Bitters for digestion?

[AnnaNZ]

Hi all. I have just signed up (from New Zealand). I have been reading posts on this forum many times over the last 3 months and it has been very helpful and interesting. Thank you so much for this. This is my story.

One day in mid-August this year, I UNUSUALLY ate a lot of white bread. That evening I developed a pain under my right rib. In the days that followed I had massive bloating of my upper abdomen like I have never experienced. The bloating eventually subsided but the pain carried on and I still have it on and off to this day. A week after the initial event, I decided to stop eating wheat bread to see if that helped (unfortunate decision). After 2 days I was confronted with the realisation that in fact I had had D for 4-6 years and no longer had it! I have also had variable joint pain for many years. I am 59 (but don't feel it!). Breast cancer age 55. Late menarche. Geographic tongue.

The day before I stopped eating wheat, I started with 'cold' symptoms, and the day before I first got my side pain, my partner started with 'cold' symptoms and slight abdominal pain. We both tested for covid and were negative but I did wonder, are the covid tests still working on newer strains? (As a back story, I contracted covid in late May 2023 on arrival in London on first Europe trip in decades!! I believe I caught this from the kind neighbour who agreed to feed our cats while we were away. She visited us the day we left NZ and after 10 minutes said, I won't get too close because I'm a bit sick but its not covid. 2 days later she advised that her daughter had covid... We had been soooo careful in the week leading up to the trip.)

Back to August 2023, I started experimenting with my diet to see if I could find what was causing the pain. I noticed that walking during the day was very difficult, felt like I had a brake across my stomach however I could walk easily before breakfast.

I went to the GP on 4 September and she ran lots of blood tests including the coeliac screen but of course it was negative as I had given up wheat (although being a newby I hadn't realised there was some triticale wheat in my muesli). Now started burping, burning stomach, much yawning, lots of muscle and joint pain and one hive on my face. (Spring was starting in NZ and I know I am sensitive to Birch trees.) All of the blood tests were fine, negative for H. Pylori, an ensuing ultrasound was fine apart from 2 liver cysts (which are generally regarded as benign I hear).

GP started me on Omeprazole which I took for 6 weeks. I continued narrowing my diet, trying low FODMAP, stopping lactose, caffeine, chocolate, black pepper, other peppers, carrageenan, chicory root, soymilk etc.

GE appt - she suggested that I quit the Omeprazole as it didn't seem to be helping. To be fair, my heartburn did go but not the side pain. She said we could do a gastroscopy but not really much point unless I do a gluten challenge.

 

I requested a Coeliac gene test and my result is DQA1*05 AND DQB1*03:01 (known as DQA1*05). I was advised that there is a very low chance of my being Coeliac.

1 November, as part of my dinner, I had half a raw carrot cut into matchsticks. After eating half of my portion, I just could not push another matchstick down my throat. My throat told me not possible. The next day I had massive joint pain in a new place at the base of my forefinger. At this point, I recalled that for decades, I have had an issue with raw carrot and that I always cut it small because I had had trouble eating it. I refreshed my memory and googled oral allergy syndrome. This is most common with Birch allergy where your body mistakes many different raw fruit and veggies with birch protein. Another rabbithole to go down. Now I am avoiding all raw fruit as well. Feeling pretty desperate on the food front! 2 nights ago at 2.30am I moved out of the home/street which is full of massive plane trees and 2 birch trees and even went to the after hours doctor and got some prednisone as my throat felt like I could no longer burp (as opposed to loads of burping).

I have another appt with the GP this Thursday to decide what next.

That was a long story. I read on this website that drinking bitters might help with digestion/pain. Can anyone recommend exactly which or are there any you shouldn't have? How should you take them? I have an ancient bottle of Angostura bitters in the pantry... If you are still here, thanks for reading! :-)

[trents]

Welcome to the forum, Anna!

Have you considered NCGS (Non Celiac Gluten Sensitivity) as opposed to celiac disease? Also, it sounds to me like you have other food sensitivities/intolerances. Have you looked into the AIP (Autoimmune Protocol Diet)? I would also suggest keep a food diary to see if you can spot patterns between what you eat when and the symptoms you describe. Have you been checked for H. Pylori? 

Edited November 14, 2023 by trents

[AnnaNZ]

Hi Trent. 

Thanks for your response.

Yes I have certainly considered NCGS. There seem to be differing opinions on the net as to how far NCGS goes. I haven't heard of the AIP before. I can look at that.

I have kept an extensive food diary and every time I think I have nailed it, I am proved wrong. Which makes me start to wonder, will it hurt when I eat anything and is it just a matter of low stomach acid (6 weeks of Omeprazole) and poor digestion.

H. Pylori was negative.

[AnnaNZ]

Oh the AIP diet is harsh! I thought I was doing it tough now. I think I need a restriction holiday for a few days (not the gluten though).

[Wheatwacked]

Welcome AnnaNZ,

     Sounds like you have a good doctor. The fact that you had improvement on GFD indicates that you have either Celiac Disease or Non Celiac Gluten Sensivity.  A few weeks on a gluten free diet according to some researchers should not have affected your antigens.  People still test positive after months of gluten free.  Besides, you were still consuming wheat in your muesli. Once you feel up to it a Gluten Challenge with the latest recommendations would be a good idea if you want to differentiate between the two Gluten Sensitivities.  An endoscopy with biopsies for Celiac Disease can be possitive, even though blood tests are negative.

       Based on your story the answer is that you are suffering from Vitamin D deficiency, Thiamin deficiency, and Choline deficiency.  Probably others as well.  It is not something doctors are taught to look for.

      It seems that normally the Celiac Genes are modulated by vitamin D, but when an illness strikes it overtaxes our immune system and depletes vitamin D.  Around 40% of the developed world has low or deficiency in D.  Why? We have been scared into overprotective measures against UV light.  And due to a manufacturing error in infant formula in England in the 1950 most of the world banned vitamin D fortification. Without UV light we don't make vitamin D.  In the US there are only about a million cases of skin cancer so it works for that.  Unfortunately there are 50 million cases of autoimmune disease.  With low D your immune system is compromised.  Daily oral dosing of vitamin D3 using 5000 TO 50,000 international units a day in long-term hospitalized patients: Insights from a seven year experience

The test for hydroxy 25 vitamin D is inexpesive and accurate.  At the end of summer, getting normal sunlight you should be around 200 nmol/L.  If I were a betting man, I would say you are around 50 nmol/L or less.

Low D will cause gastroparesis, not emptying the stomach, which your carrot stick story might indicate.  Worth looking into.

1 hour ago, AnnaNZ said:

I was advised that there is a very low chance of my being Coeliac.

And yet you improved with reduced gluten diet.  

1 hour ago, AnnaNZ said:

My throat told me not possible. The next day I had massive joint pain in a new place at the base of my forefinger.

Thiamin can be depleted very quickly and can lead to Beriberi,  Wernicke encephalopathy.  The best test, decreased transketolase activity, is not available everywhere.  "observation of a patient's clinical response to thiamine administration remains the easiest, least expensive form of testing, clinicians usually miss the subclinical forms of beriberi. Beriberi (Thiamine Deficiency) Workup

Thiamin is needed to process carbohydrates.

There is no good test for choline status.  Most is gotten from eggs, liver, beef. Four eggs have the same amount of choline as 10 cups of cooked brocolli. Choline is needed to process fats.  90% of the Western world does not get even the adequate intake.  It can cause gallbladder issues because the bile is mostly choline salts.  "The mildest and most common symptom of gallbladder disease is intermittent pain called biliary colic. Typically, a patient experiences a steady gripping or gnawing pain in the upper right abdomen near the rib cage, which can be severe and can radiate to the upper back. Some patients with biliary colic experience the pain behind the breastbone. Nausea or vomiting may occur.  Gallbladder Disease"

In short, supplementing these essential nutrients at a high enough dose to quickly reverse these deficiencies, might ease the pain in a few weeks.

The bitters might increase your stomach acid, but maybe not so good for you.

Products allowed/disallowed in the Gluten Contamination Elimination Diet (GCED), targeting the elimination of gluten cross-contamination

[AnnaNZ]

Thanks for your response Wheatwacked. I haven't had thiamine or choline tested but Vitamin D has been tested. 

25 Hydroxy Vitamin D Results: 57 nmol/L Range: 50 - 150

Results: Reference range:<25 Moderate to severe vitamin D deficiency

25 - 50 Mild deficiency

50 - 150 Optimal target range for bone health
 

Here in NZ we are still in Spring and this year my city Auckland has possibly had the highest amount of rainfall ever - from December 2022 right through summer to winter. I have in fact been consciously trying to lift my Vitamin D levels over the past month, as well as getting exercise, by walking three times a week before breakfast, and before the UV levels are too elevated. NZ has a problem of low ozone overhead and high skin cancer rates. It is true that over the years I have avoided the sun for that reason.

[Wheatwacked]

 

53 minutes ago, AnnaNZ said:

25 Hydroxy Vitamin D Results: 57 nmol/L

I guessed right.

       57 nmol/L is adequate if you only consider rickets, the only effect the nutrititional boards accept for making their decisions.  You may not have rickets, but your immune system is seriously compromised.

I keep mine at 200 nmol/L by taking 250 mcg (10,000 IU).  Have been since 2015. 200 nmol/L is the same as 80 ng/ml.  Even at 10,000 IU a day it took two years to get from 47 ng/ml to 80 ng/ml. (117 nmol/L to 200 nmol/L).  Some labs use ng/ml, others use nmol/L so it is easy to confuse them.  Multiply ng/ml by 2.5 to get nmol/L.  As I 

Quote

 

“When combined with supplemental magnesium, vitamin D repletion has dramatically changed my practice,” said McCarthy, whose family practice is affiliated with The Memorial Hospital of Belleville, Ill.

• “There are now very few patients with infections, and asthmatics who are coming off medications are staying off of them. Elevations in blood pressure now require many fewer medications,” he said.
• McCarthy has been employing these methods since February 2007, and patient acceptance has been high. He said he checks each patient’s 25(OH)D level and supplements to reach a target of 80 ng/mL in adults and children. Of the first 1,500 patients McCarthy tested, 40% began with vitamin D levels less than 20 ng/mL and 70% less than 35 ng/mL. Only 1% initially had values within his target range.
• According to McCarthy, his target range is based upon several factors:
• A lifeguard study that found vitamin D levels in the 70 ng/mL range up to 100 ng/mL (nature’s level) were associated with no adverse effects;
• Data in patients with breast cancer showing a reduction in the incidence of new cancer with postulated 0 point at 80 ng/mL;
• Colon cancer data showing a reduction in the incidence of new cancer (linear) with postulated 0 point at 75 ng/mL;
• More than 200 polymorphisms of the vitamin D receptor requiring higher D levels to attain same desired outcomes;
• When a patient misses dosing, an attained level of 80 ng/mL gives the patient an additional month of good levels off of vitamin D.  Surge of information on benefits of vitamin D

 

•  

 

 

[Wheatwacked]

Last summer, in addition to the 10,000 IU a day I spent 3 hours a week mowing, shirtless and no protection and it rasised my 25 hydroxy D to 97 ng/ml.  Normal range here is 30 ng/ml to 150 ng/ml.  ( 75 nmol/L to 375 nmol/L ).

I'll repeat this one again: "In the US there are only about a million cases of skin cancer so it works for that.  Unfortunately there are 50 million cases of autoimmune disease."  Supplementation is the answer because despite the dire warnings of vitamin D toxicity where ever you look, it is actually quite rare.

[AnnaNZ]

That is really interesting Wheatwacked! Thank you. I am off to bed now but I will look into this further tomorrow.

[Russ H]

21 hours ago, Wheatwacked said:

The bitters might increase your stomach acid, but maybe not so good for you.

 

Yes, Angostura bitters contain gentian root, which is alleged to help digestive problems in herbal medicine. There is no evidence that they help and could well antagonise a sensitive stomach.

[Wheatwacked]

When I was a kid there was coke, and Ginger ale was soothing.  For breakthroughs Alka seltzer, [aspirin and bicarbonate] for about 4 hours relief.  Fun fact. aspirin is acetylsalicylic acid.  Salicylic acid is the essential little known vitamin B11.   For the pain in your gut take choline, phosphatidyl choline is the form in food so does not have to be processed through the liver to be used. You will experience improvement rather quickly.  Stomach pain, maybe brain fog, energy, cardiovascular inflamation, breaks down the toxin homocystein.  Choline Fact Sheet for Health Professionals.  

Quote

 

Vitamin B11 – Salicylic Acid

Salicylic Acid is an important ‘beta-hydroxy’ that is synthesized by the amino acid phenylalanine.

It is essential to the formation and growth of body tissues, DNA and RNA, fetal brains and spinal cords, as well as being helpful for acne, psoriasis, corns, calluses and other skin irritations.

 

 

[AnnaNZ]

9 hours ago, Russ H said:

Yes, Angostura bitters contain gentian root, which is alleged to help digestive problems in herbal medicine. There is no evidence that they help and could well antagonise a sensitive stomach.

OK thanks Russ.

[AnnaNZ]

2 hours ago, Wheatwacked said:

When I was a kid there was coke, and Ginger ale was soothing.  For breakthroughs Alka seltzer, [aspirin and bicarbonate] for about 4 hours relief.  Fun fact. aspirin is acetylsalicylic acid.  Salicylic acid is the essential little known vitamin B11.   For the pain in your gut take choline, phosphatidyl choline is the form in food so does not have to be processed through the liver to be used. You will experience improvement rather quickly.  Stomach pain, maybe brain fog, energy, cardiovascular inflamation, breaks down the toxin homocystein.  Choline Fact Sheet for Health Professionals.  

 

Thanks a lot for the advice!! Funnily enough I happened to drink ginger ale for the first time in decades 3 nights ago!

What I haven't been able to figure out it, is the pain to be expected no matter what I eat, just a fact of a damaged gut that needs to get better or is the pain because of what I am eating that particular day. Most mornings there is no pain but it comes on during the day.

I guess you have been coeliac a very long time?

[Wheatwacked]

All my life.  I was a "colicky" baby.  Picky eater.  Hypochondriac. Mouthbreather. Underweight. Underacheiver. ADD.  Anorexic. Alcoholic from 1984 until I started gluten free. And more. I learned not to bother complaining because there was "nothing wrong".  When I did take meds, they either did not work or made me sicker.  My son was biopsy diagnosed as an infant in 1976 at weaning.   I finally started GFD as a "Hail Mary"  in 2014.  That's an American football term for a desperation long forward pass as a last resort.

Even with GFD and prednisone I was taking Alka Selzer sometimes twice a day for my stomach. It wasn't until I started taking 840 mg Phosphatidyl Choline a day that my gut pain and erratic stool issues ended.  If I stop the gut issues come back after a while. Still have periods of anorexia.

Supplementing my diet with B1, B3. B5, DHEA and Choline I lost 30 pounds of belly fat and am now back to the size clothes I wore at 25.  It took 10,000 IU vitamin D to break my long depression. I worked my way up from 1000 IU a day increasing every two weeks, until I started 10,000 and three days later it was a light bulb moment and I actually said out loud "Sunshine in a bottle!."  That was in 2015 and have been taking it since, started getting tested every three months in 2018 ( I was only at 117 nmol/L, now steady around 200 nmol/L) with only good effects.

 

[AnnaNZ]

Wow! That is a long sad story (with a happier ending). It is great that you are on this forum to inspire people on!

Did you get a biopsy in the end or had you had enough of the medical system?

Would it be safe for me to assume that if my lower intestine is fine and I have no bloating, then the pain is to be expected rather than due to a particular food I am currently eating? 

[trents]

2 minutes ago, AnnaNZ said:

Would it be safe for me to assume that if my lower intestine is fine and I have no bloating, then the pain is to be expected rather than due to a particular food I am currently eating? 

Expected? Pain is not normal and has a cause.

[AnnaNZ]

1 minute ago, trents said:

Expected? Pain is not normal and has a cause.

Hi Trent. What I mean is, is that part of the healing after giving up gluten? As opposed to one of the foods I am currently eating giving me further trouble.

[trents]

Which one of those pains are you still experiencing? Under the rib pain? Joint pain? Since you eliminated gluten starting in August, I would think anything gluten related would be much better or gone by now.

[Wheatwacked]

Not just safe. Beneficial. The Safe Tolerable upper limit for choline is 3500 mg.  They set that because the side effects occur at around 7000 mg.  The side effects are fishy body odor and lowered blood pressure.

Have you noticed more pain after eating fats vs carbs?

On 11/13/2023 at 6:09 PM, AnnaNZ said:

Now started burping, burning stomach, much yawning, lots of muscle and joint pain

On 11/13/2023 at 6:09 PM, AnnaNZ said:

That evening I developed a pain under my right rib.

Quote

 

How Celiac Disease May Affect Your Risk for Gallbladder Disease

If you have gallstones—especially if your gallstones are blocking the duct where bile empties into your small intestine—your gallbladder may become inflamed. This condition is known as cholecystitis.

Symptoms of cholecystitis include pain (often severe) on the right side of your abdomen, just below your rib cage, nausea and vomiting, and fever

Without enough choline, your bile gets thick.  Many have had gallbladder removed but it only affords temporary relief.

Phosphatidylcholine

"Choline is as essential nutrient for humans, and it is necessary for the structural integrity and signaling function of all cells. Choline is also used for neurotransmission, where choline combines with another compound called acetyl CoA, forming acetylcholine, a neurotransmitter of muscle activation. Since phosphatidylcholine is a precursor to acetylcholine, it has been used for the purpose of strengthening and toning LES-muscle contraction [lower esophageal sphincter]. Choline can be found in foods such as eggs and meats including poultry and fish. Higher doses of choline are needed for the treatment of GERD; therefore, supplementation with phosphatidylcholine is the best option in comparison to food sources."

[knitty kitty]

Hello, @AnnaNZ!

In Celiac Disease, part of the autoimmune response is the release of histamine in response to gluten.  The Mast Cells that release histamine can become hypersensitive and release histamine in response to the slightest provocation by some foods.  High Histamine levels can cause continuing inflammation and digestive problems.

By cutting out these foods that trigger the Mast Cells to release histamine, and by taking some helpful supplements and vitamins and minerals, the inflammation will subside.  After the inflammation has calmed, food tolerance should improve.

Some foods naturally contain more histamine than others.  Crustaceans and seafood contain high levels of histamine, as does processed meats, alcohol, legumes, nuts, fermented foods, and citrus fruits.  These should be eliminated from the diet.

High histamine foods that should be removed include nightshades (tomato, potato, eggplant and peppers).  Nightshades contain alkaloids that promote Leaky Gut Syndrome.  Leaky Gut Syndrome allows undigested food molecules into the bloodstream where they can lodge in joints or organs causing pain and inflammation.

Dairy also causes inflammation.  In some people, dairy can trigger an autoimmune response the same as gluten because segments of the gluten molecules and dairy protein casein molecules are exactly alike.  

Processed foods that contain high fructose corn syrup can promote SIBO (small intestine bacterial overgrowth).  The high fructose corn syrup forms a "mesh" that the bacteria use to crawl up into the small intestine where they are not supposed to be.  This causes more histamine release and inflammation.

Legumes (beans, lentils and peas) and pseudo grains contain high levels of histamine and plant lectins.  Lectins are hard to digest.  While cooking can break down some of these, lectins they are still inflammatory.  Raw veggies have higher levels of lectins than cooked veggies.

Some foods can stimulate histamine release like coffee, and caffeinated drinks.  

Eliminating these foods for three weeks or so will help your system calm down and you can begin adding in other foods one at a time to check for possible reactions.  Keeping a food journal is essential in pinpointing problematic foods.

Omeprazole and other PPI's affect the PH level in the stomach, making digestion even more difficult.  Supplementing with Niacin B 3 and Thiamine B 1 increases stomach acid production and secretion.  These vitamins also help the gallbladder produce and secrete digestive enzymes and bile.  The pancreas also benefits from Thiamine and Niacin by increasing insulin and digestive enzymes production and secretion.  The eight essential B vitamins all need each other to function properly, so a B Complex vitamin supplement is beneficial.  Magnesium is also helpful in reducing inflammation.  Vitamin D helps regulate inflammation and the immune system if the level is greater than 80 nmol/L, as @Wheatwacked said.  

Diamine Oxidase (DAO) supplements help with digestion.  We can make DAO normally, but until there's healing and better absorption, supplementing DAO can help with digestion.

This is a brief summary of the Autoimmune Protocol Diet, developed by Dr. Sarah Ballantyne, a Celiac herself.  Her book The Paleo Approach is very helpful.  

If you can suffer through 4-6 years of D while getting sicker, then you can endure three weeks of limited diet to get better.  Changing ones attitude towards food can be difficult, but healing is worth it.  

Hope this helps!

[AnnaNZ]

On 11/16/2023 at 8:50 AM, trents said:

Which one of those pains are you still experiencing? Under the rib pain? Joint pain? Since you eliminated gluten starting in August, I would think anything gluten related would be much better or gone by now.

Hi. My joint pain is negligible now which is good. I usually start with under the rib pain late morning. And sometimes I have abdominal cramps in front. Sometimes gurgling noises in my throat and sometimes feeling like it is tight in my oesophagus. 

[AnnaNZ]

On 11/16/2023 at 10:00 AM, Wheatwacked said:

Not just safe. Beneficial. The Safe Tolerable upper limit for choline is 3500 mg.  They set that because the side effects occur at around 7000 mg.  The side effects are fishy body odor and lowered blood pressure.

Have you noticed more pain after eating fats vs carbs?

Without enough choline, your bile gets thick.  Many have had gallbladder removed but it only affords temporary relief.

Phosphatidylcholine

"Choline is as essential nutrient for humans, and it is necessary for the structural integrity and signaling function of all cells. Choline is also used for neurotransmission, where choline combines with another compound called acetyl CoA, forming acetylcholine, a neurotransmitter of muscle activation. Since phosphatidylcholine is a precursor to acetylcholine, it has been used for the purpose of strengthening and toning LES-muscle contraction [lower esophageal sphincter]. Choline can be found in foods such as eggs and meats including poultry and fish. Higher doses of choline are needed for the treatment of GERD; therefore, supplementation with phosphatidylcholine is the best option in comparison to food sources."

Fats vs carbs - the pain usually starts late morning - I guess that relates to breakfast? I have some kind of rice-based bread for breakfast. lemon and ginger tea.

The GP and GE seem to be happy with my gallbladder.

(Burping is much reduced, no more heartburn.)

[Wheatwacked]

Eat something else for breakfast.  I have 3 eggs, breakfast sausage, potato and 2 cans of Red Bull.

[AnnaNZ]

6 hours ago, knitty kitty said:

Hello, @AnnaNZ!

In Celiac Disease, part of the autoimmune response is the release of histamine in response to gluten.  The Mast Cells that release histamine can become hypersensitive and release histamine in response to the slightest provocation by some foods.  High Histamine levels can cause continuing inflammation and digestive problems.

By cutting out these foods that trigger the Mast Cells to release histamine, and by taking some helpful supplements and vitamins and minerals, the inflammation will subside.  After the inflammation has calmed, food tolerance should improve.

Some foods naturally contain more histamine than others.  Crustaceans and seafood contain high levels of histamine, as does processed meats, alcohol, legumes, nuts, fermented foods, and citrus fruits.  These should be eliminated from the diet.

High histamine foods that should be removed include nightshades (tomato, potato, eggplant and peppers).  Nightshades contain alkaloids that promote Leaky Gut Syndrome.  Leaky Gut Syndrome allows undigested food molecules into the bloodstream where they can lodge in joints or organs causing pain and inflammation.

Dairy also causes inflammation.  In some people, dairy can trigger an autoimmune response the same as gluten because segments of the gluten molecules and dairy protein casein molecules are exactly alike.  

Processed foods that contain high fructose corn syrup can promote SIBO (small intestine bacterial overgrowth).  The high fructose corn syrup forms a "mesh" that the bacteria use to crawl up into the small intestine where they are not supposed to be.  This causes more histamine release and inflammation.

Legumes (beans, lentils and peas) and pseudo grains contain high levels of histamine and plant lectins.  Lectins are hard to digest.  While cooking can break down some of these, lectins they are still inflammatory.  Raw veggies have higher levels of lectins than cooked veggies.

Some foods can stimulate histamine release like coffee, and caffeinated drinks.  

Eliminating these foods for three weeks or so will help your system calm down and you can begin adding in other foods one at a time to check for possible reactions.  Keeping a food journal is essential in pinpointing problematic foods.

Omeprazole and other PPI's affect the PH level in the stomach, making digestion even more difficult.  Supplementing with Niacin B 3 and Thiamine B 1 increases stomach acid production and secretion.  These vitamins also help the gallbladder produce and secrete digestive enzymes and bile.  The pancreas also benefits from Thiamine and Niacin by increasing insulin and digestive enzymes production and secretion.  The eight essential B vitamins all need each other to function properly, so a B Complex vitamin supplement is beneficial.  Magnesium is also helpful in reducing inflammation.  Vitamin D helps regulate inflammation and the immune system if the level is greater than 80 nmol/L, as @Wheatwacked said.  

Diamine Oxidase (DAO) supplements help with digestion.  We can make DAO normally, but until there's healing and better absorption, supplementing DAO can help with digestion.

This is a brief summary of the Autoimmune Protocol Diet, developed by Dr. Sarah Ballantyne, a Celiac herself.  Her book The Paleo Approach is very helpful.  

If you can suffer through 4-6 years of D while getting sicker, then you can endure three weeks of limited diet to get better.  Changing ones attitude towards food can be difficult, but healing is worth it.  

Hope this helps!

Thanks Knitty Kitty. One issue I have is no diagnosis so it's hard to know how far I go down this path until I get one. I saw my GP on Thursday and we have agreed to proceed with the gluten challenge. I was hoping to get rid of my pain before that happened. The throat tightening has made me nervous about doing a gluten challenge too.

I have taken 1 x cetirizine pd for years and have now started twice a day.

I have been keeping a detailed food diary for several months now.

This is my diet in a nutshell:

Gluten, fermented foods - no

Alcohol, coffee, chocolate, carrageenan - cut out some time ago

Citrus - cut out a week ago

Dairy - wasn't a big dairy eater but cut out 100% yesterday (aside from ghee which is apparently lactose and casein free)

Nuts - cut out yesterday

Soy, tofu - cut out soy milk a while ago, haven't had tofu in a while, as of yesterday 100% out

Seafood - was eating white fish, salmon, canned tuna - as of yesterday cut out 

Egg - was eating a lot - as of yesterday cut out

legumes - eating 

Nightshades - eating lots of potatoes

DF coconut yoghurt - I eat every day

Rice-based bread - I eat every day

Cooked vegetables and rice - yes

Fruit - I am only eating cooked fruits as of a week ago

Meat - yes

Thanks for your help 🙂

[AnnaNZ]

24 minutes ago, Wheatwacked said:

Eat something else for breakfast.  I have 3 eggs, breakfast sausage, potato and 2 cans of Red Bull.

Hmmm, I would not have thought that breakfast was healthy...