I have Celiac Sprue. Based on the number of people in PFit, I can't be anywhere near the only one. I avoid gluten, even the tiniest amounts, faithfully. No cheating here - I get too sick. When I accidentally ingest a small amount of gluten, I have symptoms for almost exactly 2 weeks. The symptoms range from 'brain fog,' anger and irritabililty to GI issues, muscle pain, poor sleep, fatigue and dizziness. (Now you know why I *do not* cheat on the diet!)

The problem? On Saturday, I accidentally ate part of a piece of pizza that was not gluten free I ordered the gluten free pizza, but that's not what they brought to the table. I didn't realize it until I'd swallowed a single, but rather large, bite. This is the most gluten that I've ingested since my diagnosis 8 years ago. On Sunday, predictably, the symptoms started showing up.

Monday I went for my run early in the day to avoid the heat. I kept my heart rate 25-30 beats below my aerobic (anaerobic?) threshold at about 145bpm. At that effort, it should have been an easy run. Yet it was perhaps my most difficult training run in the last 18 months. I was exhausted, and my body just didn't want to do the work. Today I did the intervals. It was difficult, but not as bad as yesterday. It was easier to get my heart rate up than usual.

My question is, are there any risks of continuing training at normal intensity while my body has this autoimmune response going on that is attacking my intestines? If I had the flu or a cold, I would definitely back off on the training. If I had allergies, I would not. But this is different than an allergy because the immune response is (to repeat myself) damaging my intestines. This damage will of course heal with time, but does continuing to train at normal intensity make it any worse?

Also, is there anything I can do to help treat the symptoms?

Thanks!
Eric

PS - please keep in mind Celiac is not the same gluten intolerance... Celiac has the added "benefit" of the body attacking the intestines, and that's the aspect that I'm interested in here.


What is your training goal full/half etc.? - marathon, 2:59:59
Are you a walker, runner or mix? - Runner
How long have you been training as a walker/runner? - Second marathon with PFit; last was last year
What is your current injury? - See above
How long it’s been a problem? - Last few days
What makes it worse? - Eating gluten
What is your height, weight, shoe size? - 5'7", 160, 8
Have you had any treatment? If yes, what was done? - Taking broad spectrum enzymes (including for gluten)

Hi Eric,
Although I don't have personal, first hand knowledge of Celiac, I've treated patients in the past, as well as studied it as well as many other gastro-intestinal conditions in and out of school. Yours is interesting to me due to the autoimmune issue. It makes the answer for me easy.

Yes there is an issue with continuing high intensity exercise during an exacerbation. Celiac is one giant inflammatory response. Your body does not require any further inflammation during this process....in fact it would benefit from the opposite. Proper diet, rest, hydration, re-inoculation of GI flora...and so on.

Two weeks of low intensity activity and stretching is a small price to pay for comfort and overall general health. Have you tried Echinacea or Golden Seal? I'm curious. They both have anti inflammatory effects on the gut. Slippery Elm is a stomach soother too. It is also recommended you supplement with a multivitamin due to the decreased absorption of nutrients during the inflammatory phase.

Dr. Nelson and Dr. Staruch are ND's at the office and are well informed on treatment of your issue. It sounds like you are very aware of what you eat and how to control your condition. If you needed any further help, I'd refer you to the Docs listed above.


Dr. Greg

Dr. Greg,

Thanks for the response. I was waiting for additional responses before replying, but they haven't appeared. =( I suppose Celiac isn't that well known, though.

Although I was loathe to follow your recommendation, for fear of not meeting my time goal in the marathon, my body has quite clearly told me that your advice is good. I've been running a little easier, and a bit shorter, than I have been. I don't think that 2 weeks of easing up this far out from the marathon will have a major impact on my time. Thanks again for the advice.

Eric

Just a comment. My husband developed celiac disease a couple of years ago and had to stop PFit due to severe inflammation and internal bleeding. He found that until he got the inflammation under control, exercising irritated his condition. But, once he got it under control, exercise actually improved his condition. I'd say to go with what your body is telling you.

Liza