Sidney Stohs, Ph.D.  Senior
 Vice President of Research and Development, AdvoCare; former       
Dean, School of Pharmacy, Creighton University; professor of 
pharmacology       and toxicology; holder of the Gilbert F. Taffe Jr. 
Endowed Chair       in Research; fellow, American College of Nutrition; 
fellow, Academy       of Toxicological Sciences; author, more than 300 
research and educational       publications; doctorate in biochemistry 
and microbiology, University       of Wisconsin.
  
             
            
          
        
  
Gluten Intolerance and Celiac Disease
Celiac disease is an autoimmune disorder that has immunologic,
 environmental and genetic components. It is one of the most common 
immune-mediated disorders characterized by a response to ingested wheat 
gluten and related proteins from rye and barley, leading to inflammation
 and damage to the intestinal lining (mucosa). The incidence of celiac 
disease in the United States is believed to be about 1% of the 
population. Characteristic symptoms include diarrhea, chronic 
malabsorption, anemia, occasional constipation, abdominal cramps, gas 
and bloating. However, not all individuals suffer from abdominal 
distress. Some individuals may experience fatigue, headache, 
neurological problems, distress, infertility, weakness and skin 
conditions such as dermatitis herpetiformis.
The eight food allergens that account for 90% of known food 
allergies include milk, eggs, fish, shellfish, tree nuts, peanuts, wheat
 (gluten) and soy beans. Gluten intolerance disorders bear the names 
celiac disease, sprue, and gluten enteropathy. The incidence of gluten 
intolerance is much greater than 1% in conjunction with diabetes, 
neurological disorders, skin diseases, digestive disorders including 
irritable bowel syndrome (IBS), joint disorders, infertility, chronic 
fatigue syndrome and fibromyalgia. Individuals with gluten intolerance 
have required an average of 9 years from the onset of symptoms until a 
firm diagnosis was obtained. This has been due in part to the lack of 
sensitive and rapid immunologic assays for gluten proteins. Recently 
developed immunologic assays are becoming more available, and health 
care providers are slowly learning to recognize that gluten intolerance 
is widespread and much more common than had been previously recognized. A
 recent study suggests that over ¼th of the population in the United 
States is gluten sensitive based on immunologic assays, while 
approximately 1% may have progressed to a serious symptomatic disease 
state.
The treatment for gluten intolerance–related conditions is a 
gluten-free diet, and if one wishes to remain symptom free, the gluten 
free diet must be maintained for life. Gluten is a mixture of several 
proteins found primarily in wheat, barley and rye. Oats contain a 
related protein that the vast majority of individuals with gluten 
sensitivity can tolerate. However, oats are frequently milled using the 
same equipment for wheat, barley and rye, and may therefore be 
contaminated with these grains. As a consequence, it may be prudent to 
avoid oat-based products.
One should avoid any ingredient derived from wheat, barley and rye 
including such ingredients as malted barley, hydrolyzed proteins from 
these grains, filler flour, graham flour, barley extract, hydrolyzed 
wheat starch, wheat bran and germ, wheat protein, wheat-derived amino 
acids, oat extract, oat flour and vegetable starch. Products such as soy
 and Brewers yeast should also be avoided because they may contain 
extracts from wheat, barley or rye.
Unfortunately, gluten is used in the manufacture of virtually all 
packaged, canned and boxed processed foods to improve palatability and 
texture. Gluten is in essence a glue that may hold products together. 
Common processed foods that contain hidden gluten include breads, 
cereals, cookies and cakes, flavored potato chips, frozen dinners, 
pastas, pies, sauces and gravies, some salad dressings, soy sauce, 
teriyaki sauce, dried and canned soups, barbecue sauce, breaded meats 
(fish, chicken, shrimp, steak, etc.), crackers, and cous cous.
Frequently, symptoms can be relieved in gluten-sensitive individuals 
by going gluten-free for two weeks. However, in severe cases, a longer 
period of time may be required. Some individuals may have a concurrent 
sensitivity to other proteins in addition to gluten, as for example, 
casein and whey found in milk-derived products, tomatoes, white 
potatoes, eggplant, peppers, tobacco, peanuts and soy.
Flour substitutes that can be used in lieu of gluten-containing 
flours include corn flour and corn meal, almond flour and almond meal, 
buckwheat (soba) flour and groats, flax seed flour, millet, fava bean 
flour, besan (chickpea or garbanzo bean) flour, potato flour, quinoa, 
rice and rice flour, sorghum (milo), soy flour, tapioca flour, teff and 
amaranth flour.
AdvoCare products are not produced at certified gluten-free 
manufacturing facilities. Therefore, we do not certify any AdvoCare 
products as gluten-free. Individuals who have celiac disease and are 
gluten-intolerant are advised to consult their healthcare providers 
regarding AdvoCare products that may be suitable for their use.