As the world of people who are wheat-free continues to grow, I am witnessing a range of weird re-exposure reactions when people, intentionally or inadvertently, get re-exposed.
Among the peculiar reactions:
Congestive heart failureA woman with a clear-cut syndrome of wheat intolerance that was evidenced by diabetes, excessive expression of small LDL particles (around 2000 nmol/L at the start), high triglycerides, gastrointestinal distress, widespread joint pain, and a peripheral neuropathy (impaired coordination, reduced sensation to the legs), and negative blood markers for celiac disease, improved substantially across the entire collection of symptoms. She lost around 40 pounds of weight, reduced HbA1c substantially, dropped small LDL dramatically (to zero), triglycerides to double-digit values, with modest improvement in coordination and peripheral neuropathy, marked improvement in joint discomfort. With each re-exposure, e.g, a
couple of bites of birthday cake at her grandson's birthday party, she experienced water retention and congestive heart failure of 27-30 pounds but developing over 7 days. This happened 4-5 times with water retention developing over the precise same time course. On each occasion, she responded to diuretics, losing the 27-30 pounds of retained water, with no other cause identified (no change in left ventricular ejection fraction, no change in kidney status, no change in serum albumin or protein levels, no change in thyroid status, etc.).
Functional achalasiaA young man had been wheat-free for over one year
inadvertently had wheat in the form of orzo, mistaking it for rice (since orzo is rice-shaped pasta). Within minutes, food became trapped in his esophagus, necessitating an endoscopy to extract the food. No pathologic findings were seen: no esophageal stricture, inflammation, ulcer, or tumor. There was also no evidence nor history to suggest eosinophilic esophagitis.
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