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dermatitis herpetiformis and cross reaction?


MO1984

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MO1984 Newbie

I’ve been really struggling with getting my dermatitis herpetiformis flare ups under control lately. Somehow, despite my mother’s dermatitis herpetiformis always being on her back, and my brother’s always on his legs, mine roves around my body. It has now settled, quite uncomfortably in my nether regions. Despite a strict gluten-free diet I’m currently having the worst flare up I’ve ever had, and can’t shake it. 

This morning I had an AHA! moment, and am wondering if others have experienced this. Coffee cross reaction. Some studies have shown that the protein in coffee can trigger an autoimmune response. I generally find that I can enjoy coffee periodically it’s not an issue, however, if I consume it daily, or even 3 times a week habitually, I start to feel the creeping symptoms of chronic exposure. Sluggish morning, bloat, etc. This is cross reaction, not cross contamination: whole beans, roasted locally, ground on site, no added flavors. 

about two months ago I started using a gluten-free mushroom coffee thing, and felt fantastic! It has a very small amount of coffee in it, and the benefits of the other components has been astounding. But now, two months in, my dermatitis herpetiformis is out of control. I haven’t, however, felt overt “glutened” symptoms…so I’m wondering if maybe the low daily coffee intake has somehow triggered the autoimmune dermatitis herpetiformis without triggering the gut symptoms? 

Good grief, celiac is a tricky disease… and this is coming from someone who’s over 23 years into diagnosis. 


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knitty kitty Grand Master

Welcome to the forum, @MO1984,

I have dermatitis herpetiformis, too.  I've learned that glutamate can make dermatitis herpetiformis worse.  Some foods like mushrooms can contain high levels of glutamate.  Coffee and caffeine cause increased production of glutamate.  

Glutamate is a helpful excitatory neurotransmitter that our bodies can make.  It helps wake us up in the morning.  It keeps us alert when under stress.  But too much can cause insomnia.  And too much glutamate can cause the antibodies associated with dermatitis herpetiformis (tTg 3) to become more active and deposit in the skin.  

dermatitis herpetiformis is pressure sensitive.  dermatitis herpetiformis eruptions occur where there's pressure on the skin, like in the crotch where the skin folds together, under elastic bands in underwear, and along seams of clothing.  

Wearing loose clothing made of natural fibers helps immensely.  

Hope this helps!

Scott Adams Grand Master

If you have DH you will likely also want to avoid iodine, which is common in seafoods and dairy products, as it can exacerbate symptoms in some people. This article may also be helpful as it offers various ways to relieve the itch:

 

MO1984 Newbie
On 10/14/2024 at 2:21 PM, knitty kitty said:

Welcome to the forum, @MO1984,

I have dermatitis herpetiformis, too.  I've learned that glutamate can make dermatitis herpetiformis worse.  Some foods like mushrooms can contain high levels of glutamate.  Coffee and caffeine cause increased production of glutamate.  

Glutamate is a helpful excitatory neurotransmitter that our bodies can make.  It helps wake us up in the morning.  It keeps us alert when under stress.  But too much can cause insomnia.  And too much glutamate can cause the antibodies associated with dermatitis herpetiformis (tTg 3) to become more active and deposit in the skin.  

dermatitis herpetiformis is pressure sensitive.  dermatitis herpetiformis eruptions occur where there's pressure on the skin, like in the crotch where the skin folds together, under elastic bands in underwear, and along seams of clothing.  

Wearing loose clothing made of natural fibers helps immensely.  

Hope this helps!


 

oh my goodness! I kid you not it took maybe 30 hours after stopping the drink for the rash to start to clear. I think I will try the matcha version and hope it’s just the coffee issue, because it was helping my energy so much. BUT now I know to keep a close eye for the mushroom negative effect… thank you so much!!! 

MO1984 Newbie
18 minutes ago, Scott Adams said:

If you have dermatitis herpetiformis you will likely also want to avoid iodine, which is common in seafoods and dairy products, as it can exacerbate symptoms in some people. This article may also be helpful as it offers various ways to relieve the itch:

 

Wow, I had no idea dermatitis herpetiformis is so easily triggered! So there are definitely things that could trigger the dermatitis herpetiformis, and not the gluten reaction… I’m gathering. Yikes. 
 

im learning so much, thank you! Only in the last year or so has my dermatitis herpetiformis really become a factor, so I’m just figuring it all out. 

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    • Scott Adams
      Based on those results alone, it’s not possible to say you have celiac disease. The test that is usually most specific for celiac, tTG-IgA, is negative in your results, and the endomysial antibody (EMA) is also negative, which generally argues against active celiac disease. However, your deamidated gliadin IgA is elevated, and your total IgA level is also high, which can sometimes affect how the other antibody tests behave. Another important factor is that you were reducing gluten before the test, which can lower antibody levels and make the results less reliable. Because of that, many doctors recommend a gluten challenge (eating gluten regularly for several weeks) before repeating blood tests or considering an endoscopy if symptoms and labs raise concern. It would be best to review these results with a gastroenterologist, who can interpret them in context and decide whether further testing is needed.
    • trents
      Since you compromised the validity of the antibody testing by experimenting with gluten withdrawal ahead of the testing, you are faced with two options: 1. Reintroduce significant amounts of gluten into your diet for a period of weeks, i.e., undertake a "gluten challenge". The most recent guidelines are the daily consumption of at least 10g of gluten (about the amount found in 4-6 slices of wheat-based bread) for at least two weeks leading up to the day of testing. Note: I would certainly give it more than two weeks to be sure. 2. Be willing to live with the ambiguity of not knowing whether gluten causes you problems because you have celiac disease or NCGS (Non Celiac Gluten Sensitivity). There is no test for NCGS. Celiac disease must first be ruled out and we have tests for it. Celiac disease has an autoimmune base. NCGS does not. GI symptoms overlap. In the early stages of celiac disease, other body systems may not be showing stress or damage so, symptomatically, it would be difficult to distinguish between celiac disease and NCGS. Both conditions require elimination of gluten from the diet for symptom relief. Some experts feel that NCGS can be a precursor to celiac disease.
    • suek54
      Hi Kayla Huge sympathies. I was diagnosed in December, after 8 months of the most awful rash, literally top to toe. Mine is a work in progress. Im on just 50mg dapsone at the moment but probably need an increased dose to properly put the lid on it. As you have been now glutened, I wondered whether it might be worth asking for a skin biopsy to finally get a proper diagnosis? Sue  
    • MicG
      I had been eating reduced gluten until about 3 days before the test. I did realize that wasn’t ideal, but it was experimental to see if gluten was actually bothering me. One slip up with soy sauce and it was quite clear to me that it was, lol. 
    • trents
      Possibly. Your total IGA (Immunoglobulin A, Qn, Serum) is actually high so you are not IGA deficient. In the absence of IGA deficiency, the most reliable celiac antibody test would be the t-Transglutaminase (tTG) IgA for which your score is within normal range. There are other things besides celiac disease that might cause an elevated DGP-IGA (Deamidated Gliadin Abs, lgA) for which you do have a positive score. It might also be of concern that your total IGA is elevated as that can indicate some other health problems, some of which are serious.  Had you been practicing a gluten free or a reduced gluten free diet prior to the blood draw? Talk to your physician about these things. I would also seek an endoscopy/biopsy of the small bowel to check for damage to the villous lining, which is the gold standard diagnostic test for celiac disease.
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