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Gluten-Free Diet

How to Tell if Drugs are Gluten-Free

Last Updated on by the Celiac-Disease.com Staff 2 Comments

As if following the gluten-free diet isn’t tough enough when we feel good, having to make sure that medication is also gluten-free can be a challenge. Over-the-counter meds don’t seem to be as much of a problem in my experience. Some OTC companies even label their medication “gluten-free” on the bottle. I find the most trouble with prescription medication.

There is a website is maintained by Steve Plogsted, a pharmacist at Nationwide Children’s Hospital in Columbus, Ohio, that lists hundreds of gluten-free drugs. I have used this resource countless times to check medications that have been prescribed for myself or my son. There is a new update on the top of the page that I feel that it is important to pass on:

Some drug companies have been telling people that some of the drugs that they manufacture contain gluten. When I investigated their claims it appears that the reason they are blatantly claiming that their drugs are contaminated is because they have used a sugar alcohol as an excipient.

Sugar alcohols are not truly sugars or alcohols rather they are carbohydrates that provide a source of calories. The sugar alcohols are naturally found in a number of fruits and vegetables and may be extracted from many sources including any starch, including wheat. During the manufacturing process they are completely refined leaving behind no gluten proteins similar to making table sugar. The mostly widely used sugar alcohols used in prescription drug manufacturing are mannitol and xylitol. Both of the products are used either as sweeteners in liquid drug products or as bulking agents in the solid dosage forms.

The sugar alcohols are used in many diabetic products as well as in many health foods such as nutrition bars. Any person who consumes one of the sugar alcohols in significant quantities can experience gastrointestinal disturbances and diarrhea which may mimic symptoms celiac patients may suffer after being exposed to gluten.

National celiac organizations such as the Gluten Intolerance Group of North America. consider mannitol to be safe for use in celiac patients. Additionally, if you go to the Celiac.com website dated 11/29/07 you will find a list of items safe for the celiac patient to consume. On that list you will also find both mannitol and xylitol as well as the following sugar alcohols sorbitol, malitol, lactilol and isomalt.

What does this means for the celiac patient? If you happen to contact a drug company for information and you are told that a drug contains gluten you really need to push them to tell you which excipient in that drug product is considered the source of the gluten contamination. If it turns out to be one sugar alcohols you may wish to re-evaluate their response. While it is always up to the celiac patient to determine whether a product is safe for them, the prevailing literature continues to suggest that these sugar alcohols are safe for use.

I am glad that I read this, and now feel better armed with information and more confident should I encounter a medication that contains gluten according to the drug company. Another thing to remember is to ask your pharmacist the same questions if they are the ones to call the drug company, as I know mine has done this for me in the past.

Safe Grains and Flours on a Gluten-Free Diet

Last Updated on by the Celiac-Disease.com Staff 3 Comments

Being new or even a seasoned gluten-free eater, it can still be difficult to navigate what is safe and what is not.  Especially when it comes to grains. Just when you feel you have it down, you know what grains and common food items are safe, someone throws a tricky one at you.

Just today as I was talking with a friend, she asked me if I had tried farro, and I had to think about it second to remember that it is a type of wheat.  Grains go beyond just your typical wheat and rice, and when you hear all the common and ancient grains, it can get very confusing.  And based on last week’s article asking what people wanted to see more of on celiac-disease.com, I wanted to give a simple list of what grains were safe, and what grains are not safe.

Safe Gluten-Free Grains

Almond Meal

Amaranth

Arrowroot

Bean flours (such as garbanzo, fava, black bean, etc…)

Buckwheat (don’t let the name fool you). Also note, that items such as buckwheat noodles and pancakes may also add wheat, so always check before buying/eating.

Cassava

Coconut flour

Corn flour

Cornmeal

Cornstarch

Guar gum

Kasha (buckwheat)

Lentils

Millet

Millet flour

Mung bean starch/flour

(gluten-free) Oats*

Peanut flour

Potato flour

Potato starch

Rice (including Aborio, brown, red and black)

Rice flours

Quinoa

Sorghum flour

Soy

Sweet rice flour (do not confuse with white rice flour, they are completely different, sometimes call glutinous rice, which contains no gluten)

Tapioca Flour

Tapioca starch

Teff

Xanthan gum

Some other commonly used gluten-free ingredients in baking..

Baking soda

Baking powder

Brown sugar

Buttermilk powder

Corn syrup

Cream of tartar

Egg powder

Powdered cocoa

Powdered sugar

Sugar

*Oats are the tricky grain.  Traditional oats, such as those made by Quaker Oats are not gluten-free as they are likely cross-contaminated during harvesting and processing, with other grains.  However, gluten-free oats, such as those by Bob’s Red Mill, which are specifically labeled ‘gluten-free’ are safe and nutritious.  Some doctors have recommended that those who are new to a gluten-free diet ease themselves into eating oats after being gluten-free for six months and then trying a small amount at a time of the gluten-free oats.  There are some people that will react to the protein in oats, called avenin. If oats work for you, then oat flour is also a great, fiber-rich flour to use in baking.

And as always, eating whole foods is the best way to assure your foods are safe and gluten-free, these include meat, seafood, cheese, yogurt, eggs, fruits, vegetables, milk, and nuts.

Non-Safe Grains and Flours on a gluten-free Diet  **stay away from the following**

Barley (including barley malt)

Bulgur (also called cracked wheat)

Couscous

Durum

Einkorn

Emmer (also known as farro)

Farina

Freekeh

Graham

Kamut

Malt extract

Matzo

Mir

(non gluten-free) Oats, including oat flour and oat bran

Panko

Rye

Semolina

Seitan

Spelt

Triticale

Wheat (including wheat flour, wheat germ, and wheat starch)

Wheat berries

I think it is impossible to have an absolutely complete list, so please let me know notice if you notice anything missing, and I will add it to the list.

Gluten-Free Cold Medicine

Last Updated on by the Celiac-Disease.com Staff 1 Comment

Being sick is no fun for anyone. Trying to confirm that your cold medicine is gluten-free when you feel horrible seems like the hardest task in the world. There is a list that I use as my go-to for gluten-free medication information that can be viewed here.  My dad swears by Cold-Eeze. Every time I have had a cold since he started to use it, he is always telling me to go get some. I have never gone out of the way to check the gluten-free status up until I received an email about Cold-Eeze. I was thrilled when I found that it was gluten-free!

Cold-Eeze is available in lozenges or oral spray. There are 10 different flavors of the lozenges, including 4 sugar-free flavors.  Those flavors are:

  • Cherry
  • Honey Lemon
  • Strawberries & Cream
  • Tropical Orange
  • Lemon Lime
  • Mint Frost
  • Sugar-Free Honey Lemon
  • Sugar-Free Wild Cherry
  • Sugar-Free Pomegranate
  • Sugar-Free Chocolate Mint (safe for diabetics)

More information from Cold-Eeze:

Cold-EEZE reduces the severity and duration of the common cold.

It actually shortens your cold to help you get well sooner!

Here are a few things you should know:

  • The Cold-EEZE proprietary (zinc gluconate) formula is believed by researchers to interfere with the cold virus’ ability to reproduce.
  • The Cold-EEZE brand is the #1 pharmacist-recommended zinc cold remedy. (Source: Pharmacy Times OTC survey — June 2010, Page 80)
  • Cold-EEZE uses natural flavors and has no preservatives or colors. It is non-drowsy, non-agitating and does not affect blood pressure.
  • Cold-EEZE has legions of fans!
For Best Results:
  • Cold-EEZE treatment should begin within 24-48 hours of the start of a cold and be used daily until all symptoms resolve. The earlier, the better.
  • Completely dissolve a Cold-EEZE lozenge in your mouth. Do not chew. Repeat every 2 to 4 hours as needed.
  • The recommended daily dosage is 6 lozenges per day, which means an 18 count bag/box is a 3-day supply of Cold-EEZE for adults.
  • Children 12-17 can take 4 lozenges per day.
  • Consult your healthcare professional before giving Cold-EEZE to children under 12 years of age.
  • Cold-EEZE is safe to take with most other medications including other symptom relievers.
  • Avoid stomach upset — do not take Cold-EEZE lozenges on an empty stomach.
  • Avoid citrus fruits and juices, as well as other products containing citric acid, 30 minutes before and after taking Cold-EEZE lozenges, as they may diminish product effectiveness.
  • Zinc may interfere with the absorption of minocycline, doxycycline, tetracycline as well as Coumadin. Ask a Doctor prior to using Cold-EEZE.
  • Clinical studies demonstrated that results will vary but that on average, Cold-EEZE will shorten your cold by nearly half. As a consumer, if you are not satisfied with the results from taking Cold-EEZE, please contact us to receive a full refund of your purchase price.
NEW Cold-EEZE Cold Remedy Oral Spray

Two Sprays & Go!

The new Cold-EEZE® Cold Remedy Oral Spray is formulated with zinc gluconate, the same effective active ingredient found in the best-selling, clinically proven and #1 pharmacist recommended Cold-EEZE® lozenges. The effective proprietary formula reduces the severity and duration of the common cold.

Other key facts include:

  • Each bottle contains at least 45 doses (90 sprays).
  • The recommended two sprays per usage offer 13.3 mg of zinc gluconate, the same amount of cold remedy as in one Cold-EEZE®lozenge.
  • The new offering is available in a convenient, easy to carry spray bottle.
  • Shortens your cold, works fast.
  • #1 Pharmacist Recommended.
  • Take at the first sign of a cold.

The lozenges are labeled “gluten-free” on the back of the box and I was assured that the spray is as well.  I am not a fan of traditional cold medicines at all.  The side effects are almost worse than enduring the symptoms of the cold, in my opinion.  I love that Cold-Eeze is homeopathic and doesn’t cause drowsiness, lightheadedness, or affect blood pressure. I am going to make sure to keep this on hand for the next time I have any inkling of a cold, so I can try to shorten the duration.

Have you tried Cold-Eeze?  Has it worked for you? What do you usually use when you feel a cold coming on?

Help, I’ve Consumed Gluten!

Last Updated on by the Celiac-Disease.com Staff Leave a Comment

Most of our articles on the celiac-disease website are about gluten-free products, restaurants, and reviews, in other words, we write about how to avoid gluten. But even those of us who are vigilant, read ingredient lists over and over, and ask tens of questions every time we eat out at a restaurant will at some point be accidentally “glutened”.  To be “glutened” is not an official word, you won’t find it in the dictionary, but for those of us who have celiac, or are gluten-free out of necessity, it has become part of our nomenclature.  If I use this term with people unfamiliar with the gluten-free world, I get some pretty odd looks, but for those who follow eating gluten-free, we know all too well.

When we get glutened, symptoms can vary greatly.  Some people feel it as soon as they have swallowed the offending food item, while others may not feel anything for days.  Some of us may get an upset stomach, or a rash, some may have neurological symptoms, some may have a blinding headache, some may have weakness, some may be sick for months, and some of us actually have no symptoms.  Many of us in this last group is the luckiest one….they can eat gluten, and not feel the pain afterward.  When it is a reality, it may be the most dangerous of them all, because their bodies are actually suffering silently.  They are still incurring the damage inside, but don’t feel the symptoms, so that doesn’t even have a gauge to know when they accidentally get it.

Unfortunately, there is no set list to give as a warning about how someone will feel if they accidentally (or intentionally, for that matter) ingest gluten.  It is just such a personalized thing, that everyone reacts differently.  And may even react differently depending on how much gluten they have eaten.

I like to consider myself extremely careful with my gluten-free way of life.  Since being diagnosed with celiac, I have gone cold turkey and transformed our house into my gluten-free haven.  Our house is the one place where I know I am safe.  I do the shopping and cooking, so I know that most things coming into the house were brought there by me, and I will check over ingredients once, even twice of items from toothpaste to lipstick to tater tots.  My family is now educated on it, and they also know only gluten-free items make it past the door.  Even when I have guests over for a dinner party, book group, or drinks, I ask them only to bring the beverages, I will supply the food, just so I can remain feeling comfortable in my own house.

Of course, eating out is more difficult to control, and every time you eat out, you are taking a chance of cross-contamination.  Even a restaurant with a gluten-free menu, strict handling procedures, and the best intentions can inadvertently make you sick.  After a while, you will begin to learn the places where you feel comfortable and where you don’t.  I went from being a person that loved eating at any hole-in-wall and eating anything put in front of me without question.  Since having celiac that has completely changed, and I have definitely become a creature of habit, and tend to return to places where I feel I can eat safely.

Recently I discovered no matter how careful I was, I could not escape being glutened.  Ironically, it seems the times I have been glutened, since being diagnosed, has been at home, the place that I consider my safe place.  Once it was from tempeh, once from ricotta cheese, once from a spice blend, it will get me from products that I believed were safe and the ingredients looked to be safe as well.  These events have happened less than a handful of times, and when it has, my symptoms tend to start as mild heartburn which gradually gets worse and worse within an hour until I feel extremely uncomfortable, bloated, and in pain.  Sometimes I will also get the chills and get sleepy.  If I am out somewhere when it strikes, I would be useless.  To get relief from these symptoms, I take Pepto immediately, followed by at least 2 cups of hot chamomile tea.  I will still feel pretty awful for an hour or two, but I will gradually start to feel better after an hour of taking these things.  But the experience is still miserable enough that I would never, ever intentionally do this to me.

But this most recent episode was a complete break in my gluten-free security system.  I tend to buy my daughter gluten-free frozen waffles as a quick option for breakfast.  I have been buying them for years (even before being gluten-free), and I always look at the box to be sure I am not buying ones that contain gluten.  I always, always double-check.

So one morning, a couple of weeks ago, as I was getting ready to take my daughter to school, I asked my husband if he could heat one up for me too.  This is extremely unusual, as I try to stay away from empty carbs, but I knew I would be out for a while, and needed to eat something fast.  While I was running out the door, I grabbed the waffle and my tea and went to the car.  I started eating the waffle in the car and thought to myself, wow, this texture is different. Maybe they added flaxseed to it or something.  I thought it was grainy.  And then I had a sudden thought (after completely finishing the waffle – big mistake), called my husband and he confirmed my worst fears.  I ate a gluten waffle. I actually accidentally bought gluten-filled waffles, and neither my husband nor myself noticed.

This was honestly a nightmare come true.  I have had dreams about eating this quantity of gluten, I didn’t think it would actually ever happen. I have not had this much gluten since before being gluten-free.  The only gluten I have had since has been minuscule, by mistake.  I had no clue what to expect, was I going to pass out?  Was I going to be sick on the spot?

After bringing my daughter to school, I went straight home to try and do damage control.  I drank endless amounts of hot tea and water.  2 hours went by and so far nothing, not even any stomach discomfort.  I thought maybe the waffle was mislabeled and it really was gluten-free.  Or maybe I had so much, my body was in shock and couldn’t react?  But I was soon to find out how wrong I was.  It hit me completely differently this time, with hours of feeling like I was on a very rocky boat and throwing up non-stop, not even able to keep down water, and ending up with a horrible migraine and in bed. I actually never had a stomach ache this time, however.

It was a truly miserable experience, and even though I felt better by the next day, it is not worth it to ever feel that way again.  I couldn’t believe the waffles slipped by my extremely careful eye.

The moral, for me, is to always check, check, check…even if you think you are buying the same thing you buy week after week, a quick glance at the ingredients is more than worth it.  Mistakes will happen all along the way, which is almost inevitable, but taking a couple of extra minutes while shopping or asking questions when being served, by someone else, is so worth it in the end.

What symptoms do you get when you get glutened? Or what has been your worst glutened experience?

Thirty Minute or Less Gluten-Free Meal Ideas

Last Updated on by the Celiac-Disease.com Staff 2 Comments

We are all busy.  Before the gluten-free diet it was easy to swing by the closest fast food restaurant and pick up dinner.  Now, though it is possible, I try to avoid it.  Following the gluten-free diet forces me to think more about my food choices.  If I choose to eat out, whether it be fast food or a sit-down restaurant, I have to consider whether or not I can eat safely.  Safely means gluten-free, it doesn’t take into account any of the other health problems that may result from frequent dining out on higher sodium, higher calorie or higher fat foods.

One way I try to avoid falling into the trap of picking something up on the way home is meal planning.  I try to meal plan on Sundays before I head out to the grocery store so I have everything I will need for those meals in the house.  Once that step is complete, I try to prep as much as I can on Sunday or Monday so that I have less steps to prepare the meal on the day it rolls around.  If meat needs to be defrosted, I use our second refrigerator for that.  Notice that I used the words “I try”.  There are times that this doesn’t happen and there are times that it does, but I don’t follow through on the plan.  I am not perfect – none of us are.

I try to have a back up plan in place for those days when I have failed to follow my plan.  Keeping supplies on hand that are shelf-stable or can be frozen is one way to be prepared.  Here is my list of pantry and/or freezer items that I try to keep on hand:

  • Ground beef or turkey
  • Prego three cheese spaghetti sauce
  • Gluten-free pasta
  • Brown rice
  • Quinoa
  • Black beans
  • Garbanzo beans
  • Chebe foccacia or pizza mix (can easily be made into a pizza crust)
  • Eggs
  • Potatoes
  • Hormel chili with beans
  • Edamame
  • Diced tomatoes
  • Udi’s gluten-free pizza crust (freezer)
  • Taco seasoning (or a blend of your own – cumin, chile powder, cayenne pepper, garlic powder, etc.)
  • corn tortillas

Several quick meals can be created from the ingredients I listed above.  Dinner doesn’t have to be elaborate, just enough to get the tummy full and the body refueled.  Some of our quick, go-to gluten-free meals that take 30 minutes or less are:

  • Tacos – Brown ground meat, season & serve in corn tortillas with a side of salad and corn
  • Spaghetti – Brown ground meat & dump in a jar of Prego; boil pasta and toss with meat sauce.  Serve with green salad.
  • Chili with brown rice/quinoa.  Serve with a green salad.
  • Breakfast for dinner – fried or scrambled eggs, frittata or omelet.  Serve with fried potatoes and a large bowl of fruit.  Add fresh spinach to scramble for extra nutrients.
  • Pizza – Spread diced tomatoes (or Prego sauce) on an Udi’s gluten-free crust.  Top with mushrooms & cheese (or whatever you like).  Serve with a green salad.
  • Rice/quinoa bowls made with beans or edamame.  Add roasted vegetables to the mix.  Serve with a side of gluten-free garlic toast.

Some things I do on Sunday to make my week easier:

  • Cook enough rice or quinoa for a few meals & keep in the refrigerator or freezer
  • Slice vegetables for salads
  • Clean & slice fruit for salads/sides (some fruit goes bad faster when cut, so use caution)
  • Clean & cut vegetables for sides or use in meals.  Roasting vegetables brings out a unique flavor.  Store roasted veggies in the fridge for adding to salads, omelets, rice bowls or pizza.
  • Occasionally I will buy a rotisserie chicken (or even roast one myself) to use in lunches & dinners through the week.

Another option to consider is using a crock pot.  I don’t do this a lot, but when I do I freeze some of what I make for fast go-to meals.  Some crock pot meals that freeze well:

  • Pulled pork – pork loin + 1 –2 cups of white vinegar, salt & pepper cooked on low for 8 hours.  Toss with your favorite BBQ sauce.  Serve and freeze leftovers.
  • Pork & sauerkraut – boneless pork loin or boneless chops + 1 bag sauerkraut + salt & pepper.  Cook on low for 8 hours.  Serve over mashed or baked potatoes and freeze leftovers.
  • Pot roast – boneless chuck roast + carrots + potatoes + onions + salt & pepper.  Cook on low for 8 hours.  Serve with a green salad and freeze leftovers.
  • Roast chicken – roll up several balls of foil & place on the bottom of your crock pot.  Season your chicken and place the chicken on top of the foil balls.  Roast on low for 8 hours.  Serve as you wish and eat leftovers for the week.

While using the crock pot obviously takes longer than 30 minutes, the prep should only take minutes in the morning before you head out the door for work and then you have most of your meal ready when you get home.  If you are looking to get more creative with your crockpot, check out Stephanie O’Dea’s “A Year of Slow Cooking”.