Myeloma and celiac

December 14th 2007 post: A topic that has been discussed recently on a couple of websites, that is, Cancer Compass (http://tinyurl.com/2daxza) and Beating Myeloma, is the celiac disease-myeloma connection. There are a ton of studies on celiac disease, also known as gluten intolerance. According to this one (abstract: http://tinyurl.com/2hk8jj), it is: “an autoimmune inflammatory disease of the small intestine that is precipitated by the ingestion of gluten, a component of wheat protein, in genetically susceptible persons. Exclusion of dietary gluten results in healing of the mucosa, resolution of the malabsorptive state, and reversal of most, if not all, effects of celiac disease. Recent studies in the United States suggest that the prevalence of celiac disease is approximately one case per 250 persons.” Now, I grew up in Italy on a pasta diet. I LOVE pasta and cannot imagine my life without it. But this topic concerned me enough to buy some gluten-free pasta and think about going on a gluten-free diet at some point early next year. Let’s have a look at a few of these studies.

A study (abstract: http://tinyurl.com/2hfhgz) published in “Leukemia Research” in December of 2006 points out that “it is well known that in sera of some patients with intolerance to gluten, with celiac disease, the IgA or IgG immunoreactivity to gliadin, and elevated levels of IL-6, could be present too.” Gliadin is a glycoprotein (a carbohydrate plus a protein) found in wheat, oats, rye, barley and other cereals.

Now, this is very interesting. Let’s see: 1. Gluten intolerance is associated with high levels of IL-6. But people with celiac disease also have high levels of IL-1beta, which strongly induces IL-6. Not good. 2. The immunoglobulins IgA and IgG are involved in the immune system reaction to gliadin. What a coincidence, huh? Hmmm.

This study is the first to report “that antibodies from some M-component could be directed to gliadin antigens.” Even though more research is needed, multiple myeloma could possibly be a “more severe form of gluten intolerance than celiac disease,” connected to our immune system’s reaction to gliaden antigens. In other words, those who have this particular food intolerance could possibly and eventually develop myeloma. Did I understand this correctly??? I am almost at a loss for words.

Another excerpt: “As IgA or IgG antigliadin immunoreactivity found in sera of patients with celiac disease is diminished in patients on gluten-free diet (GFD) and by some antibiotics, it could be of importance to consider whether the same approach in patients with MM (and with antigliadin immunoreactivity), applied at the end of conventional therapy would stop myeloma progression.” How about that? Go on a gluten-free diet, as some myeloma and MGUS folks in my acquaintance already have, and see if that is enough to stop myeloma from progressing. Who knows?

Another 2006 study, published in “Aging Clinical and Experimental Research (full study: http://tinyurl.com/ythyfm), tells us that “Although lymphoproliferative disorders and intestinal tumors are the most commonly seen malignancies, many other malignancies including multiple myeloma may develop.” The study examines the specific case of an elderly patient who was eventually diagnosed with celiac disease, after 15 years of diarrhea and other symptoms. “In our case, failure of diagnosis despite 15 years of symptoms played an important role in the development of malabsorption-related complications such as anemia, electrolyte imbalance and osteoporosis, as well as multiple myeloma.” I noticed a rather curious thing: the abstract tells us that the patient had plasma cell dyscrasia but not myeloma; then the full study states that the patient was diagnosed with early-stage myeloma. Odd. Oh well. Point is, though: this study affirms that myeloma may develop in patients with celiac disease.

A 1990 German study (http://tinyurl.com/yrlfa3) examined the fate of 52 people diagnosed with celiac disease: 15% of them developed cancer, including one case of myeloma. A 2004 Irish study (http://tinyurl.com/28gkm9), titled “Celiac Disease and Malignancy,” looked at 77 patients with celiac disease. One had myeloma. Interesting statistics, if nothing else. Could there be a gluten intolerance connection for some of us? Isn’t it worth at least getting tested?

December 19th post: A friend (thank you!) sent me a case study published in 1980 and titled “Multiple myeloma and adult celiac disease.” It discusses the case of a 75-year-old woman with multiple myeloma (a bone marrow biopsy or BMB revealed 80% malignancy), a resident of Wisconsin, who “was admitted to the hospital because of diarrhea and abdominal pain.” She had had this kind of trouble for “25 years prior to admission.” So had a few close relatives. Her intestinal woes vanished after she began a gluten-free diet.
 
Keeping in mind that this study was written 27 years ago (!), let’s read the following: “The appearance of malignity in patients with celiac disease has been well described and several theories have been offered in explanation. An abnormal immune surveillance allowing for the development of a malignant clone of cells is most popular. Proponents of this theory cite the various studies demonstrating a defect in the immune apparatus, such as a reduction in the number of ‘T’ cells or immunoglobulins, or demonstrating a defect in immune function, such as impaired response to mitogens or reduced cytotoxicity. Other explanations include inherent genetic predisposition (celiac patients with malignancy have a higher frequency of having the histocompatibility antigens HLA-A1, HLA-B8, and HLA-B12), and the accumulation of dietary carcinogens because of the lack of detoxifying enzymes and appropriate cell turnover in the small bowel mucosa.” Hmmm. Detoxifying enzymes, eh? I must look into this when I have more time (hah!).
 
Further on, “Multiple myeloma, a malignant conversion of an immune functioning cell, had not been reported in association with celiac disease. It is tempting to speculate that chronic antigenic stimulation in a patient with abnormal immune response resulted in the plasma cell dycrasia. In patients with multiple myeloma who have persistent, unexplained diarrhea or steatorrhea, endoscopy and biopsy are indicated to rule out amyloid or celiac disease.”

Plasma cell dyscrasia, by the way, is a group of diseases characterized by the proliferation of a single clone of plasma cells. This clone produces a huge amount of a single antibody, or monoclonal antibody, known as M-protein. Multiple myeloma is part of this group and so are other plasma cell malignancies, such as Waldenstrom’s macroglobulinemia. And MGUS. I think it’s always good to review this stuff (sometimes I forget specifics, too!).

Update. My January tests turned out negative for celiac disease. Bring on the pasta! 😉

18 thoughts on “Myeloma and celiac

  1. Patty

    Months after I was diagnosed as asymtomatic MM I went to a nutritionalist that did muscle testing to develope an eating plan. It resulted in no gluten in my diet. I did test fine to sprouted breads and used those for about a year or more. A skin problem resolved immediately. Then I came across an article about the gluten sensitivity in a monkey that is genetically the same as humans. The study reveiled that these monkeys developed the IGG and IGA protein. After I read this I decided I would be off all gluten containing foods. I miss my wheat pasta – especially since I am 100 % Italian decent – but I have substituted the rice pasta instead. I noticed a definite GI improvement as a result! I will look for the article and repost the information.

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  2. Sue

    This might sound ridiculous, but how do people get doctors to order tests for Celiac Disease? I asked a gastro doctor to order the tests for me 5 years ago, and he refused. Primary Care Doctors will no order them either. Is this an HMO insurance thing or just a ridiculous doctor thing?

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  3. Jim

    No, it’s just a ridiculous doctor deity thing because my primary care physician has no problem ordering it neither does my family doctor and has ordered it on occasion without prompting. Also try using curcumn with bromelean, piperine, or bio-curcumin.

    Reply
  4. Mary Earhart

    Please don’t rely on a single test to rule out gluten intolerance. There are many false negatives. My daughter has celiac and my husband has the two worst gluten intolerant genetic markers that you mention. He is 70 years old and has insisted since he doesn’t have celiac that gluten is not a problem for him. He has developed a destructive lesion on his 10th rib, we expect a diagnosis of MM or plasmacytoma. Thank you for this article. He is now willing to go gluten free. I hope it is not too late.

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  5. Juliet

    I was diagnosed with Smoldering Myeloma in Feb. 2010. I went off gluten a month later due to mild intestinal distress and acid reflux. I immediately felt better. My Myeloma bloodwork and symptoms have steadily improved since my initial diagnosis. In Feb. 2011, after 11 months gluten free, my free light chains assays were normal! Back in 2010, I did have an intestinal biopsy and blood tests for Celiac, all were negative. Doctors were puzzled. I eventually found confirmation of mild gluten intolerance with the ALCAT test. I believe Gluten Intolerance was subtly in the background my whole life. I still eat the same foods just different flours – no big deal once you learn how. And, if I have better results on the Myeloma front – so worth it!

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    1. Jan

      Hi Juliet, just wondered how your health is and if you are still on a GF diet. My husband has had MM for 5 years and is very unwell now with acute renal failure and extremely high free light chains. I have felt that he is gluten intolerant but he refuses to keep trying a GF diet even though he feels and looks so much better, as eating normal bread etc seems to be more important to him. I dare not bring it up with his doctors as they don’t seem to want to look sideways at any possible food link. I know that in my case my severe asthma disappeared completely when I discovered I was coeliac and went on a GF diet and energy and vitality returned! My husband has had sinus issues for as long as we have been married (38 years) and beyond and that is not a normal human function to be blocked up or blowing your nose constantly. Just interested to know if you have been able to reverse your numbers with diet?
      Best wishes, Janette

      Reply
  6. Gary Walker

    I have MM and have been gluten free for about 3 years. I was tested for Celiac and dairy sensitivity using the Enterolabs procedure which anyone can get. You don’t need a Doctor’s order.

    Sometimes I wonder IF going gluten and dairy free let down my immune system’s guard. Prior to that my nose was constantly running as my immune system responded to the dairy and gluten. Once I stopped dairy my sinuses cleared up!

    Bottom line is that despite going gluten and dairy free I still developed a plasmacytoma on my foot AND have lesions on my skull, clavicles, and possible tumors on my sternum and spine. I felt absolutely great until March of 2011 when my foot started to hurt after a Duathlon. The pain persisted and developed to include the sternum and spine. I’m starting stem cell transplant in about 3 months. All but the gentlest of hugs gives me pain in the chest and back.

    Gluten free may help those with gastro issues feel better….but don’t expect it to cure your MM.

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  7. :)

    I agree with the one comment, you should not rely on a blood test to diagnose Celiac Disease.

    I have read up about the MGUS/CD connection, while I am not a doctor, it makes sense to me. Often though, things are connected in ways we simply don’t grasp yet, especially in the human body.

    Surely, once one has become ill with MM, just eliminating gluten won’t do the trick. But it may be important to avoid gluten, in case it is the cause. One can treat MM as much as one likes, if one keeps feeding it with gluten (if gluten is indeed the culprit), MM will never go away.

    Thank you so very much for your wonderful blog, I have learned tremendously from it.

    :)

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  8. :)

    In regards to pasta, Bionaturae makes wonderful gluten free pasta – in Italy! Dr. Schar makes wonderful gluten free products, in Italy and Germany. Pizza crust, baguette, biscuits, focaccia, toast, bread, crackers…
    It is possible to eat everything as in the past, just with different flours.

    :)

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  9. Kat

    I have been mgus IgG Kappa with free light chain and Bence Jones protein in my urine since 1998. I was diagnosed at 38 years old but suspect I had it at least 10 years prior. I suspected a Gluten Allergy and did the blood test, negative, tried again and negative. I found out that if you also have an immune deficiency, I have IgA deficiency and IgG subclass immune deficiency that you will test negative for Celiac. So I embarked on a Gluten free diet and am stable so far. I know I do feel better, less bloating. Funny my numbers increased after I went off my vegan diet. I am now embarking on a Gluten free vegan diet again and see if this brings my numbers down. I will report back at my next blood test next year. I think anything we do to “clean up” our diet and eat good whole foods is beneficial. :)

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  10. diane

    well Margaret..just when you think you have minded all the back content in this blog… very interesting, i looking at the IgA (me) connections and malabsorption/ vit D and calcium involvement. It just seems a rather fundamental link that doctors could easily look at. I know my quality of life has improved greatly having gone gluten free after i was tested for the genetic markers (positive) although i was not tested for the anti bodies, nor did i have the biopsy. I am still not absorbing Vit D, and need 100,000 iu by injection each month, which is connected with the SMM in not a good way. The genetic connection and the fact that my father died of lymphoma makes me think he had the same problem, but never knew.

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  11. Kat

    Happy to report my numbers went down by 50% from smoldering to Mgus with the elimination of both Gluten and soy and my liver function (ALT, AST) tests were normal for the first time in many years! I had promised to report back and I am saying even if you test negative for Celiac, you could be sensitive and you owe it to yourself to try to go Gluten free for at least 6 months (be strict) if you feel better and your numbers are better that’s all the testing you need to do. I was so happy in my Immunologist’s office I had tears…I had been so afraid when my numbers went up and now I had some control back and being Gluten free isn’t so bad, it does take some planning ahead. Best of luck to you all…can’t wait to share these results with my oncologist in February for my annual check in!

    Reply
  12. Paula NZ

    No BUT I am gong to follow it soon.
    My treatment has bought my paraprotein down from 19% to 1.1% also lGg down to 5.9 from 26/28 although the Alymoidoisis is still only halved, but I have another 3 months of the 9 month treatment to go.
    I am definitely going to follow GUT health as in Dr Mercola and Dr Natasha McBride from the UK a biochemist who explained the gut health gluten/celiac/candida/fungi/immune through to bone marrow connection..this is explained in the article in her interview with Dr Mercola.

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  13. Bev Johns

    My husband has been diagnosed with multiple myeloma and I wondered whether anyone has been successful with treating it with a gluten free diet. We asked for a celiac test this past week and are awaiting results. Does anyone know of recent studies on celiac and multiple myeloma. Any help would be greatly appreciated because we are very afraid of chemotherapy.
    Thanks.
    Bev

    Reply

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