Posts Tagged ‘autoimmunity’

Immunity, Bacteria, and Babies!

November 16th, 2011

by Sean Croxton

Truth bombs were falling out of the sky last night as I sat down at my desk to watch the rest of Dr. Natasha Campbell-McBride’s lecture from the Wise Traditions London DVD.

I learned all about how the health of the digestive system plays a HUGE role in asthma, epilepsy, depression, and a whole lot more! Mind blowing info, indeed.

Tomorrow, I plan on filling you guys in on the whole asthma situation. Did you know that asthma meds actually cause long-term lung damage?

It’s true!

But today I felt the need to talk about one of my favorite topics, reproduction. I love talking about baby making!

Click the video below to learn how your immune system was inherited from your mother, and why it is so incredibly important for women (and men) to ensure that their guts are well stocked with healthy flora.

Too many babies are coming into this world with the chips down. What results is an ugly cascade of compromised immunity, infections, antibiotics, worsened gut flora and immunity, leaky gut, toxicity, food sensitivities, and autoimmunity.

Talk about a domino effect!

Let’s nip this thing in the bud by educating ourselves and eating with our children in mind.

If you’re interested in learning more about health baby-making, click HERE to check our my buddy Chris Kresser’s Healthy Baby Code program. You’ll dig it.

See you tomorrow!

Sean Croxton
Author, The Dark Side of Fat Loss

The Glutathione-Autoimmune Connection! (Part 2)

May 17th, 2011

by Sean Croxton

NOTE: If you have not read yesterday’s blog, this one will likely go over your head. Check it out and come on back!

So now that we’ve met the players in this game, let’s discuss how we can keep them from screwing up team chemistry and resulting in autoimmunity.

Once considered quackery, the role of the gut mucosa, or intestinal barrier, has over the years become a more established factor in triggering autoimmunity. As you learned yesterday, when your gut is inflamed with big holes punched in it (intestinal hyperpermeability), undigested food particles and other not-so-nice stuff can make their way into the circulation (your bloodstream) and trigger an immune response.

But what happens when your immune system gets a little trigger-happy? What happens when that undigested rib-eye steak molecule you’ve been fighting off for years starts to look a lot like your thyroid, or your pancreas, or your adrenal glands?

In a case of mistaken identity, your immune system begins attacking tissues, organ, and glands. It can even attack hormones like estrogen, leaving you infertile. No bueno. This process is called molecular mimicry, confusing one molecule with another.

Environmental toxins, called haptens, can also trigger autoimmune reactions. Haptens include inorganic compounds like the formaldehyde coming out of your carpet, chemicals in your water, as well as heavy metals like mercury, lead, and cadmium.

Here’s where glutathione comes in. As I explained in last week’s Underground Antioxidant blog, one of glutathione’s primary roles is detoxification. It acts like sticky paper grabbing onto toxins and carrying them out of the body for you. In other words, when rogue chemicals and bad guys come into your body, glutathione takes the hit for you, allowing the immune system to rest.

However, when glutathione levels are depleted due to aging, toxicity, stress, and poor diet, YOU take the hit. And you take it right in the immune system! When environmental toxins enter the body with your glutathione defenses down, big bad TH-17 is upregulated, contributing to autoimmune flare-ups.

If you recall, the activity of the TH-17 system determines the severity of the autoimmune flare-up. If you are currently dealing with autoimmunity, or would like to avoid it altogether, downregulating TH-17 by way of maximizing glutathione levels is certainly in your best interest.

Note: If you are a practitioner and suspect toxicity is playing a role in your patient’s or client’s autoimmune condition, you may want to think twice about using heavy detox protocols (like chelation) without increasing glutathione levels first. Heavy metal chelation can be devastating to anyone with autoimmunity if glutathione is not there to take the hit.

Let’s get back to the TH-1 and TH-2 balancing act. Autoimmune conditions typically (but not always) show dominance in one system over the other. The role of the T-regulatory cells is to reduce this polarity. When there is a downregulation of these T-regulatory cells, TH-1 and TH-2 go off kilter, thus triggering the faulty immune process.

Glutathione to the rescue!

Research shows that glutathione plays a critical role in upregulating T-regulatory cells, bringing TH-1 and TH-2 back into balance and calming autoimmunity.

Speaking of research, this study published in the Journal of Pharmaceutical Science demonstrated “a significant correlation between plasma glutathione and SLE (lupus) severity exists that may aid evaluation of the disease severity and usefulness of the management of SLE”. (sources: Pubmed & Kharrazian lecture slides)

SLE, or lupus, is the most destructive of all autoimmune conditions. This study showed that those with the most severe symptoms had the lowest glutathione levels.

If its role in the activation of the T-regulatory cells, the balancing of TH-1 and TH-2, downregulation of destructive TH-17, and improved detoxification isn’t enough for you, consider this. Glutathione also reduces intestinal barrier inflammation, promotes healing of the mucosa, and contributes to healthy gut function. In other words, it helps keep the flies out, reducing or eliminating yet another autoimmune trigger.

Glutathione’s ability to enhance tissue healing is critical not only for preventing autoimmunity but also for recovery from autoimmune flare-ups. This likely explains the reduced exercise-induced muscle soreness when taking Protandim, which is proven by peer-reviewed research to increase glutathione by 300%.

An additional therapeutic measure for dampening autoimmunity is to increase levels of superoxide dismutase (SOD), another powerful antioxidant enzyme. Coincidentally, the discoverer of SOD is Dr. Joe McCord, the primary formulator of Protandim and winner of the 1997 Elliott Cresson medal for co-discovering the biology of free radical reactions in living organisms. That means he co-discovered the entire field of free radical biology.

I think he’s credible! :)

This paper from The Ohio State University published in 2011 demonstrates a threefold increase in SOD activity in the Protandim-treated group.

Boom.

I cannot say enough about how vital and imperative it is for you to maintain healthy glutathione levels, not only for preventing or dampening autoimmunity, but also slowing down cellular aging, reducing oxidative stress, and protecting you from chronic degenerative diseases. I hope that this series of blogs has opened up your eyes to the power of this critical antioxidant enzyme.

There are 50 million people in this country with autoimmune disease. One of the most well-known is former talk show host Montel Williams, who was diagnosed with multiple sclerosis (MS) in 1999. MS develops when the immune system attacks the myelin sheaths coating the neurons in the brain. Symptoms include lack of coordination, double vision, jerky eye movements, involuntary leg movements, slurred speech, muscle weakness, and seizures.

In the video below, Montel gives his testimonial regarding the power of Protandim, a supplement that he credits so much for allowing him to live a fairly normal life that he tried to buy the company. However, it was not for sale.

This is not a sales pitch. I’m just sharing what I know can help millions of people boost health and fight disease. No more. No less.

That’s it for me today. It has given me much pleasure to share this life-changing information on nutrigenomics, hittin’ switches, NRF2, glutathione, and autoimmunity this past week.

Tune in tomorrow for another Inspire Millions challenge from Brett Klika and me! If you have low back pain, you won’t want to miss it!

I’m out! Keep hittin’ those switches!! ☺

Source: Lecture notes/slides from Dr. Datis Kharrazian’s Autoimmune Regulation by the Nitric Oxide and Glutathione Systems lecture

Protandim

Sean
www.undergroundwellness.com

The Glutathione-Autoimmune Connection! (Part 1)

May 16th, 2011

by Sean Croxton

I love living in downtown San Diego.

I couldn’t imagine living anywhere else.

I’ve been here for almost three years. The people are nice, crime is low, and Padres season never fails to liven things up during the spring and summer months.

But if there is one thing I haven’t gotten used to in all my time here it’s the one-way streets. Those things come out of nowhere! There have been plenty of days when I’d come to my senses at just the last moment before going against traffic down 7th Avenue.

I prefer walking to driving anyway. At least once a week I catch myself waving my arms frantically from the sidewalk in an attempt to get an errant driver’s attention.

No one wants to see an accident.

But imagine a place where no one called out to that driver, a place where oncoming traffic preferred not to flash their lights and slow down, where bystanders just stopped, watched, and waited for a head-on collision.

That would be crazy.

Such is the state of conventional medicine’s approach to autoimmunity. Allow me to explain.

Right now, approximately 50 million Americans, or one in five people reading this blog right now, suffer from autoimmune disease. According to our good friend-in-gluten Dr. Tom O’Bryan, autoimmunity is the number three cause of morbidity (sickness) and mortality (death) in the industrialized world. Unfortunately, many people with autoimmune conditions are either misdiagnosed or not diagnosed at all.

Autoimmunity is what happens when your body’s immune system goes haywire and confuses your own tissues as foreign invaders. The immune system produces antibodies against these tissues, causing their progressive destruction.

The keyword here is progressive. It doesn’t happen overnight.

For example, your immune system may be currently producing antibodies to your thyroid. You may not feel any effects today, however five years from now you may experience symptoms of hypothyroidism.

Your doc may ignore the antibodies (they usually never test for them anyway) and prescribe some form of thyroid medication. Yet the problem does not reside in the thyroid itself. Rather, the root cause is the autoimmune reaction being perpetrated by the thyroid antibodies produced by your immune system! Medication won’t stop these antibodies from flaring up and chewing away at your thyroid tissue. The destruction continues.

So you’re in and out of the doc’s office for years with the same recurring symptoms that only seem to be getting worse. Eventually, you are diagnosed with Hashimoto’s thyroiditis, an autoimmune condition for which severe conditions are commonly treated with steroid medications. Not good.

Here’s my beef. In order for an autoimmune condition to be officially diagnosed, there must be severe tissue destruction. But again, this destruction does not happen overnight. It is progressive. What absolutely boggles my mind is that the current medical approach to autoimmunity is to be the bystander watching the car drive against traffic without warning until an accident happens!

Maybe it’s just me, but I would assume that early detection of these antibodies (we’ll discuss this tomorrow) as well as addressing the faulty immune system would be a much more effective approach in controlling autoimmunity.

Notice that I used the phrase “controlling autoimmunity”. Once the autoimmune genes have flipped on, they stay on. The best we can do is contain them. This may be discouraging for some, but containment is certainly preferable to severe tissue destruction.

Think of it this way. You can turn your car around and drive with traffic instead of against it.

Understanding the cast of characters playing a role in autoimmunity is paramount to containing it. The key players we will discuss today are the mucosal/intestinal barrier, the TH-1 and TH-2 immune systems, the regulatory T-cells, and TH-17 system.

You’re Letting the Flies In!
A healthy mucosal barrier acts like the screens that cover your windows, letting the good guys in and keeping the bad guys out. This protective mucosal layer lines your airways, lungs, intestines, and reproductive tract.

Your intestines are where 80% of your immune system resides. When the intestinal barrier is compromised, it is like a kid coming around and poking holes in your window screens on a hot day with no air conditioning. Next thing you know, you’ve got a house full of flies, gnats, and mosquitoes. Ugh!

When your intestinal barrier is compromised due to inflammation, bacterial and/or fungal overgrowth, parasites, stress, medications, and/or food sensitivities, you’re in the same predicament as you were with the holey window screens. But this time undigested food particles and various gut bugs can cross over into your bloodstream where they’re not welcome. When this happens, your immune system recognizes these antigens as invaders and mounts an immune response to fight them off. In other words, it acts just like you when you have a room full of flies. Your immune system grabs a magazine and starts whacking away!

Of course, you can’t spend your whole summer swatting flies. If you’re smart, you’ll go to the hardware store and buy yourself some new window screens. And maybe give that crazy kid a spanking. We’ll get back to this. The new screens. Not the kid.

Playing Seesaw with the Fat Kid
The design of your immune system is something to behold. It makes nerds like me get all excited and stuff!

The two pathways of primary importance to those with autoimmune reactions (antibodies only, no diagnosis) and autoimmune disease (severe tissue destruction, diagnosed) are the TH-1 and TH-2 systems.

The TH-1 system goes on the attack when it encounters an invader (antigen). You can think of it as the FBI chasing after the bad guys.

The only problem with this FBI squad is that they got hit hard by federal budget cuts and lost their vision coverage, making them dependent on the TH-2 system to properly identify intruders for them in the case of future antigenic invasions. The TH-2 system does this by tagging intruders and entering them into a criminal database. That way, the next time the intruders attack, the TH-1 system will be ready to pounce all over them.

An imbalance between these two systems is where the immune system goes wrong and autoimmunity begins. If the two sat on opposite sides of a seesaw, they should both have their feet off the ground. However, when the systems become polarized with one side of the seesaw on the ground and the other way up in the air, you should start looking for oncoming traffic.

An overactive TH-1 system is an immune system in “shock and awe” attack mode just looking for something to go after, including your own harmless tissues, glands, and organs.

An overactive TH-2 system is one that gets tag-happy, sticking tags on everything it can, including innocent bystanders like perfectly healthy foods you consume every day. Consequently, mistaken identity goes on the rise with your immune system committing frequent acts of friendly fire.

Autoimmune conditions tend to be TH-1 or TH-2 dominant. While there are certainly exceptions to the rule, TH-1 dominant conditions include Hashimoto’s thyroiditis, multiple sclerosis, and Type 1 diabetes. TH-2 dominant conditions include lupus and dermatitis.

Regulators! Mount up.
If the dominance of one side of the immune system is keeping the seesaw from moving, you need the help of the T-regulatory (T-3) cells to even them out. Think of them as seesaw-balancing specialists. When these cells are asleep on the job, imbalance occurs and one side of the seesaw hits the dirt.

Quite interestingly, opioids stimulate T-regulatory cell activity. This is why many autoimmune conditions go into remission while spending time laughing with loved ones.

Crazy, huh?

There’s Always a Villain
The final character in this immunological movie is TH-17. He’s all about drama. The severity of autoimmune flare-ups depends on the activity of TH-17. When activity is high due to increased stress, lack of sleep, or depleted glutathione, bad things happen.

Did someone say “glutathione”?

(((the crowd goes wild)))

Sorry, guys! I’m out of time. Gotta wait until tomorrow when you’ll learn how raising your glutathione levels repairs the intestinal barrier, balances TH-1 and TH-2 via activation of T-regulatory cells, turns down that big meanie TH-17, and much more!

Same underground time! Same underground channel!

Out!

CLICK HERE FOR PART 2!

Sean
www.undergroundwellness.com
Protandim

Detecting Gluten Sensitivity: The New Frontier

December 21st, 2010

by Sean Croxton

I used to be the King of Whole Grains.

Indoctrinated to be a processed food salesman by my university-taught nutrition courses, I spent several years drilling the base of the USDA Food Guide Pyramid into the skulls of my personal training clients.

“Six to eleven servings of bread, rice, and pasta a day, you people!! How on Earth do you expect to meet your energy and fiber requirements? Do it! DO IT NOW!”

Fast-forward ten years to present day and I can’t help but wonder how much damage my whole grain zealotry may have caused. Who knows how many of my clients were overweight, fatigued, depressed, and more due to undiagnosed gluten sensitivity.

I honestly didn’t know any better.

And even when I thought I knew the intricacies of gluten sensitivity and celiac disease, I really didn’t. Yeah, I knew more than the average person, but I was still in the Stone Age as far as the research was concerned.

That all changed last week when I had the privilege of attending Dr. Datis Kharrazian’s Understanding the Complexity of Gluten Sensitivity seminar here in San Diego. As always, Dr. K blew my mind with his thorough research and clear presentation on a topic that literally affects millions of people. The doc dropped some monster truth bombs!

I also had the unexpected opportunity to meet Dr. Thomas O’Bryan, the world’s leading expert on gluten. If you missed his appearance on UW Radio, be sure to check it out. It’s definitely one of my all-time favorites.

With new information comes responsibility. So, even though I can’t by any means claim to be an authority on gluten, I feel it is my duty to share what I believe to be a new, promising paradigm in the detection and diagnosis of gluten sensitivity. This is literally information that will not only change lives, but save them as well.

Gluten sensitivity is an immune response to gluten, which is found in commonly consumed grains such as wheat, spelt, kamut, oats (unless designated gluten-free), rye, and barley. In other words, it’s pretty much the bottom of the food pyramid I was at one time enamored with, the very same foods we are advised to eat the most often. I could probably write a short book on how this errant dietary recommendation has caused much pain and suffering by way of inflammation, intestinal destruction, neurological disorders, and autoimmunity, but today we’ll stick to the matter of detection. Again, I direct you to Dr. O’Bryan’s interview to learn more about the repercussions of gluten sensitivity.

In my own Functional Diagnostic Nutrition practice, one of the first recommendations I give to my clients is the removal of all gluten-containing grains. Actually, these days I even go a step further and not only remove gluten, but all grains, legumes (including peanuts), and dairy products. It never ceases to amaze me how the removal of gluten alone can cause such a profound improvement in my clients lives. Energy improves. Bloating disappears. Bowels become regular. Libido returns. Brain fog dissipates. Skin clears up. One simple recommendation can make a world of difference.

Despite their apparent improvements on a gluten-free diet, many of these same people had at one time been tested for celiac disease and gluten sensitivity. All had tested negative, giving them no conclusive reason to stop consuming gluten.

But if the tests came up negative, then why do they feel so much better when they stop eating gluten?

The answer is that the tests most commonly used to detect gluten sensitivity are nowhere near as thorough as you’d think.

Let’s start with celiac disease, a genetic autoimmune condition that falls under the umbrella of gluten sensitivity. With celiac, the consumption of gluten causes damage to the small intestine. According to Dr. Kharrazian in his bestselling book Why Do I Still Have Thyroid Symptoms?, “the disease affects up to one in 100 Americans, although only 1 in 8 are expected to be aware of their condition, as symptoms are silent.”

Dr. O’Bryan describes celiac as one of the most common lifelong disorders in the United States and Europe. In fact, autoimmune disease (when your immune system attacks your own glands, tissues, and organs) is ten times more common in those with celiac disease and gluten sensitivity than the general population (1). Coincidence? I think not. When we consider that autoimmune disease is the number three cause of morbidity and mortality in the industrialized world, you can understand why detecting sensitivity to gluten is of critical importance. At the same time, we must also wonder why it is so seldom diagnosed.

The gold standard for celiac diagnosis is a small intestinal biopsy, which requires a sample of the cells in the intestinal wall to detect gluten-induced injury. An extremely uncomfortable procedure to begin with, intestinal biopsy commonly results in false negatives since intestinal damage can vary from one location to the next. Also, since the intestinal cells are replaced every few days, the biopsied area may have healed prior to the procedure. In fact, the intestine will appear perfectly normal after just a week or two of strict compliance with a gluten-free diet (2). Hardly a definitive test by any stretch, many true celiacs slip through the cracks. Told that gluten is not the cause of their health challenges, many spend the rest of their lives seeking help for “unexplained illnesses”. Meanwhile, they are eating themselves sick.

Another marker for celiac disease is tissue transglutaminase and endomysial antibodies. This blood test is said to be 97% accurate, an extremely impressive statistic when taken at face value. However, it only exhibits such pinpoint accuracy when there is total villous atrophy, or when the small intestinal lining has been worn all the way down! With only partial villous atrophy the test’s accuracy plummets to 32%. What this means is that the test is wrong 7 times out of 10 and that in order to be diagnosed with celiac the intestinal wall has to be demolished beyond recognition! In other words, you may in fact have celiac disease, but your gut just isn’t bad enough yet for the doctor to diagnose it. So you just continue eating gluten until sufficient damage accumulates for standard diagnosis. Silly, I know!

Speaking of silliness, gluten sensitivity (which may or may not be celiac) is often detected by what are called gliadin antibodies. Gluten is actually made up of two components, gliadin (the protein part) and glutenin (the sticky part). The gliadin protein is believed to be the immune-reactive component (more on this later). A positive gliadin antibodies test indicates the immune system is mounting a defense against the protein.

The big problem with the gliadin antibody test is that there are four components of gliadin: alpha, beta, gamma, and omega. However, this test only measures the alpha portion, since it is most commonly associated with celiac disease. The test ignores the remaining three potentially reactive gliadin components! You can test negative for alpha, but may still be positive for beta, gamma, or omega. Unfortunately, you’d never know since you were not tested for them! This is the “state-of-the-art” testing we’ve relied upon for the detection of a potentially debilitating condition.

But wait, there’s more.

Glutenin: Gliadin’s Other Half
As mentioned above, gluten is composed of gliadin and glutenin. It has long been believed that only the gliadin portion is responsible for gluten sensitivity. According to a study published in the European Journal of Gastroenterology and Hepatology (2006), “it is highly probable that the glutenin proteins are toxic.” In other words, laboratories are only testing for half of the potentially immune-reactive components of gluten. And for the half that they do test (gliadin), only one-quarter of it is being measured (alpha gliadin).

Traditional gluten testing does not look for glutenin antibodies.

Deamidated Gliadin
We have yet another reason to avoid processed foods. By way of a process called deamidation, food manufacturers alter the gliadin protein in order to make it more water soluble and easier to mix with other foods and liquids. This deamidation process also occurs naturally in the intestines, which can be a problem within itself. But the use of deamidated wheat isolates in our food supply has become a hidden source of food allergy. In fact, immune T-cells respond more readily to deamidated gliadin than non-deamidated gliadin.

What all this means is that an individual can have no sensitivities to any other forms of gliadin but its deamidated form in processed foods. And the immune system’s response to it will be far more aggressive.

Traditional gluten testing does not look for deamidated gliadin antibodies.

Wheat Germ Agglutinin (WGA): Rethinking Sprouted Wheat
WGA is the lectin component of wheat. As I mentioned in my previous blog, lectins are present in all grains and can pass through the gut wall in their intact form, causing the immune system to recognize them as foreign invaders and mount a defense against them. WGA, the most studied of the lectin family, is found in high concentrations in whole-wheat products, especially sprouted wheat. Maybe that Ezekiel bread isn’t so good for you after all.

WGA reactions can cause red blood cells to clump together. Not good. It can also break down the blood-brain barrier and inhibit nerve growth factor (just as bad as it sounds). Common WGA-induced symptoms are poor circulation, cold hands and feet, reduced learning capacity, and brain fog.

Traditional gluten testing does not look for wheat germ agglutinin antibodies.

Gluteomorphins: Are You an Addict?
Many people who go gluten-free claim that the diet actually makes them feel worse. This can be quite baffling if one is unfamiliar with gluteomorphins. Common in autistic children, gluteomorphins are opiod peptides formed during the digestion of the gliadin component of the gluten protein (3). For these folks, getting off of gluten can be like kicking a cocaine habit!

The discontinuance of any addictive substance will result in a period of withdrawal lasting a few days to several weeks. In the case of gluteomorphin withdrawal, symptoms can include neurochemical imbalances, altered mood, and gastrointestinal distress. Yes, gluten can be a drug.

An individual whose immune system is making antibodies to gluteomorphins will have a much tougher time in the early phases of a gluten-free diet.

Traditional gluten testing does not look for gluteomorphin antibodies.

Wrapping It Up
Ugh! I hate when my blogs turn out this long. Another antibody to look for is prodynorphin. A basic building block of endorphins, the manufacturing of prodynorphin can become depleted in gluten sensitive individuals, leading to vulnerability to drug addiction, schizophrenia, bipolar disorders, and a form of epilepsy (3).

Lastly, many gluten sensitive individuals go off of gluten and continue to have problems. This can be due to cross-reactivity with other foods, including rice, corn, quinoa, chocolate, cow’s milk, and more. Your best bet is to avoid all grains. And while you’re at it, cut out the legumes and dairy too. If you don’t think you can do this, I highly recommend you get tested for any cross-reactive foods.

So, how do you get tested for what today’s standard lab tests tend to miss? Well, as of today you can’t. Remember, I did say that this is a NEW paradigm of gluten sensitivity detection. After over a year of anticipation, Cyrex Laboratories will finally open its doors on January 11, 2011 and will make the definitive tests for gluten sensitivity available to the millions of people who desperately need them. For more information, please visit www.cyrexlabs.com. This is a very exciting time in the field of immunology and autoimmunity!

Again, I’m no expert on gluten sensitivity. Nor should any of us have to be in order to get the best testing possible for such a potentially debilitating condition. The effects of undiagnosed gluten sensitivity are far-reaching. It can literally affect all parts of the body and be involved in any disease process. You can be gluten sensitive and have absolutely no gastrointestinal symptoms. In fact, more people will have gluten disruption against the brain than against their intestinal tracts. It can be a silent killer slowly wearing down the body until enough destruction has occurred to warrant an autoimmune disease diagnosis. If the antibodies are present, autoimmunity can’t be far behind.

Get tested. And get the right test.

Hang tight. January 11th is right around the corner.

Disclaimer: The author is in no way affiliated with Cyrex Laboratories. He just thinks this stuff is really cool!

Sources
1. ACAM Podcast: Antibody Array for the Detection of Autoimmune Disease Disorders Associated with Gluten Sensitivity and Celiac Disease presented by Dr. Thomas O’Bryan. Available on iTunes
2. Dangerous Grains by James Braly, M.D., and Ron Hoggan, M.A.
3. Dr. Datis Kharrazian, Understanding the Complexity of Gluten Sensitivity lecture slide notes

Sean Croxton