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Celiac Disease: Exploring Four Myths

An Expert Shines Light On Common Misconceptions About This Genetic Autoimmune Disease Triggered By Gluten. ...

Healthwatch 15

An expert shines light on common misconceptions about this genetic autoimmune disease triggered by gluten.

Gluten-free bread & bagels with 12 appetizing toppings like avocado & olives, hummus & chickpeas, sliced hardboiled eggs & greens; concept is celiac disease

Celiac disease is a digestive and immune disorder that can keep the body from absorbing necessary nutrients. "Our conception and awareness of celiac disease has evolved over the past few decades, but there are still aspects that remain poorly understood," says Dr. Ciaran Kelly, medical director of the Celiac Center at Beth Israel Deaconess Medical Center and professor of medicine at Harvard Medical School.

Perhaps not surprisingly, misconceptions are widespread among the general public. One example? Many people assume that everyone who has celiac disease is plagued by abdominal pain, bloating, or diarrhea. But actually, many adults newly diagnosed with this inherited gluten intolerance don't have these symptoms.

What's more, gluten — the sticky protein found in grains such as wheat, barley, and rye — can cause gastrointestinal distress and other symptoms in people who don't have celiac disease. Read on for a deeper dive into four myths and facts about celiac disease and related digestive conditions.

Myth # 1: Celiac disease is usually diagnosed at a young age

Not typically. While celiac disease can develop any time after a baby's first exposure to gluten, it's usually diagnosed much later in life. According to the National Celiac Association, the average age of diagnosis is between 46 and 56. Around 25% of people are diagnosed after age 60.

Celiac disease is slightly more common in women and among people with other autoimmune conditions, including type 1 diabetes, Hashimoto's thyroiditis (a common cause of low thyroid levels), and dermatitis herpetiformis (a rare condition marked by an itchy, blistering rash).

"We don't know why some people go from being susceptible to actually having celiac disease," says Dr. Kelly. The prevailing theory is that some sort of physical or emotional stress — such as a viral infection, surgery, or anxiety from a stressful life event — may "flip the switch" and cause the disease to appear, he says. "Increasing numbers of people are being diagnosed at midlife and older, often after they're found to have conditions such as anemia or osteoporosis caused by nutrient deficiencies," says Dr. Kelly.

Myth #2: Celiac disease only affects the gut

When people have celiac disease, eating gluten triggers an immune system attack that can ravage the lining of the small intestine. A healthy small intestine is lined with fingerlike projections, called villi, that absorb nutrients. In celiac disease, the immune system attacks the villi, causing them to flatten and become inflamed — and thus unable to adequately absorb nutrients.

While gastrointestinal problems can occur, they aren't always present. In fact, celiac disease can present with many different symptoms that affect the nervous, endocrine, and skeletal systems. A few examples are brain fog, changes in menstrual periods, or muscle and joint pain.

Myth # 3: Celiac disease versus gluten intolerance

If you feel sick after eating gluten, you probably have celiac disease, right? Actually, that may not be true. Some people have non-celiac gluten sensitivity (also called gluten intolerance), which can cause uncomfortable digestive symptoms after eating gluten. But gluten intolerance differs from celiac disease.

Celiac disease is diagnosed with blood tests that look for specific antibodies. If antibodies are present, a definitive diagnosis requires an intestinal biopsy to look for signs of damage that characterize the condition.

Non-celiac gluten sensitivity does not trigger antibodies or cause intestinal damage. Yet some people with this problem say they also experience brain fog, trouble concentrating, muscle aches and pain, and fatigue after eating gluten-containing foods.

"Non-celiac gluten sensitivity appears to be a real phenomenon, but it's not well defined," says Dr. Kelly. It's unclear whether people experiencing it are intolerant to gluten or to something else in gluten-containing foods.

One possibility is sugarlike molecules known as FODMAPs, which are found in many foods — including wheat. Short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, gas and bloating can occur when gut bacteria feed on FODMAPs.

Another possibility is an allergy to wheat, which can cause symptoms such as swelling, itching, or irritation of the mouth and throat after eating wheat. Other symptoms include a skin rash, stuffy nose, and headache, as well as cramps, nausea, and vomiting. Some people may develop a life-threating allergic reaction known as anaphylaxis.

Myth #4: A gluten-free diet always relieves the symptoms and signs of celiac disease

The sole treatment for celiac disease — adopting a diet that avoids all gluten-containing foods — doesn't always help. This problem is known as nonresponsive celiac disease.

"About 20% of people with celiac disease have ongoing symptoms, despite their best efforts to stick to a gluten-free diet," says Dr. Kelly. Others have intermittent signs and symptoms, particularly when they are accidentally exposed to gluten. Accidental exposures often happen when people eat prepared or restaurant foods that claim to be gluten-free but are not. Cross contamination with gluten-containing foods is another potential route.

Potential solutions to nonresponsive celiac disease are being studied. Three promising approaches are:

Enzymes that break down gluten, which people could take alongside gluten-containing foods. "It's a similar concept to the lactase pills taken by people who are lactose intolerant to help them digest dairy products," says Dr. Kelly.

Dampening the immune response to gluten by inhibiting an enzyme called tissue transglutaminase that makes gluten more potent as an antigen.

Reprogramming the immune response to prevent the body from reacting to gluten.

Harvard Health Publishing

Can Saw Palmetto Treat An Enlarged Prostate?

Scientific Evidence Shows Little Or No Benefit. Marketed As A Natural Remedy For An Enlarged Prostate,...

Healthwatch 15

Scientific evidence shows little or no benefit.

Close-up of ripe berries on a branch of a saw palmetto tree; the berries are used in the making of a dietary supplement.

Marketed as a natural remedy for an enlarged prostate, saw palmetto is a top-selling dietary supplement. It's extracted from berries that grow on saw palmetto palm trees, which are native to the southeastern United States.

By one estimate, more than a third of all US adults who take supplements use saw palmetto specifically. Some evidence suggests that saw palmetto has anti-inflammatory properties, and its use as folk medicine dates back over a century.

But experts at Harvard say men should view its supposed benefits for prostate health skeptically. "Saw palmetto is unlikely to harm you, but it probably won't provide any major benefits either," says Dr. Heidi Rayala, an assistant professor of urology at Harvard Medical School and Beth Israel Deaconess Medical Center.

BPH and the potential effect of saw palmetto

It's common for men to develop an enlarged prostate, or benign prostatic hyperplasia (BPH), when they get older. BPH impedes urinary flow through the urethra, causing obstructive symptoms that can worsen with time.

Just how saw palmetto might act on the prostate to improve symptoms isn't entirely clear, however. Some evidence suggest it mimics the effects of certain drugs used for treating BPH, including 5-alpha reductase inhibitors such as finasteride (Proscar), which shrink the prostate gland.

In the US, no herbal supplement is approved as BPH treatment. The American Urological Association cautions that studies backing saw palmetto for treating enlarged prostates have numerous flaws, including short durations and a lack of placebo controls. Most of the supporting evidence comes from small studies paid for by companies that sell dietary supplements.

What do randomized clinical trials show?

The best-conducted research shows no benefits from saw palmetto for BPH. During one study, 225 men with moderate to severe BPH were treated with either a placebo or 160 milligrams (mg) of saw palmetto, taken twice daily for a year. The investigators detected no difference in outcomes, but they also acknowledged that doses tested in the study may have been too low to produce measurable effects.

So, during a larger subsequent study, researchers tested higher doses of saw palmetto ranging up to 320 mg given three times a day. Nearly 370 men ages 45 and older were randomized to treatment or placebo groups. After year and a half, men in both groups reported feeling either no worse or a little better. Remarkably, 40% of the placebo-treated men said symptoms had improved, suggesting the simple act of taking a pill could have something to do with the supplement's perceived benefits.

Dr. Michael Barry, a professor of medicine at Harvard Medical School, led the study. He urges men to consult with their doctors before trying saw palmetto, mainly to rule out other potential causes of urinary obstruction, which can include bladder or prostate cancer. And saw palmetto may interfere with the blood's clotting ability, making it risky for men who take blood thinners.

Recent results and comments

The latest evidence on saw palmetto and BPH comes from a Cochrane Review of 27 placebo-controlled studies enrolling a combined 4,656 participants. Results published in 2024 showed no improvement in urinary symptoms or quality of life from taking saw palmetto (alone or with other herbal supplements) over durations ranging up to 17 months.

"If the ingredients in these herbal products worked well for urinary symptoms, drug companies would have already had them approved by the FDA as a medicine that insurance companies would have to cover," Dr. Rayala said. "It's okay to take them, but just be cautious about spending too much of your own money on these alternatives."

"It is easy to understand why so many find taking a naturally occurring supplement for treating urinary difficulties in middle age appealing," said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of the Harvard Medical School Guide to Prostate Diseases. "However, evidence of effectiveness with saw palmetto is lacking, and its use for BPH and other common urinary symptoms without a full evaluation of the potential cause should be discouraged."

Harvard Health Publishing

US And Saudi Arabia Agree To $142bn Weapons Sale During Trump Visit

The White House Says An Agreement With Saudi Arabia Includes Investments In Weapons And Technology Totaling $600bn. The Administra...

Worldnews 10

The White House says an agreement with Saudi Arabia includes investments in weapons and technology totaling $600bn. The administration of United States President Donald Trump says that Saudi Arabia will invest $600bn in the United States, including through technology partnerships and a weapons sales agreement worth $142bn. A fact sheet shared by the White House on Tuesday explains that the agreement, which also includes collaboration in areas such as energy and mineral development, is the largest-ever weapons sale between the two countries. “The deals celebrated today are historic and transformative for both countries and represent a new golden era of partnership between the United States and Saudi Arabia,” the fact sheet reads. The pact represents a deepening of economic and military ties between the two countries, a trend that has continued for decades under both Republican and Democratic US presidents. Trump was in the Saudi capital of Riyadh on Tuesday as part of a Middle East tour, marking the first major international trip of his second term as president. Later in the week, he is expected to make stops in Qatar and the United Arab Emirates. But already, the trip has renewed criticisms that Trump may use the diplomatic outing to advance personal interests. The proposed transfer of a $400m luxury aeroplane, for instance, from Qatar to the US Department of Defence has raised questions in the US about the ethics and constitutionality of accepting gifts from foreign governments. During his first term as president, in 2017, Trump likewise included Saudi Arabia on his first major trip abroad, a voyage that similarly culminated in a multibillion-dollar arms deal. But the global outcry over the 2018 murder of Saudi journalist Jamal Khashoggi at a consulate in Istanbul briefly threatened to upend the relationship. The US government has alleged that forces linked to Saudi Crown Prince Mohammad bin Salman were responsible for the killing. Tuesday’s agreement is designed to help modernise the Saudi military with “state-of-the-art warfighting equipment and services from over a dozen US defense firms”, according to the White House fact sheet. “The first key component of this is upgrading the defence capabilities of Saudi Arabia,” Al Jazeera correspondent Hashem Ahelbarra reported from Riyadh. “This is a country that has been trying to invest vast amounts of money over the last few years” in its military, he added. But the newly minted deal is not limited to security cooperation. The agreement also lays out a plan in which Saudi Arabia will invest $20bn in energy infrastructure and data centres for artificial intelligence in the US, a significant infusion of cash into industries with close ties to the Trump administration. In both areas, US companies stand to reap a potential windfall. “Saudi Arabia wants to become one of the top global investors in artificial intelligence, and that’s why you see many tech CEOs here in Riyadh, who are looking forward to getting some of those contracts,” said Ahelbarra. The deal also includes references to collaboration on energy infrastructure and mineral investments, without offering many details. Various US administrations, including during Trump’s first term in office, have used the inducement of greater collaboration on security and arms sales to push Saudi Arabia to normalise diplomatic relations with Israel. The two countries have never had formal diplomatic ties. But during Trump’s first term, the Republican leader initiated a series of agreements known as the Abraham Accords to boost ties between Israel and various Middle East states. Countries like the United Arab Emirates, Bahrain and Sudan agreed to recognise Israel as part of the agreements. But Saudi Arabia has been a holdout — and normalising ties between it and Israel could be seen as a crowning achievement for the second Trump administration. Israel’s war in Gaza, however, has complicated those efforts. United Nations experts have warned that Israel’s actions in Gaza were consistent with genocide, and South Africa has accused Israel of genocide before the International Court of Justice. The International Criminal Court, meanwhile, has issued arrest warrants for Israel’s Prime Minister Benjamin Netanyahu and former Minister of Defence Yoav Gallant over accusations of war crimes. The spiralling death toll in Gaza and allegations of human rights abuses have caused outrage in the region and hardened Riyadh’s insistence that normalisation should come only as part of a wider agreement on a Palestinian state, a move Israel is not willing to consider. Follow Al Jazeera English:...

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Zelenskyy Will Have Face-to-face Talks In Istanbul, But Will Putin?

The Ukrainian Leader Will Travel To Meet Turkiye’s Erdogan And See If His Russian Counterpart Turns Up. Ukrainian President Volody...

Worldnews 6

The Ukrainian leader will travel to meet Turkiye’s Erdogan and see if his Russian counterpart turns up. Ukrainian President Volodymyr Zelenskyy says he will travel to Turkiye this week and wait to have face-to-face talks with Russian President Vladimir Putin amid intensive pressure from the United States administration and European leaders to find a settlement to end the more than three-year-long war. Zelenskyy said on Tuesday that he will be in Ankara on Thursday to conduct the negotiations. He will meet Turkish President Recep Tayyip Erdogan, and the two will wait for Putin to arrive, he said. Zelenskyy and Erdogan would then both travel to Istanbul. Putin has not yet said whether he will be at the talks he proposed. Moscow has not directly responded to Zelenskyy’s challenge for Putin to meet him in person at the negotiating table. Kremlin spokesman Dmitry Peskov again refused on Tuesday to tell reporters whether Putin will travel to Istanbul and who else might represent Russia at the potential talks. “As soon as the president considers it necessary, we will make an announcement,” Peskov said. Russia has only said it would send a delegation to Istanbul “without preconditions”. If Zelenskyy and Putin were to meet on Thursday, it would be their first face-to-face meeting since December 2019. Much has changed since then. United States President Donald Trump has urged the two sides to attend as part of Washington’s efforts to stop the fighting. Trump has offered to join the talks himself. Trump said on Monday he was “thinking about actually flying over” to Istanbul to attend the negotiations. That was welcomed by Zelenskyy, but there was no reaction from Moscow. “All of us in Ukraine would appreciate it if President Trump could be there with us at this meeting in Turkiye. This is the right idea. We can change a lot,” Zelenskyy said. Trump publicly asked Zelenskyy to attend, after Putin on Sunday proposed the direct talks following a rejection of a 30-day ceasefire that Ukraine and its Western allies insisted should come first. The Ukrainian leader said he would, but that Putin should also attend in person. On Tuesday, his adviser Mykhailo Podolyak reiterated that Zelenskyy would only meet Putin and no other members of the Russian delegation. Meanwhile, German Chancellor Friedrich Merz pressed again for an unconditional 30-day ceasefire on Tuesday. “We are waiting for Putin’s agreement,” he said. “We agree that, in case there is no real progress this week, we then want to push at European level for a significant tightening of sanctions … We will focus on further areas, such as the energy sector and the financial market,” Merz added. He welcomed Zelenskyy’s readiness to travel to Istanbul, “but now it is really up to Putin to accept this offer of negotiations and agree to a ceasefire. The ball is in Russia’s court.” I have just heard President Trump's statement. Very important words. I supported @POTUS idea of a full and unconditional ceasefire — long enough to provide the foundation for diplomacy. And we want it, we are ready to uphold silence on our end. I supported President Trump… — Volodymyr Zelenskyy / Володимир Зеленський (@ZelenskyyUa) May 12, 2025 Meanwhile, Ukraine said its air defence units destroyed all 10 drones that Russia launched overnight on Tuesday. This is the lowest number of drones that Russia has launched in an overnight attack in several weeks. The Ukrainian military’s general staff said as of 10pm (19:00 GMT) on Monday, there had been 133 clashes with Russian forces along the front line since midnight, when the ceasefire proposed by European powers was to have come into effect. Ukraine’s top commander, Oleksandr Syrskii, was quoted by Zelenskyy as saying the heaviest fighting still gripped the Donetsk region, the focus of the eastern front, and Russia’s western Kursk region, nine months after Kyiv’s forces staged a cross-border incursion. Meanwhile, Russia accused Ukraine of attacking Belgorod, with Governor Vyacheslav Gladkov saying on Tuesday that Ukrainian forces used 65 drones and more than 100 rounds of ammunition to attack the region in the past day. Follow Al Jazeera English:...