluten free: Research things before buying them. T ake your time at the store and read the labels. Not everything labeled gluten-free is good for you. Use helpful apps to identify products and ingredients. Using these apps could be a lifesaver when unsure about a product and may help you save money by choosing the right products. Plan ahead what you need before going shopping. Don't go hungry to the store and just start shopping with your stomach. You will spend a lot of money that way. Trust me...I know. I've have done it before! Learn how to make things yourself. By learning how to cook things you will realize there is a plethora of ingredients, dishes, and foods from all over the world that are actually naturally gluten free, healthy, delicious, and above all: it won't break the bank. Do meal prepping to save time and money. If you don't have much time to cook a fresh meal every day, just do some meal prepping, refrigerate or freeze, and then consume when you need it. Doing this will help you plan for meals and budget your money better. Avoid certain gluten free products until you know more about them. Breads, flours, pasta, pastries, baking mixes, spices, beverages, pizzas, etc. They tend to be very expensive and most of them are horrible when it comes to taste and textures. Give yourself sometime to research and ask others living a gluten free lifestyle for suggestions regarding products. Go to places that offer gluten free foods in their everyday menu. Guess what? There are many restaurants that already serve food and dishes that are naturally gluten free. All you have to do is research a little, ask questions, and ensure that the facilities do practice safety protocols in order to avoid cross-contact. Some good examples of these restaurants are: Southeast Asian: rice noodles, fish sauce, and coconut-based foods are naturally gluten-free. Indian: rice, chickpeas (also called “gram flour”), and curries are naturally gluten-free. Japanese and Korean: rice, seafood, and meat are naturally gluten-free, but be aware that most sauces will contain soy sauce (wheat). Ask for tamari if available. Avoid Udon or ramen noodles, which are made with wheat. South American: rice, beans, corn, and tapioca-based products are plentiful. This is a very easy cuisine to navigate gluten-free. African and Middle Eastern: teff, millet, lentils, and cassava (tapioca) are commonly used starches and naturally gluten-free. Spanish, Latin, and Caribbean: rice, beans, corn, seafood, grilled and baked meat based dishes, salads and vegetables, etc. Mediterranean: most Mediterranean cuisines have a lot of dishes that are naturally gluten free (Greek, Italian, Spanish, Israeli, Egyptian, Lebanese, Croatian, Moroccan, Turkish, etc). European Countries: Some European cuisines can be challenging to navigate gluten-free, but many European countries include allergen labeling on packaged foods and in restaurants, making it easier to identify products that contain gluten. Use resources available to you ( apps , support groups , international organizations , social media groups , magazines and publications , and blogs & websites like this one with free recipes and information for everyone to use). ​ Source: Celiac.org ​ Cheesecakes About Joe Contact Joe Where Gluten is Found Hidden Gluten Is it Gluten Free or Not? Distilled Beverages & Vinegars Cosmetics, Medications & Toys Cross-Contact & Cross-Contamination What to do when "Glutened"

The information contained in this section has been procured from John Hopkins Medicine , the Mayo Clinic and Lupus Corner. It is all for educational purposes and not intended to be taken as medical advice . What is Lupus Nephritis? ​ Lupus nephritis is a frequent complication in people who have systemic lupus erythematosus — more commonly known as lupus. ​ Lupus is an autoimmune disease. It causes your immune system to produce proteins called autoantibodies that attack your own tissues and organs, including the kidneys. ​ Lupus nephritis occurs when lupus autoantibodies affect structures in your kidneys that filter out waste. This causes kidney inflammation and may lead to blood in the urine, protein in the urine, high blood pressure, impaired kidney function or even kidney failure. Cooking Blog Source: Mayo Clinic ​ HOME Recipes All About Gluten Autoimmune Disorders Support Groups Cheesecakes About Joe Contact Joe Type 1 Diabetes Causes ​ As many as half of adults with systemic lupus develop lupus nephritis. Systemic lupus causes immune system proteins to damage the kidneys, harming their ability to filter out waste. ​ Source: Mayo Clinic Four Major Types of Lupus ​ 1. Systemic Lupus Erythematosus Systemic lupus erythematosus (SLE) is the most common form of lupus. When people talk about lupus in general, this is the type they’re most likely referring to. SLE affects many organs, especially skin, joints and kidneys. ​ 2. Lupus of the Skin There are three types: ​ Acute cutaneous lupus Chronic cutaneous lupus erythematosus, or discoid lupus erythematosus (DLE). The main symptom of chronic cutaneous lupus erythematosus, or DLE, is a rash that can leave major scars. It’s typically on your face, neck and scalp, but may also be on or in your ears and, less frequently, on your upper torso. These scaly areas slowly expand at the edges and then heal, leaving discolored skin and sunken scars. DLE on your scalp can cause permanent hair loss. This type of lupus is more common in smokers and African-Americans. Subacute cutaneous lupus erythematosus ​ A skin biopsy is sometimes necessary to diagnose these types of lupus, as each has its own characteristic lesions and patterns. ​ 3. Chronic Cutaneous Lupus Erythematosus The main symptom of chronic cutaneous lupus erythematosus, or DLE, is a rash that can leave major scars. It’s typically on your face, neck and scalp, but may also be on or in your ears and, less frequently, on your upper torso. These scaly areas slowly expand at the edges and then heal, leaving discolored skin and sunken scars. DLE on your scalp can cause permanent hair loss. This type of lupus is more common in smokers and African-Americans. ​ 4. Drug-Induced Lupus Erythematosus This type of lupus is separate from SLE and is caused by taking certain prescription drugs. The presentation of drug-induced lupus is like SLE, including joints and inflammation around the lungs. The drugs most commonly connected with drug-induced lupus include: ​ Hydralazine: used (rarely) to treat high blood pressure or hypertension Procainamide: used (rarely) to treat irregular heart rhythms Isoniazid: used to treat tuberculosis Minocycline: used to treat acne Anti-TNF: used to treat rheumatoid arthritis, psoriatic arthritis and spondyloarthropathy Source : John Hopkins Medicine Neonatal Lupus Erythematosus ​ Neonatal lupus is a rare condition that affects babies of women who have anti-Ro and anti-La antibodies. These antibodies from the mother act on the baby’s heart conduction system. At birth, the infant may have a skin rash, liver problems or low blood cell count. ​ Source: John Hopkins Medicine ​ Symptoms and Signs of Lupus ​ Signs and symptoms of lupus nephritis include: ​ Blood in your urine Foamy urine (due to excess protein in urine) High blood pressure Swelling in your hands, ankles or feet High levels of a waste product called creatinine in your blood Sores in your mouth or nose Hair loss visible to others Rash lasting for days to weeks in areas that have been exposed to the sun Swollen or stiff joints, which may be worse in the morning Chest pain with every deep breath, lasting more than 24 hours Pale fingers that may become numb and tingle when exposed to cold or stress (Raynaud’s phenomenon) Low blood counts Fever Weight loss ​ Source: Mayo Clinic Source: John Hopkins Medicine ​ Who’s at the highest risk of developing lupus? ​ We do know who has a stronger chance of developing lupus: ​ Gender: Even though anyone can get lupus, it most often affects women. They’re nine to ten times more likely than men to develop it. Age: Lupus can occur at any age, but most are diagnosed in their 20s and 30s. Race: Lupus is two to three times more common in African-American women than in Caucasian women. It’s also more common in Hispanic, Asian, and Native American women. African-American and Hispanic women are more likely to have severe forms of lupus. Family history: Relatives of people with lupus have a greater chance of developing lupus. Only about 2 percent of children whose mothers have lupus will develop it. ​ Source: John Hopkins Medicine ​ Testing ​ Several tests can help your doctor determine if you have lupus and — if you do have it — its severity. You will usually have the following tests. The details they gather are all pieces of the puzzle that can lead to a lupus diagnosis. ​ Complete blood count (CBC) : checks for low counts of red blood cells, white blood cells and platelets. Complement tests: measures the level of complement — proteins in your blood that help destroy foreign substances. Low levels of complement can indicate lupus. Chemistry panel: assesses your kidney and liver functions. Urinalysis and urine protein-to-creatinine ratio: assesses for lupus of the kidneys. Lupus autoantibody tests: tests for anti-dsDNA, anti-Sm, anti-RNP, anti-Ro, anti-La, Coombs and antiphospholipid antibodies. Source: John Hopkins Medicine Diagnosis ​ Tests to diagnose lupus nephritis include: ​ Blood and urine tests. In addition to standard blood and urine tests, you may be asked to collect your urine for an entire day. These tests measure how well your kidneys are working. Kidney biopsy. A biopsy — where your doctor removes a small section of kidney tissue for lab analysis — is the most definitive test for diagnosing lupus nephritis. It can also help determine how severe your disease is. ​ Source: Mayo Clinic ​ Treatment ​ There's no cure for lupus nephritis. Treatment aims to: ​ Reduce symptoms or make symptoms disappear (remission) Keep the disease from getting worse Maintain remission Avoid the need for dialysis or a kidney transplant Source: Mayo Clinic Current Treatments Available The following are some of the medication-based treatments available: ​ Hydroxychloroquine: an antimalarial drug that is effective for treating lupus-related arthritis and rashes. It reduces flares by 50 percent and may also help prevent blood clots. Corticosteroids and immune suppressants: often recommended for people with serious or life-threatening problems such as kidney inflammation, lung, heart or central nervous system lupus. This includes high-dose corticosteroids such as prednisone and drugs that suppress the immune system, such as azathioprine, cyclophosphamide, mycophenolate and methotrexate. Biologics : target specific parts of the immune system instead of affecting many areas of the immune system. Belimumab is FDA-approved for treating lupus. Source: John Hopkins Medicine ​ Immune suppressants ​ For severe lupus nephritis, you might take drugs that slow or stop the immune system from attacking healthy cells, such as: ​ Steroids, such as prednisone Cyclosporine Tacrolimus Cyclophosphamide Azathioprine (Imuran) Mycophenolate (CellCept) Rituximab (Rituxan) When immunosuppressive therapies don't lead to remission, clinical trials may be available for new therapies. ​ Source: Mayo Clinic ​ Treatment options for kidney failure ​ For people who progress to kidney failure, treatment options include: ​ Dialysis. Dialysis helps remove fluid and waste from the body, maintain the right balance of minerals in the blood, and manage blood pressure by filtering your blood through a machine. Kidney transplant. You may need a new kidney from a donor if your kidneys can no longer function. ​ Source: Mayo Clinic Conservative treatments ​ In general, doctors may recommend these treatments for people with kidney disease: ​ Diet changes. Limiting the amount of protein and salt in your diet can improve kidney function. Blood pressure medications. Drugs called angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) can help control blood pressure. These drugs also prevent protein from leaking from the kidneys into the urine. Drugs called diuretics can help you get rid of excess fluid. ​ However, conservative treatment alone isn't effective for lupus nephritis. ​ Source: Mayo Clinic ​ Other Treatments for Lupus-related Complications ​ Your doctors may prescribe other medications to treat problems that are common with lupus. Some of those include: ​ Anticonvulsants for seizures Antibiotics for infections Antihypertensive drugs for high blood pressure Statins for high cholesterol Drugs for osteoporosis Vitamin D to help improve kidney lupus ​ Source: John Hopkins Medicine ​ ​ Living with Lupus ​ Maintaining a healthy lifestyle can help manage your lupus symptoms. Here are a few easy ways to take care of yourself: ​ Eat a heart-healthy diet. Maintain a healthy weight. Exercise several times a week. Reduce your sun exposure by staying out of the sun as much as possible, wearing clothes that cover your skin and using sunscreen of SPF 100. See your doctor for infections. Don’t smoke. ​ Source: John Hopkins Medicine ​ ​ Lupus and Gluten ​ Gluten intolerance and celiac disease frequently coexist with lupus. In one survey, the percentage of people with autoimmune diseases and celiac disease was as high as 30% (with the general population having a rate of autoimmune disease ranging from 3-9.4%). However, most scientists do not believe that there is a causal link to lupus. ​ Instead, people with these conditions might share genes or gene combinations that make them more susceptible to autoimmune diseases, allergies , and intolerances to otherwise harmless proteins. The length of time that a person is exposed to gluten doesn’t appear to have an effect , which supports this theory. ​ A gluten-free diet also did not prevent autoimmune disease in a 2002 study. But, that doesn’t mean that gluten-free diets don’t have value to people with lupus. ​ Source: LupusCorner ​ Lupus and a Gluten Free Diet ​ For people with gluten intolerance or celiacs, gluten can cause flares , worsen symptoms, and trigger the onset of disease . Gluten is also known to affect the microbiome, the colonies of bacteria that call our gut home . This complex network is highly connected to lupus and other autoimmune diseases. Because it does affect these systems, a gluten free diet can potentially help people with lupus who also have gluten intolerances or sensitivities. ​ Source: LupusCorner ​ Is it Lupus or Celiac Disease? ​ Gluten intolerance can have both gut and non-gut-related symptoms. It can even be mistaken for SLE . because the inflammatory markers and symptoms can look almost exactly the same . This makes sense as both are caused by similar immune system issues firmly rooted in genetics. ​ In fact, this 2004 study provides a case where three different people presented symptoms that were diagnosed as lupus, but were really gluten sensitivity. ​ So how can you tell the difference? ​ Going on a gluten-free diet will help with an intolerance, but will have only a limited effect on lupus. Also, if you don’t have gluten intolerance, a restrictive diet won’t help very much with lupus. Figuring out your personal needs and tolerances is key. ​ Lupus medications will have less of an effect on gluten intolerance because they aren’t treating the core issue. ​ Talk to your lupus treatment team if you suspect that you may be intolerant, have lupus, or potentially both. Figuring out what is going on with your body is the first step to finding the medical regimen – and diet – that is best for you. ​ Source: LupusCorner

The information contained in this section has been procured from the Mayo Clinic , John Hopkins Medicine and VeryWellHealth. It is all for educational purposes and not intended to be taken as medical advice . What is Gastritis? ​ Gastritis is a general term for a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers. Regular use of certain pain relievers and drinking too much alcohol also can contribute to gastritis. ​ Gastritis may occur suddenly (acute gastritis), or appear slowly over time (chronic gastritis). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn't serious and improves quickly with treatment. Cooking Blog Source: Mayo Clinic HOME Recipes All About Gluten Autoimmune Disorders Support Groups Cheesecakes About Joe Contact Joe Wheat Allergy What causes Gastritis? ​ Gastritis is an inflammation of the stomach lining. Weaknesses or injury to the mucus-lined barrier that protects your stomach wall allows your digestive juices to damage and inflame your stomach lining. A number of diseases and conditions can increase your risk of gastritis, including Crohn's disease and sarcoidosis, a condition in which collections of inflammatory cells grow in the body. ​ Gastritis may be caused by many things. It can be caused by diet and lifestyle habits such as: Drinking too much alcohol Eating spicy foods Smoking Extreme stress Long-term use of aspirin and over-the-counter pain and fever medicines (nonsteroidal anti-inflammatory drugs or NSAIDs) Health issues that can lead to gastritis include: Infections caused by bacteria and viruses Major surgery Traumatic injury or burns Some diseases can also cause gastritis. These include: Autoimmune disorders. When your immune system attacks your body’s healthy cells by mistake. Chronic bile reflux. When bile, a fluid that helps with digestion, backs up into your stomach and food pipe (esophagus). Pernicious anemia. A form of anemia that happens when your stomach is not able to digest vitamin B12. ​ Source: Mayo Clinic Source: John Hopkins Medicine ​ Risk Factors for Gastritis ​ Factors that increase your risk of gastritis include: ​ Bacterial infection. Although infection with Helicobacter pylori is among the most common worldwide human infections, only some people with the infection develop gastritis or other upper gastrointestinal disorders. Doctors believe vulnerability to the bacterium could be inherited or could be caused by lifestyle choices, such as smoking and diet. Regular use of pain relievers. Common pain relievers — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, Anaprox) — can cause both acute gastritis and chronic gastritis. Using these pain relievers regularly or taking too much of these drugs may reduce a key substance that helps preserve the protective lining of your stomach. Older age. Older adults have an increased risk of gastritis because the stomach lining tends to thin with age and because older adults are more likely to have H. pylori infection or autoimmune disorders than younger people are. Excessive alcohol use. Alcohol can irritate and erode your stomach lining, which makes your stomach more vulnerable to digestive juices. Excessive alcohol use is more likely to cause acute gastritis. Stress. Severe stress due to major surgery, injury, burns or severe infections can cause acute gastritis. Your own body attacking cells in your stomach. Called autoimmune gastritis, this type of gastritis occurs when your body attacks the cells that make up your stomach lining. This reaction can wear away at your stomach's protective barrier. Autoimmune gastritis is more common in people with other autoimmune disorders, including Hashimoto's disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency. Other diseases and conditions. Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn's disease and parasitic infections. Source: Mayo Clinic ​ Symptoms of Gastritis ​ Each person’s symptoms may vary. Gastritis doesn't always cause signs and symptoms. The most common symptoms of gastritis include: ​ Stomach upset or pain Belching and hiccups Belly or abdominal bleeding Nausea and vomiting Feeling of fullness or burning in your stomach Loss of appetite Blood in your vomit or stool (a sign that your stomach lining may be bleeding) The symptoms of gastritis may look like other health problems. Always see your healthcare provider to be sure. Source: Mayo Clinic Source: John Hopkins Medicine ​ Complications ​ Left untreated, gastritis may lead to stomach ulcers and stomach bleeding. Rarely, some forms of chronic gastritis may increase your risk of stomach cancer, especially if you have extensive thinning of the stomach lining and changes in the lining's cells. ​ Tell your doctor if your signs and symptoms aren't improving despite treatment for gastritis. ​ Chronic gastritis hurts your stomach lining. It can raise your risk for other health problems such as: ​ Peptic ulcer disease, painful sores in your upper digestive tract Gastric polyps, small masses of cells that form on the inside lining of your stomach Stomach tumors, both cancerous and non-cancerous You may also get atrophic gastritis. This can happen if your gastritis is caused by the H. pylori bacteria or by an autoimmune disorder. Atrophic gastritis destroys the stomach lining cells that make your digestive juices. This raises your risk for getting stomach cancer. ​ Source: Mayo Clinic Source: John Hopkins Medicine ​ ​ Diagnosis & Testing ​ Your healthcare provider will give you a physical exam and ask about your past health. You may also have tests including: ​ Upper GI (gastrointestinal) series or barium swallow. This X-ray checks the organs of the top part of your digestive system. It checks the esophagus, stomach, and the first part of your small intestine (duodenum). You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on the X-ray. Upper endoscopy, also called EGD (esophagogastroduodenoscopy). This test looks at the inside of your esophagus, stomach, and duodenum. It uses a thin, lighted tube, called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of these organs. He or she can also take a small tissue sample (biopsy) if needed. Blood tests. You will have a test for H. pylori, a type of bacteria that may be in your stomach. Another test will check for anemia. You can get anemia when you don’t have enough red blood cells. Stool spectrum. This test checks to see if you have stomach bacteria that can cause gastritis. A small sample of your stool is collected and sent to a lab. Another stool specimen can check for blood in your stool which may be a sign of gastritis if there has been bleeding. Breath test. You may have a test where your breath is collected and analyzed for a stomach bacteria. Tests for H. pylori. Your doctor may recommend tests to determine whether you have the bacterium H. pylori. Which type of test you undergo depends on your situation. H. pylori may be detected in a blood test, in a stool test or by a breath test. ​ Source: John Hopkins Medicine Source : Mayo Clinic ​ Treatments ​ Your healthcare provider will make a care plan for you based on: ​ Your age, overall health, and past health How serious your case is How well you handle certain medicines, treatments, or therapies If your condition is expected to get worse What you would like to do Tr eatment of gastritis depends on the specific cause. Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances. ​ Medications used to treat gastritis include: ​ Antibiotic medications to kill H. pylori. For H. pylori in your digestive tract, your doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin) and amoxicillin (Amoxil, Augmentin, others) or metronidazole (Flagyl), to kill the bacterium. Be sure to take the full antibiotic prescription, usually for seven to 14 days. Medications that block acid production and promote healing. Proton pump inhibitors reduce acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant) and pantoprazole (Protonix). Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist and spine fractures. Ask your doctor whether a calcium supplement may reduce this risk. Medications to reduce acid production. Acid blockers — also called histamine (H-2) blockers — reduce the amount of acid released into your digestive tract, which relieves gastritis pain and encourages healing. Available by prescription or over-the-counter, acid blockers include famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine (Axid AR). Antacids that neutralize stomach acid. Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients. Source: John Hopkins Medicine Source : Mayo Clinic ​ ​ Gastritis Prevention ​ Experts don’t know it is possible to stop gastritis from happening. But you may lower your risk of getting the disease by: ​ Having good hygiene habits, especially washing your hands. This can keep you from getting the H. pylori bacteria. Not eating or drinking things that can irritate your stomach lining. This includes alcohol, caffeine, and spicy foods. Not taking medicines such as aspirin and over-the-counter pain and fever medicines (nonsteroidal anti-inflammatory drugs or NSAIDS). ​ Source: John Hopkins Medicine ​ ​ Living with Gastritis ​ You may find some relief from signs and symptoms if you: ​ Eat smaller, more-frequent meals. If you experience frequent indigestion, eat smaller meals more often to help ease the effects of stomach acid. Avoid irritating foods. Avoid foods that irritate your stomach, especially those that are spicy, acidic, fried or fatty. Avoid alcohol. Alcohol can irritate the mucous lining of your stomach. Consider switching pain relievers. If you use pain relievers that increase your risk of gastritis, ask your doctor whether acetaminophen (Tylenol, others) may be an option for you. This medication is less likely to aggravate your stomach problem. ​ Source: Mayo Clinic ​ What to Eat and Avoid when Suffering from Gastritis ​ If you have celiac disease and need to avoid gluten and wheat, you may need to be careful about the gluten-free alternatives you choose. Some popular options, such as pasta made from corn, are not suitable for a gastritis diet. ​ Below is a list of safe (compliant) and non-safe (non-compliant) foods for those with gastritis: ​ Compliant ​ Beans and legumes (as tolerated) Eggs, egg whites, or egg substitutes (not fried) Seafood, shellfish (not fried) Honey Low-acid vegetables (cucumber, white potato, carrots) Low-sugar, low-acid fruit (pumpkin, blueberries, strawberries, apples) Mild, low-salt cheese Oats, barley (avoid if you have celiac disease or Gluten allergy, sensitivity, or intolerance) Peppermint, ginger, turmeric Plain, low-fat yogurt Probiotic-rich foods (sauerkraut, kimchi, kombucha) Rice Skinless lean poultry (chicken, turkey) Whole grain bread and pasta (avoid if you have celiac disease or Gluten allergy, sensitivity, or intolerance) ​ Non-Compliant ​ Acidic fruits (citrus) and vegetables (onion) Alcohol Chocolate Coffee and Tea Corn and products made with corn (pasta, bread) Dairy products Energy drinks Fatty/greasy food, fast food, spicy food Fried or hard-boiled eggs Garlic (small amounts as tolerated) Ice cream, cakes, and pastries, baked goods Marinades, salsa, mayonnaise, creamy sauces Nuts and nut butter (small amounts may be tolerated) Potato chips, packaged snacks Processed meat (sausage, hot dogs), lunch meat Red meat, duck, goose Refined grains, fresh bread, pasta made with refined flour Smoked meats Soda, carbonated beverages Spices, herbs, seasonings (especially black pepper) Tomato and tomato products (juice, paste, sauce) Source: VeryWellHealth ​ Fruits and Vegetables ​ Produce that is very acidic, especially citrus fruit and tomatoes, are best avoided if you have gastritis. Vegetables used to add spice or a lot of flavors, such as onions, can also be hard to tolerate if you have stomach irritation. ​ Instead, choose low-acid or more neutral (alkaline) fruits and veggies—preferably those that are good sources of fiber—such as apples, berries, pumpkin, and carrots. ​ Source: VeryWellHealth ​ Grains ​ For the most part you’ll want to choose whole grain bread, brown rice, pasta, and other grains. However, if you are having gastritis symptoms that are making it harder for you to eat, plain white rice or white potato can be easier to digest . ​ Oats, barley, and quinoa are other nutritious options. I f you do not eat wheat, avoid pasta alternatives or bread made from corn, which is not approved for a gastritis diet. ​ Source: VeryWellHealth ​ Dairy You’ll want to avoid full-fat dairy products, but low-fat yogurt that’s also low in sugar and packed with probiotics can be a healthy addition to a gastritis diet. Some hard cheeses that are low in salt may be tolerated in small portions. You’ll want to avoid any sauces, fillings, or puddings made with rich, heavy cream. ​ Source: VeryWellHealth ​ Protein Eggs, egg whites, and egg substitutes can be an excellent source of protein. However, you will want to prepare them soft-boiled, poached, or scrambled rather than fried. Avoid pairing them with salty, processed, breakfast meat like sausage or ham, refrain from adding butter or milk, and avoid seasoning (even black pepper). ​ Red meat is not approved, but you may choose from lean cuts of turkey or chicken and some seafood (as long as it isn’t fried). ​ Nuts and nut butter, as well as beans and legumes, can be high in fat but they are versatile sources of protein to include in your diet. Start with smaller portions (without added sugar) and see what you are able to tolerate. ​ Source: VeryWellHealth ​ ​ Desserts Any food that is high in fat and sugar should be avoided on the gastritis diet. Baked goods, pastries, and ice cream or puddings tend to be rich and can irritate an inflamed stomach (especially if they are made with dairy). Chocolate is also not approved. ​ Source: VeryWellHealth ​ Beverages Some people with mild gastritis can tolerate weak tea or coffee with a splash of low-fat milk or non-dairy creamer. Honey can also be added to tea. In general, though, these beverages are very acidic and not approved for a gastritis diet. ​ Cold drinks with a lot of sugar, such as soda and energy drinks, are also not approved. Acidic juices (such as orange juice or other citrus fruit, as well as tomato juice) are not approved. Some fruit juice may be OK, but choose varieties that are low in sugar. ​ Avoid alcoholic beverages, including wine, beer, and cocktails. If you drink alcohol, your doctor will likely advise you to stop if you have gastritis. ​ Source: VeryWellHealth

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The information contained in this section has been procured from the Mayo Clinic, John Hopkins Medicine, and Healtfully.com. It is all for educational purposes and not intended to be taken as medical advice . What is Hashimoto's Disease? ​ Hashimoto's disease is a condition in which your immune system attacks your thyroid, a small gland at the base of your neck below your Adam's apple. The thyroid gland is part of your endocrine system, which produces hormones that coordinate many of your body's functions. ​ Inflammation from Hashimoto's disease, also known as chronic lymphocytic thyroiditis, often leads to an underactive thyroid gland (hypothyroidism). Hashimoto's disease is the most common cause of hypothyroidism. It primarily affects middle-aged women but can also occur in men and women of any age and in children. ​ Doctors test your thyroid function to help detect Hashimoto's disease. Treatment of Hashimoto's disease with thyroid hormone replacement usually is simple and effective. Cooking Blog ​ HOME Recipes All About Gluten Autoimmune Disorders Support Groups Cheesecakes About Joe Contact Joe Rheumatoid Arthritis Symptoms ​ You might not notice signs or symptoms of Hashimoto's disease at first, or you may notice a swelling at the front of your throat (goiter). Hashimoto's disease typically progresses slowly over years and causes chronic thyroid damage, leading to a drop in thyroid hormone levels in your blood. The signs and symptoms are mainly those of an underactive thyroid gland (hypothyroidism). ​ Signs and symptoms of hypothyroidism include: ​ Fatigue and sluggishness Increased sensitivity to cold Constipation Pale, dry skin A puffy face Brittle nails Hair loss Enlargement of the tongue Unexplained weight gain Muscle aches, tenderness and stiffness Joint pain and stiffness Muscle weakness Excessive or prolonged menstrual bleeding Depression Memory lapses ​ Source: Mayo Clinic ​ When to see a doctor ​ See your doctor if you develop these signs and symptoms: ​ Tiredness for no apparent reason Dry skin Pale, puffy face Constipation ​ You'll also need to see your doctor for periodic testing of your thyroid function if: ​ You've had thyroid surgery You've had treatment with radioactive iodine or anti-thyroid medications You've had radiation therapy to your head, neck or upper chest ​ If you have high blood cholesterol, talk to your doctor about whether hypothyroidism may be a cause. ​ And if you're receiving hormone therapy for hypothyroidism caused by Hashimoto's disease, schedule follow-up visits as often as your doctor recommends. It's important to make sure you're receiving the correct dose of medicine. Over time, the dose you need to adequately replace your thyroid function may change. ​ Source: Mayo Clinic ​ What causes Hashimoto's? ​ Hashimoto's disease is an autoimmune disorder in which your immune system creates antibodies that damage your thyroid gland. Doctors don't know what causes your immune system to attack your thyroid gland. Some scientists think a virus or bacterium might trigger the response, while others believe a genetic flaw may be involved. ​ A combination of factors — including heredity, sex and age — may determine your likelihood of developing the disorder. ​ Source: Mayo Clinic ​ Risk factors ​ These factors may contribute to your risk of developing Hashimoto's disease: ​ Sex . Women are much more likely to get Hashimoto's disease. Age. Hashimoto's disease can occur at any age but more commonly occurs during middle age. Heredity. You're at higher risk for Hashimoto's disease if others in your family have thyroid or other autoimmune diseases. Other autoimmune disease. Having another autoimmune disease — such as rheumatoid arthritis, type 1 diabetes or lupus — increases your risk of developing Hashimoto's disease. Radiation exposure. People exposed to excessive levels of environmental radiation are more prone to Hashimoto's disease. ​ Source: Mayo Clinic ​ ​ Complications ​ Left untreated, an underactive thyroid gland (hypothyroidism) caused by Hashimoto's disease can lead to a number of health problems: ​ Goiter. Constant stimulation of your thyroid to release more hormones may cause the gland to become enlarged, a condition known as a goiter. Hypothyroidism is one of the most common causes of goiters. It's generally not uncomfortable, but a large goiter can affect your appearance and may interfere with swallowing or breathing. Heart problems. Hashimoto's disease may also be associated with an increased risk of heart disease, primarily because high levels of low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol — can occur in people with an underactive thyroid gland (hypothyroidism). If left untreated, hypothyroidism can lead to an enlarged heart and, possibly, heart failure. Mental health issues. Depression may occur early in Hashimoto's disease and may become more severe over time. Hashimoto's disease can also cause sexual desire (libido) to decrease in both men and women and can lead to slowed mental functioning. Myxedema . This rare, life-threatening condition can develop due to long-term severe hypothyroidism as a result of untreated Hashimoto's disease. Its signs and symptoms include drowsiness followed by profound lethargy and unconsciousness. A myxedema coma may be triggered by exposure to cold, sedatives, infection or other stress on your body. Myxedema requires immediate emergency medical treatment. Birth defects. Babies born to women with untreated hypothyroidism due to Hashimoto's disease may have a higher risk of birth defects than do babies born to healthy mothers. Doctors have long known that these children are more prone to intellectual and developmental problems. There may be a link between hypothyroid pregnancies and birth defects, such as a cleft palate. A connection also exists between hypothyroid pregnancies and heart, brain and kidney problems in infants. If you're planning to get pregnant or if you're in early pregnancy, be sure to have your thyroid level checked. ​ Source: Mayo Clinic Diagnosis ​ In general, your doctor may test for Hashimoto's disease if you're feeling increasingly tired or sluggish, have dry skin, constipation, and a hoarse voice, or have had previous thyroid problems or a goiter. ​ Diagnosis of Hashimoto's disease is based on your signs and symptoms and the results of blood tests that measure levels of thyroid hormone and thyroid-stimulating hormone (TSH) produced in the pituitary gland. These may include: ​ A hormone test. Blood tests can determine the amount of hormones produced by your thyroid and pituitary glands. If your thyroid is underactive, the level of thyroid hormone is low. At the same time, the level of TSH is elevated because your pituitary gland tries to stimulate your thyroid gland to produce more thyroid hormone. An antibody test. Because Hashimoto's disease is an autoimmune disorder, the cause involves production of abnormal antibodies. A blood test may confirm the presence of antibodies against thyroid peroxidase (TPO antibodies), an enzyme normally found in the thyroid gland that plays an important role in the production of thyroid hormones. But the TPO antibody test isn't positive in everyone with Hashimoto's thyroiditis. Many people have TPO antibodies present, but don't have a goiter, hypothyroidism or other problems. ​ In the past, doctors weren't able to detect an underactive thyroid (hypothyroidism), the main indicator of Hashimoto's disease, until symptoms were fairly advanced. But by using the sensitive TSH test, doctors can diagnose thyroid disorders much earlier, often before you experience symptoms. ​ Because the TSH test is the best screening test, your doctor will likely check TSH first and follow with a thyroid hormone test if needed. TSH tests also play an important role in managing hypothyroidism. These tests also help your doctor determine the right dosage of medication, both initially and over time. ​ Source: Mayo Clinic ​ Treatment ​ Treatment for Hashimoto's disease may include observation and use of medications. If there's no evidence of hormone deficiency, and your thyroid is functioning normally, your doctor may suggest a wait-and-see approach. If you need medication, chances are you'll need it for the rest of your life. ​ Source: Mayo Clinic ​ Synthetic Hormones ​ If Hashimoto's disease causes thyroid hormone deficiency, you may need replacement therapy with thyroid hormone. This usually involves daily use of the synthetic thyroid hormone levothyroxine (Levoxyl, Synthroid, others). ​ Synthetic levothyroxine is identical to thyroxine, the natural version of this hormone made by your thyroid gland. The oral medication restores adequate hormone levels and reverses all the symptoms of hypothyroidism. ​ Source: Mayo Clinic ​ Monitoring the dosage ​ To determine the right dosage of levothyroxine initially, your doctor generally checks your level of TSH after six to eight weeks of treatment and again after any dose changes. Once the dose that normalizes your thyroid tests is determined, your doctor is likely to check your TSH level about every 12 months as the dosage you need may change. Excessive amounts of thyroid hormone can accelerate bone loss, which may make osteoporosis worse or add to your risk of this disease. Overtreatment with levothyroxine can also cause heart rhythm disorders (arrhythmias). ​ If you have coronary artery disease or severe hypothyroidism, your doctor may start treatment with a smaller amount of medication and gradually increase the dosage. Progressive hormone replacement allows your heart to adjust to the increase in metabolism. ​ Levothyroxine causes virtually no side effects when used in the appropriate dose and is relatively inexpensive. If you change brands, let your doctor know to ensure you're still receiving the right dosage. ​ Also, don't skip doses or stop taking the drug. If you do, signs and symptoms will gradually return. ​ Source: Mayo Clinic ​ Effects of other substances ​ Certain medications, supplements and some foods may affect your ability to absorb levothyroxine. However, taking levothyroxine four hours before or after other medications could remedy the problem. Talk to your doctor if you eat large amounts of soy products or a high-fiber diet or if you take any of the following: ​ Iron supplements, including multivitamins that contain iron Cholestyramine (Prevalite), a medication used to lower blood cholesterol levels Aluminum hydroxide, which is found in some antacids Sucralfate, an ulcer medication Calcium supplements ​ Source: Mayo Clinic Is a combination of hormones needed? ​ Levothyroxine is the synthetic form of the natural T-4. T-4 is converted into T-3 in the body. While most people are treated successfully with levothyroxine alone, some people don't feel completely normal on levothyroxine. ​ Researchers have investigated whether adjusting standard hypothyroidism treatment to replace some T-4 with small amounts of T-3 may offer benefit. But, the majority of studies have determined that the addition of T-3 does not offer any advantage over treatment with T-4 alone. ​ There is some evidence that T-3 may offer benefit to certain subsets of people, such as people who have had their thyroid surgically removed (thyroidectomy). Research is ongoing. ​ T-3 can be given alone as liothyronine (Cytomel) or in combination with T-4. Taking a combination T-4 and T-3 ends up producing higher than normal levels of T-3, especially soon after the medication is taken. This can cause a fast heart rate, anxiety and trouble sleeping. ​ But, for those who haven't gotten enough relief from T-4 alone, adding liothyronine to standard levothyroxine treatment for a three- to six-month trial is a long enough period to see if the combination helps you. ​ Source: Mayo Clinic ​ Alternative medicine ​ Standard treatment for Hashimoto's disease is levothyroxine, the synthetic form of thyroxine (T-4). However, extracts are available that contain thyroid hormone derived from the thyroid glands of pigs. These products — Armour Thyroid, for example — contain both levothyroxine and triiodothyronine (T-3). ​ Doctors have a number of concerns about thyroid hormone extracts such as Armour Thyroid, including: ​ The balance of T-4 and T-3 in animals isn't the same as in humans. The exact amount of T-4 and T-3 in each batch of a natural extract product can vary, leading to unpredictable levels of these hormones in your blood. ​ Source: Mayo Clinic ​ Key points about Hashimoto’s thyroiditis ​ Hashimoto's thyroiditis can cause your thyroid to not make enough thyroid hormone. It is an autoimmune disease. It occurs when your body makes antibodies that attack the cells in your thyroid. Symptoms may include an enlarged thyroid gland (goiter), tiredness, weight gain, and muscle weakness. You don’t need treatment if your thyroid hormone levels are normal. If you have an underactive thyroid, medicine can help. ​ Source: John Hopkins Medicine ​ The Hashimoto's-Gluten Connection ​ Hashimoto's is an organ-specific autoimmune disorder. The affected person's immune system directs its attack primarily at the thyroid gland. However, people with Hashimoto's have a similar genetic predisposition to those with celiac disease. This connection was established in a research study published in 2007 in the "World Journal of Gastroentorology" and has been repeatedly supported through further studies. Patients with Hashimoto's should be screened for celiac disease and, early in the disease process, may benefit from following a gluten-free diet. Before adopting a gluten-free diet, you should be evaluated by your physician to establish the need for such a measure. ​ Source: Healthfully.com ​ Cooking blog

The information contained in this section has been procured from the Mayo Clinic. It is all for educational purposes and not intended to be taken as medical advice . What is Wheat Allergy? ​ Wheat allergy is an allergic reaction to foods containing wheat. Allergic reactions can be caused by eating wheat and also, in some cases, by inhaling wheat flour. Avoiding wheat is the primary treatment for wheat allergy, but that isn't always as easy as it sounds. Wheat is found in many foods, including some you might not suspect, such as soy sauce, ice cream and hot dogs. Medications may be necessary to manage allergic reactions if you accidentally eat wheat. Wheat allergy sometimes is confused with celiac disease, but these conditions differ. Wheat allergy occurs when your body produces antibodies to proteins found in wheat. In celiac disease, a specific protein in wheat — gluten — causes a different kind of abnormal immune system reaction. Cooking Blog Source: Mayo Clinic What causes Wheat Allergy? ​ If you have wheat allergy, exposure to a wheat protein primes your immune system for an allergic reaction. You can develop an allergy to any of the four classes of wheat proteins — albumin, globulin, gliadin and gluten. ​ ​ Source : Mayo Clinic ​ Risk Factors ​ Certain factors may put you at greater risk of developing wheat allergy: ​ Family history. You're at increased risk of allergy to wheat or other foods if your parents have food allergies or other allergies, such as asthma. Age. Wheat allergy is most common in babies and toddlers, who have immature immune and digestive systems. Most children outgrow wheat allergy by 16, but adults can develop it, often as a cross-sensitivity to grass pollen. ​ Source : Mayo Clinic ​ Anaphylaxis ​ For some people, wheat allergy may cause a life-threatening reaction called anaphylaxis. In addition to other signs and symptoms of wheat allergy, anaphylaxis may cause: Swelling or tightness of the throat Chest pain or tightness Severe difficulty breathing Trouble swallowing Pale, blue skin color Dizziness or fainting Source : Mayo Clinic ​ When to See a Doctor ​ I f someone shows signs of anaphylaxis, call 911 or your local emergency number. Anaphylaxis is a medical emergency that requires immediate care. If you suspect that you or your child is allergic to wheat or another food, see your doctor. ​ Source : Mayo Clinic ​ ​ Wheat-dependent, Exercise-Induced Anaphylaxis ​ Some people with wheat allergy develop symptoms only if they exercise within a few hours after eating wheat. Exercise-induced changes in your body either trigger an allergic reaction or worsen an immune system response to a wheat protein. This condition usually results in life-threatening anaphylaxis. ​ Source : Mayo Clinic ​ Sources of Wheat Proteins ​ Some sources of wheat proteins are obvious, such as bread, but all wheat proteins — and gluten in particular — can be found in many prepared foods and even in some cosmetics, bath products and play dough. Foods that may include wheat proteins include: ​ Breads and bread crumbs Cakes, muffins and cookies Breakfast cereals Pasta Couscous Farina Semolina Spelt Crackers Hydrolyzed vegetable protein Soy sauce Meat products, such as hot dogs Dairy products, such as ice cream Natural flavorings Gelatinized starch Modified food starch Vegetable gum If you have wheat allergy, it's possible you might also be allergic to barley, oats and rye. Unless you're allergic to grains other than wheat, though, the recommended wheat-free diet is less restrictive than a gluten-free diet. ​ Source : Mayo Clinic ​ Symptoms of a Wheat Allergy ​ A child or adult with wheat allergy is likely to develop signs and symptoms within minutes to hours after eating something containing wheat. Wheat allergy signs and symptoms include: Swelling, itching or irritation of the mouth or throat Hives, itchy rash or swelling of the skin Nasal congestion Headache Difficulty breathing Cramps, nausea or vomiting Diarrhea Anaphylaxis ​ Source : Mayo Clinic ​ Diagnosis & Testing ​ A physical exam, detailed medical history and some tests will help your doctor make a diagnosis. Tests or diagnostic tools may include: ​ Skin test. Tiny drops of purified allergen extracts — including extracts for wheat proteins — are pricked onto your skin's surface, either on your forearm or on your upper back. After 15 minutes, your doctor or nurse looks for signs of allergic reactions. If you develop a red, itchy bump where the wheat protein extract was pricked onto your skin, you may be allergic to wheat. The most common side effect of these skin tests is itching and redness. Blood test. If a skin condition or possible interactions with certain medications prevent you from having a skin test, your doctor may order a blood test that screens for specific allergy-causing antibodies to common allergens, including wheat proteins. Food diary. Your doctor may ask you to keep a detailed record of what and when you eat and when symptoms develop for a time. Elimination diet. Your doctor may recommend that you remove certain foods from your diet, particularly those that are common allergens. Under your doctor's direction, you will gradually add foods back and note when symptoms return. Food challenge testing. You eat food suspected of being the allergy-causing agent while being monitored for allergy symptoms. Under supervision, you begin with a small amount of the food and gradually increase the amount you consume. ​ Source : Mayo Clinic ​ Treatments ​ Avoiding wheat proteins is the best treatment for wheat allergy. Because wheat proteins appear in so many prepared foods, read product labels carefully. ​ Source : Mayo Clinic ​ Medications ​ Antihistamines may reduce signs and symptoms of minor wheat allergy. These drugs can be taken after exposure to wheat to control your reaction and help relieve discomfort. Ask your doctor if a prescription or an over-the-counter allergy drug is appropriate for you. Epinephrine is an emergency treatment for anaphylaxis. If you're at risk of having a severe reaction to wheat, you may need to carry two injectable doses of epinephrine (EpiPen, Adrenaclick, others) with you at all times. A second pen is recommended for people at high risk of life-threatening anaphylaxis in case anaphylactic symptoms return before emergency care is available. Source : Mayo Clinic ​ Emergency Care ​ Emergency medical care is essential for anyone who has an anaphylactic reaction to wheat, even after receiving an injection of epinephrine. Call 911 or your local emergency number as soon as possible. ​ Source : Mayo Clinic ​ Potential future treatments ​ Scientists are working on several types of immunotherapy to treat food allergies. Immunotherapy exposes you to small amounts of the allergic substance and then increases that exposure over time. The hope is that your body will become desensitized to the allergen, and you'll have fewer or no symptoms. ​ Several small clinical trials have been done on an oral form of immunotherapy for wheat allergy that showed reduced allergy symptoms. More research is needed, however. ​ Source : Mayo Clinic ​ Lifestyle and Home Remedies ​ Y ou can take steps to avoid exposure to wheat proteins and ensure prompt treatment when you're accidentally exposed to wheat. ​ Keep others informed. If your child has wheat allergy, make sure that anyone who takes care of your child, including the principal, teachers and nurse at school or child care, knows about the allergy and the signs of wheat exposure. If your child carries epinephrine, make sure school personnel know how to use the pen, if necessary, and that they need to contact emergency care immediately. Inform friends, relatives and co-workers of your own food allergy. Wear a bracelet. A medical identification bracelet that describes the allergy and need for emergency care can help if you experience anaphylaxis and can't communicate. Always read labels. Don't trust that a product is free of what you can't eat until you read the label. Wheat proteins, especially gluten, are used as food thickeners, and they appear in many unexpected places. Also, don't assume that once you've used a certain brand of a product, it will always be safe. Ingredients change. Shop for gluten-free foods. Some specialty stores and supermarkets offer gluten-free foods, which are safe for people with wheat allergies. However, they may also be free of grains that you can eat, so sticking to gluten-free foods may limit your diet needlessly. Consult wheat-free cookbooks. Cookbooks specializing in recipes without wheat can help you cook safely and enable you to enjoy baked goods and other foods made with substitutes for wheat. Dine out cautiously. Tell restaurant staff about your allergy and how serious it can be if you eat anything with wheat. Ask staff how meals are prepared, and order simple dishes made with fresh foods. Avoid foods such as sauces that may have hidden sources of wheat proteins. ​ Source : Mayo Clinic HOME Recipes All About Gluten Autoimmune Disorders Support Groups Cheesecakes About Joe Contact Joe Coming Soon: Dairy Allergy

The information contained in this section has been procured from the Celiac Disease Foundation. It is all for educational purposes and not intended to be taken as medical advice . Hidden Gluten ​ Gluten is found in the most unexpected everyday products, foods, and ingredients. It is important to learn how to recognize "hidden gluten" so as to avoid getting "glutened" by accident. It could seem like a daunting task at first, but with time we all become experts at identifying that pesky hidden ingredient. ​ Hidden Gluten in Food Products ​ These foods must be verified by reading the label or checking with the manufacturer/kitchen staff. ​ Energy bars/granola bars – some bars may contain wheat as an ingredient, and most use oats that are not gluten-free French fries – be careful of batter containing wheat flour or cross-contact from fryers Potato chips – some potato chip seasonings may contain malt vinegar or wheat starch Processed lunch meats Candy and candy bars Soup – pay special attention to cream-based soups, which have flour as a thickener. Many soups also contain barley Multi-grain or “artisan” tortilla chips or tortillas that are not entirely corn-based may contain a wheat-based ingredient Salad dressings and marinades – may contain malt vinegar, soy sauce, flour Starch or dextrin if found on a meat or poultry product could be from any grain, including wheat Brown rice syrup – may be made with barley enzymes Meat substitutes made with seitan (wheat gluten) such as vegetarian burgers, vegetarian sausage, imitation bacon, imitation seafood (Note: tofu is gluten-free, but be cautious of soy sauce marinades and cross-contact when eating out, especially when the tofu is fried) Soy sauce (though tamari made without wheat is gluten-free) Self-basting poultry Pre-seasoned meats Cheesecake filling – some recipes include wheat flour Eggs served at restaurants – some restaurants put pancake batter in their scrambled eggs and omelets, but on their own, eggs are naturally gluten-free. Sources: Celiac Disease Foundation Cooking blog HOME Recipes All About Gluten Autoimmune Disorders Support Groups Cheesecakes About Joe Contact Joe Is it Gluten Free or Not?

The information contained in this section has been procured from the Mayo Clinic and the Center for Disease Control and Prevention (CDC) It is all for educational purposes and not intended to be taken as medical advice . What is Type 1 Diabetes ​ Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy. ​ Different factors, including genetics and some viruses, may contribute to type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults. ​ Despite active research, type 1 diabetes has no cure. Treatment focuses on managing blood sugar levels with insulin, diet and lifestyle to prevent complications. Cooking Blog Source: Mayo Clinic HOME Recipes All About Gluten Autoimmune Disorders Support Groups Cheesecakes About Joe Contact Joe AIDS/HIV What causes Type 1 Diabetes? ​ Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake) that destroys the cells in the pancreas that make insulin, called beta cells. This process can go on for months or years before any symptoms appear. ​ Some people have certain genes (traits passed on from parent to child) that make them more likely to develop type 1 diabetes, though many won’t go on to have type 1 diabetes even if they have the genes. Being exposed to a trigger in the environment, such as a virus, is also thought to play a part in developing type 1 diabetes. Diet and lifestyle habits don’t cause type 1 diabetes. ​ The exact cause of type 1 diabetes is unknown. Usually, the body's own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet, or islets of Langerhans) cells in the pancreas. Other possible causes include: ​ Genetics Exposure to viruses and other environmental factors ​ Source : Center for Disease Control and Prevention Source: Mayo Clinic ​ Risk Factors ​ Some known risk factors for type 1 diabetes include: ​ Family history. Anyone with a parent or sibling with type 1 diabetes has a slightly increased risk of developing the condition. Genetics. The presence of certain genes indicates an increased risk of developing type 1 diabetes. Geography. The incidence of type 1 diabetes tends to increase as you travel away from the equator. Age . Although type 1 diabetes can appear at any age, it appears at two noticeable peaks. The first peak occurs in children between 4 and 7 years old, and the second is in children between 10 and 14 years old. ​ Source: Mayo Clinic ​ Complications from Type 1 Diabetes ​ Over time, type 1 diabetes complications can affect major organs in your body, including heart, blood vessels, nerves, eyes and kidneys. Maintaining a normal blood sugar level can dramatically reduce the risk of many complications. Eventually, diabetes complications may be disabling or even life-threatening. ​ Heart and blood vessel disease. Diabetes dramatically increases your risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis) and high blood pressure. Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar could cause you to eventually lose all sense of feeling in the affected limbs. Damage to the nerves that affect the gastrointestinal tract can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue. Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which requires dialysis or a kidney transplant. Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially causing blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma. Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections that may ultimately require toe, foot or leg amputation. Skin and mouth conditions. Diabetes may leave you more susceptible to infections of the skin and mouth, including bacterial and fungal infections. Gum disease and dry mouth also are more likely. Pregnancy complications. High blood sugar levels can be dangerous for both the mother and the baby. The risk of miscarriage, stillbirth and birth defects increases when diabetes isn't well-controlled. For the mother, diabetes increases the risk of diabetic ketoacidosis, diabetic eye problems (retinopathy), pregnancy-induced high blood pressure and preeclampsia. ​ Source: Mayo Clinic ​ ​ What are the symptoms of Diabetes? ​ If you have any of the following diabetes symptoms, see your doctor about getting your blood sugar tested: ​ Urinate (pee) a lot, often at night Are very thirsty Lose weight without trying Are very hungry Have blurry vision Have numb or tingling hands or feet Feel very tired Have very dry skin Have sores that heal slowly Have more infections than usual ​ Source : Center for Disease Control and Prevention ​ What are the Symptoms of Type 1 Diabetes? ​ People who have type 1 diabetes may also have: nausea vomiting stomach pains Type 1 diabetes symptoms can develop in just a few weeks or months and can be severe. Type 1 diabetes usually starts when you’re a child, teen, or young adult but can happen at any age. Source : Center for Disease Control and Prevention ​ Testing ​ A simple blood test will let you know if you have diabetes. If you’ve gotten your blood sugar tested at a health fair or pharmacy, follow up at a clinic or doctor’s office to make sure the results are accurate. ​ If your doctor thinks you have type 1 diabetes, your blood may also be tested for autoantibodies (substances that indicate your body is attacking itself) that are often present with type 1 diabetes but not with type 2. You may have your urine tested for ketones (produced when your body burns fat for energy), which also indicate type 1 diabetes instead of type 2. ​ Source : Center for Disease Control and Prevention ​ Diagnosis ​ Diagnostic tests include: ​ Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates diabetes. ​ If the A1C test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as pregnancy or an uncommon form of hemoglobin (hemoglobin variant) — your doctor may use these tests: ​ Random blood sugar test. A blood sample will be taken at a random time and may be confirmed by repeat testing. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. ​ If you're diagnosed with diabetes, your doctor may also run blood tests to check for autoantibodies that are common in type 1 diabetes. These tests help your doctor distinguish between type 1 and type 2 diabetes when the diagnosis is uncertain. The presence of ketones — byproducts from the breakdown of fat — in your urine also suggests type 1 diabetes, rather than type 2. ​ Source: Mayo Clinic ​ ​ After the diagnosis ​ You'll regularly visit your doctor to discuss diabetes management. During these visits, the doctor will check your A1C levels. Your target A1C goal may vary depending on your age and various other factors, but the American Diabetes Association generally recommends that A1C levels be below 7 percent, which translates to an estimated average glucose of 154 mg/dL (8.5 mmol/L). ​ Compared with repeated daily blood sugar tests, A1C testing better indicates how well your diabetes treatment plan is working. An elevated A1C level may signal the need for a change in your insulin regimen, meal plan or both. ​ In addition to the A1C test, the doctor will also take blood and urine samples periodically to check your cholesterol levels, thyroid function, liver function and kidney function. The doctor will also examine you to assess your blood pressure and will check the sites where you test your blood sugar and deliver insulin. ​ Source: Mayo Clinic ​ Treatment ​ Treatment for type 1 diabetes includes: ​ Taking insulin Carbohydrate, fat and protein counting Frequent blood sugar monitoring Eating healthy foods Exercising regularly and maintaining a healthy weight ​ The goal is to keep your blood sugar level as close to normal as possible to delay or prevent complications. Generally, the goal is to keep your daytime blood sugar levels before meals between 80 and 130 mg/dL (4.44 to 7.2 mmol/L) and your after-meal numbers no higher than 180 mg/dL (10 mmol/L) two hours after eating. ​ Source: Mayo Clinic ​ Insulin and other Medications ​ Anyone who has type 1 diabetes needs lifelong insulin therapy. Types of insulin are many and include: ​ Short-acting (regular) insulin Humulin R Novolin R. ​ Rapid-acting insulin insulin glulisine (Apidra), insulin lispro (Humalog) insulin aspart (Novolog) ​ Intermediate-acting (NPH) insulin insulin NPH (Novolin N, Humulin N) ​ Long-acting insulin insulin glargine (Lantus, Toujeo Solostar) insulin detemir (Levemir) insulin degludec (Tresiba) ​ Source: Mayo Clinic ​ Insulin administration ​ Insulin can't be taken orally to lower blood sugar because stomach enzymes will break down the insulin, preventing its action. You'll need to receive it either through injections or an insulin pump. ​ Injections. You can use a fine needle and syringe or an insulin pen to inject insulin under your skin. Insulin pens look similar to ink pens and are available in disposable or refillable varieties. If you choose injections, you'll likely need a mixture of insulin types to use throughout the day and night. Multiple daily injections that include a combination of a long-acting insulin combined with a rapid-acting insulin more closely mimic the body's normal use of insulin than do older insulin regimens that only required one or two shots a day. A regimen of three or more insulin injections a day has been shown to improve blood sugar levels. An insulin pump. You wear this device, which is about the size of a cellphone, on the outside of your body. A tube connects a reservoir of insulin to a catheter that's inserted under the skin of your abdomen. This type of pump can be worn in a variety of ways, such as on your waistband, in your pocket or with specially designed pump belts. ​ There's also a wireless pump option. You wear a pod that houses the insulin reservoir on your body that has a tiny catheter that's inserted under your skin. The insulin pod can be worn on your abdomen, lower back, or on a leg or an arm. The programming is done with a wireless device that communicates with the pod. Pumps are programmed to dispense specific amounts of rapid-acting insulin automatically. This steady dose of insulin is known as your basal rate, and it replaces whatever long-acting insulin you were using. ​ When you eat, you program the pump with the amount of carbohydrates you're eating and your current blood sugar, and it will give you what's called a bolus dose of insulin to cover your meal and to correct your blood sugar if it's elevated. Some research has found that in some people an insulin pump can be more effective at controlling blood sugar levels than injections. But many people achieve good blood sugar levels with injections, too. An insulin pump combined with a continuous glucose monitoring (CGM) device may provide even tighter blood sugar control. ​ Source: Mayo Clinic ​ ​ Artificial pancreas ​ In September 2016, the Food and Drug Administration approved the first artificial pancreas for people with type 1 diabetes who are age 14 and older. It's also called closed-loop insulin delivery. The implanted device links a continuous glucose monitor, which checks blood sugar levels every five minutes, to an insulin pump. The device automatically delivers the correct amount of insulin when the monitor indicates it's needed. ​ There are more artificial pancreas (closed loop) systems currently in clinical trials. ​ Source: Mayo Clinic ​ Other Medications ​ Additional medications also may be prescribed for people with type 1 diabetes, such as: ​ High blood pressure medications. Your doctor may prescribe angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) to help keep your kidneys healthy. These medications are recommended for people with diabetes who have blood pressures above 140/90 millimeters of mercury (mm Hg). Aspirin. Your doctor may recommend you take baby or regular aspirin daily to protect your heart. Cholesterol-lowering drugs. Cholesterol guidelines tend to be more aggressive for people with diabetes because of the elevated risk of heart disease. The American Diabetes Association recommends that low-density lipoprotein (LDL, or "bad") cholesterol be below 100 mg/dL (2.6 mmol/L). Your high-density lipoprotein (HDL, or "good") cholesterol is recommended to be over 50 mg/dL (1.3 mmol/L) in women and over 40 mg/dL (1 mmol/L) in men. Triglycerides, another type of blood fat, are ideal when they're less than 150 mg/dL (1.7 mmol/L). ​ Source: Mayo Clinic Blood sugar monitoring Depending on what type of insulin therapy you select or require, you may need to check and record your blood sugar level at least four times a day. ​ The American Diabetes Association recommends testing blood sugar levels before meals and snacks, before bed, before exercising or driving, and if you suspect you have low blood sugar. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range — and more frequent monitoring can lower A1C levels. ​ Even if you take insulin and eat on a rigid schedule, blood sugar levels can change unpredictably. You'll learn how your blood sugar level changes in response to food, activity, illness, medications, stress, hormonal changes and alcohol. ​ Continuous glucose monitoring (CGM) is the newest way to monitor blood sugar levels, and may be especially helpful for preventing hypoglycemia. The devices have been shown to lower A1C. ​ Continuous glucose monitors attach to the body using a fine needle just under the skin that checks blood glucose level every few minutes. CGM isn't yet considered as accurate as standard blood sugar monitoring, so at this time it's still important to check your blood sugar levels manually. ​ Source: Mayo Clinic Healthy eating and monitoring carbohydrates There's no such thing as a diabetes diet. However, it's important to center your diet on nutritious, low-fat, high-fiber foods such as: ​ Fruits Vegetables Whole grains ​ Your dietitian will recommend that you eat fewer animal products and refined carbohydrates, such as white bread and sweets. This healthy-eating plan is recommended even for people without diabetes. You'll need to learn how to count the amount of carbohydrates in the foods you eat so that you can give yourself enough insulin to properly metabolize those carbohydrates. A registered dietitian can help you create a meal plan that fits your needs. ​ Source: Mayo Clinic ​ Physical Activity ​ Everyone needs regular aerobic exercise, and people who have type 1 diabetes are no exception. First, get your doctor's OK to exercise. Then choose activities you enjoy, such as walking or swimming, and make them part of your daily routine. Aim for at least 150 minutes of aerobic exercise a week, with no more than two days without any exercise. The goal for children is at least an hour of activity a day. ​ Remember that physical activity lowers blood sugar. If you begin a new activity, check your blood sugar level more often than usual until you know how that activity affects your blood sugar levels. You might need to adjust your meal plan or insulin doses to compensate for the increased activity. ​ Source: Mayo Clinic Situational Concerns ​ Certain life circumstances call for different considerations. ​ Driving. Hypoglycemia can occur at any time. It's a good idea to check your blood sugar anytime you're getting behind the wheel. If it's below 70 mg/dL (3.9 mmol/L), have a snack with 15 grams of carbohydrates. Retest again in 15 minutes to make sure it has risen to a safe level. Working . Type 1 diabetes can pose some challenges in the workplace. For example, if you work in a job that involves driving or operating heavy machinery, hypoglycemia could pose a serious risk to you and those around you. You may need to work with your doctor and your employer to ensure that certain accommodations are made, such as additional breaks for blood sugar testing and fast access to food and drink. There are federal and state laws in place that require employers to make reasonable accommodations for people with diabetes. Being pregnant. Because the risk of pregnancy complications is higher for women with type 1 diabetes, experts recommend that women have a preconception evaluation and that A1C readings ideally should be less than 6.5 percent before they attempt to get pregnant. The risk of birth defects is increased for women with type 1 diabetes, particularly when diabetes is poorly controlled during the first six to eight weeks of pregnancy. Careful management of your diabetes during pregnancy can decrease your risk of complications. Being older. For those who are frail or sick or have cognitive deficits, tight control of blood sugar may not be practical and could increase the risk of hypoglycemia. For many people with type 1 diabetes, a less stringent A1C goal of less than 8 percent may be appropriate. ​ Source: Mayo Clinic ​ Potential future treatments ​ Pancreas transplant. With a successful pancreas transplant, you would no longer need insulin. But pancreas transplants aren't always successful — and the procedure poses serious risks. Because these risks can be more dangerous than the diabetes itself, pancreas transplants are generally reserved for those with very difficult-to-manage diabetes, or for people who also need a kidney transplant. Islet cell transplantation. Researchers are experimenting with islet cell transplantation, which provides new insulin-producing cells from a donor pancreas. Although this experimental procedure had some problems in the past, new techniques and better drugs to prevent islet cell rejection may improve its future chances of becoming a successful treatment. ​ Source: Mayo Clinic Signs of Trouble ​ Despite your best efforts, sometimes problems will arise. Certain short-term complications of type 1 diabetes, such as hypoglycemia, require immediate care. ​ Source: Mayo Clinic ​ Low blood sugar (hypoglycemia). This occurs when your blood sugar level drops below your target range. Ask your doctor what's considered a low blood sugar level for you. Blood sugar levels can drop for many reasons, including skipping a meal, eating fewer carbohydrates than called for in your meal plan, getting more physical activity than normal or injecting too much insulin. ​ Learn the symptoms of hypoglycemia, and test your blood sugar if you think your levels are dropping. When in doubt, always test your blood sugar. Early signs and symptoms of low blood sugar include: ​ Sweating Shakiness Hunger Dizziness or lightheadedness Rapid or irregular heart rate Fatigue Headaches Blurred vision Irritability ​ Later signs and symptoms of low blood sugar, which can sometimes be mistaken for alcohol intoxication in teens and adults, include: ​ Lethargy Confusion Behavior changes, sometimes dramatic Poor coordination Convulsions ​ Nighttime hypoglycemia may cause you to wake with sweat-soaked pajamas or a headache. Due to a natural rebound effect, nighttime hypoglycemia sometimes might cause an unusually high blood sugar reading first thing in the morning, also known as Somogyi effect. ​ If you have a low blood sugar reading: ​ Have 15 to 20 grams of a fast-acting carbohydrate, such as fruit juice, glucose tablets, hard candy, regular (not diet) soda or another source of sugar. Avoid foods with added fat, which don't raise blood sugar as quickly because fat slows sugar absorption. Retest your blood sugar in about 15 minutes to make sure it's normal. If it's still low, have another 15 to 20 grams of carbohydrate and retest in another 15 minutes. Repeat until you get a normal reading. Eat a mixed food source, such as peanut butter and crackers, to help stabilize your blood sugar. ​ If a blood glucose meter isn't readily available, treat for low blood sugar anyway if you have symptoms of hypoglycemia, and then test as soon as possible. ​ Left untreated, low blood sugar will cause you to lose consciousness. If this occurs, you may need an emergency injection of glucagon — a hormone that stimulates the release of sugar into the blood. Be sure you always have an unexpired glucagon emergency kit available at home, at work and when you're out. Make sure that co-workers, family and friends know how to use the kit in case you are unable to give yourself the injection. ​ Source: Mayo Clinic ​ Hypoglycemia unawareness. Some people may lose the ability to sense that their blood sugar levels are getting low, called hypoglycemia unawareness. The body no longer reacts to a low blood sugar level with symptoms such as lightheadedness or headaches. The more you experience low blood sugar, the more likely you are to develop hypoglycemia unawareness. If you can avoid having a hypoglycemic episode for several weeks, you may start to become more aware of impending lows. Sometimes increasing the blood sugar target (for example, from 80 to 120 mg/DL to 100 to 140 mg/DL) at least temporarily can also help improve hypoglycemia awareness. Source: Mayo Clinic ​ High blood sugar (hyperglycemia). Your blood sugar can rise for many reasons, including eating too much, eating the wrong types of foods, not taking enough insulin or fighting an illness. ​ Watch for: ​ Frequent urination Increased thirst Blurred vision Fatigue Irritability Hunger Difficulty concentrating ​ If you suspect hyperglycemia, check your blood sugar. If your blood sugar is higher than your target range, you'll likely need to administer a "correction" — an additional dose of insulin that should bring your blood sugar back to normal. High blood sugar levels don't come down as quickly as they go up. Ask your doctor how long to wait until you recheck. If you use an insulin pump, random high blood sugar readings may mean you need to change the pump site. ​ If you have a blood sugar reading above 240 mg/dL (13.3 mmol/L), test for ketones using a urine test stick. Don't exercise if your blood sugar level is above 240 mg/dL or if ketones are present. If only a trace or small amounts of ketones are present, drink extra fluids to flush out the ketones. ​ If your blood sugar is persistently above 300 mg/dL (16.7 mmol/L), or if your urine ketones remain high despite taking appropriate correction doses of insulin, call your doctor or seek emergency care. Source: Mayo Clinic ​ Increased ketones in your urine (Diabetic Ketoacidosis). If your cells are starved for energy, your body may begin to break down fat — producing toxic acids known as ketones. Diabetic ketoacidosis is a life-threatening emergency. ​ Signs and symptoms of this serious condition include: ​ Nausea Vomiting Abdominal pain A sweet, fruity smell on your breath Weight loss ​ If you suspect ketoacidosis, check your urine for excess ketones with an over-the-counter ketones test kit. If you have large amounts of ketones in your urine, call your doctor right away or seek emergency care. Also, call your doctor if you have vomited more than once and you have ketones in your urine. ​ Source: Mayo Clinic ​ Lifestyle and Home Remedies ​ Careful management of type 1 diabetes can reduce your risk of serious — even life-threatening — complications. Consider these tips: ​ Make a commitment to manage your diabetes. Take your medications as recommended. Learn all you can about type 1 diabetes. Make healthy eating and physical activity part of your daily routine. Establish a relationship with a diabetes educator, and ask your health care team for help. Identify yourself. Wear a tag or bracelet that says you have diabetes. Keep a glucagon kit nearby in case of a low blood sugar emergency — and make sure your friends and loved ones know how to use it. Schedule a yearly physical exam and regular eye exams. Your regular diabetes checkups aren't meant to replace yearly physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications, as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma. Keep your vaccinations up to date. High blood sugar can weaken your immune system. Get a flu shot every year. Your doctor will likely recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention (CDC) recommends hepatitis B vaccination if you haven't previously been vaccinated against hepatitis B and you are an adult ages 19 to 59 with type 1 or type 2 diabetes. The CDC advises vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older and have diabetes and haven't previously received the vaccine, talk to your doctor about whether it's right for you. Pay attention to your feet. Wash your feet daily in lukewarm water. Dry them gently, especially between the toes. Moisturize your feet with lotion. Check your feet every day for blisters, cuts, sores, redness or swelling. Consult your doctor if you have a sore or other foot problem that doesn't heal. Keep your blood pressure and cholesterol under control. Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Medication may be needed, too. If you smoke or use other forms of tobacco, ask your doctor to help you quit. Smoking increases your risk of diabetes complications, including heart attack, stroke, nerve damage and kidney disease. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco. If you drink alcohol, do so responsibly. Alcohol can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so only in moderation and always with a meal. Check your blood sugar levels before going to sleep. Take stress seriously. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly, which can stress and frustrate you even more. Take a step back, and set some limits. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep. ​ Source: Mayo Clinic ​ ​ Coping and Support ​ Diabetes can affect your emotions both directly and indirectly. Poorly controlled blood sugar can directly affect your emotions by causing behavior changes, such as irritability. There may be times you feel resentful about your diabetes. ​ People with diabetes have an increased risk of depression and diabetes-related distress, which may be why many diabetes specialists regularly include a social worker or psychologist as part of their diabetes care team. ​ You may find that talking to other people with type 1 diabetes is helpful. Support groups are available both online and in person. Group members often know about the latest treatments and tend to share their own experiences or helpful information, such as where to find carbohydrate counts for your favorite takeout restaurant. ​ If you're interested in a support group, your doctor may be able to recommend one in your area. Or you can visit the websites of the American Diabetes Association (ADA) or the Juvenile Diabetes Research Foundation (JDRF) for support group information and to check out local activities for people with type 1 diabetes. You can also reach the ADA at 800-DIABETES (800-342-2383) or JDRF at 800-533-CURE (800-533-2873). ​ Source: Mayo Clinic

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