I don't have a "re-exposure story", rather an avoidance story.

I used to have terrible cold weather, exercise induced asthma.  After nordic skiing I would be wheezing, coughing, sucking on albuterol and begging for low dose corticosteroids.  I also had terrible acid reflux.

Fast forward:Wheat free for over 6 months.  No more asthma, no reflux.  Period.  End of story.

Is it the wheat?  Can't say for sure, but it's awfully suspicious.

Reflux -- starts a day later and goes for up to a week.  And Bloat:2-5 inches on my waistline in a day, lasting up to three.  Miserable.  And why, having experienced this once, have I done it often enough to verify the connection with certainty?  I am working on that one.

Last year, I had a cookie after a few months' being wheat-free. It gave me a stomach ache, acid reflux for two days and sinus congestion for four. No more wheat for me.

Wheat increased hunger with even with only a small amount. Crackers in soup was enough to set it off.

Also, when I was trying to get off wheat, I noticed that 2eggs and 2bacon and I could go 5 hours before hunger, or 2eggs and 2bacon and toast was good for three hours before hunger. That was the final step to giving up wheat. Now three years and 59 Kg loss later, there is no doubt in my mind that wheat is evil, and I do not regard it as suitable for human food. I speculate that it increases ghrelin or cortisol.

For me, in the two years since I began eating Gluten-Free (Low Carb for 6 years), the few times I've had re-exposure to wheat, I've experienced fast onset and intense abdominal pain (known exposure during the daytime) and heartburn, indigestion, intense nausea, and disrupted sleep (exposures during evening meal not discovered until the next day).  

My husband wants to think he's fine with wheat (though I know that he has at least one gene that predisposes to celiac), but IMO, he isn't.  He eats no wheat at home because that's the default, and he's OK with that.  But if he goes out to dinner at a restaurant that serves "good" artisan bread, he  will indulge in a few bites (he does restrict his carb intake, so it's still a limited amount).  More often than not, he will sleep fitfully on those nights, snore more, and wake in the night with indigestion.  He wants to bury his head in the sand and will only acknowledge the discomfort being due to eating too many carbs, not the wheat itself.  I notice he sleeps fine if he eats a small amount of potato or rice.  Go figure.  

Our 12 yo son has been eating GF for two years also.  About 6 months into GF, he unknowingly ate wheat a number of times (licorice candy laces at a friend's house), which  resulted in outbreaks of canker sores in his mouth each time.   He also exhibits mood and behavior changes when he eats wheat, which is what prompted me to test him for gluten intolerance in the first place.

I need to be able to choose more than 1 option in the poll. The top 3 choices are me. If I just eat a little, I only get GI symptoms followed by sinus headache. If I eat more, then I get arthritis symptoms (first diagnosed when I was 13. Now that I avoid wheat, it's gone unless I re-expose myself).

I see now that I should have added two more choices: 1) More than one of the above, and 2) "other," i.e., effects not listed.

Anyway, we'll have to make do. I believe we can still get a useful non-scientific sense of what readers have experienced.

I eliminated wheat on your suggestion over a year ago. Occasional re-exposure (usually dining out) has no effect on me.

If I go for 3-4 days without wheat, grains or sugar and then go out and binge on a pizza and ice cream or something like that I become explosive within 20 minutes to an hour.  It's like a wheat and sugar rage.(I'm not saying this is an excuse for rage, I'm saying it has happened to me and I believe partly do to re-exposure)  It seems the combination of the wheat plus sugar can be the worst.  
I get red rashes around my neck sometimes right away and sometimes up to a day or later and sometimes get bad diarrhea.  
I think it can be almost dangerous to cut things like gluten and sugar suddenly out of the diet without being very serious about keeping them out. I have found it very hard to cut out wheat without binging on it later after 4 or 5 days. I don't believe that my symptoms are just psychological either.
I was also diagnosed with ADHD as a young kid and then rediagnosed with adult ADHD by 3 different doctors.  I also have bouts of mania at times too.  I am considering trying to go completely gluten/refined carbohydrate free to see if it helps with the symptoms and gives me some relief.
I have never been tested for celiac or gluten intolerance but I would like to be. I think it would help explain to my girlfriend, family and friends why I can't go out and eat pizza or have a beer or ice cream.  Right now they all think I'm a hypochondriac.

Braing fogm clogged nose and slower bowel movement.

Why i dont get diarrhea when eating wheat?

Would like to add at times I have experienced an intense fatigue the next day like I can't wake up and also sharp pains in my body and headaches.

I ditched wheat a year ago after my wife was diagnosed celiac. I immediately experienced a number of health improvements (blood lipids, sleep, allergies, etc.).

Fast forward: We all suffered some inadvertent wheat exposure yesterday via some chocolate covered Brazil nuts (of all things). This accidental A-B-A experimental design resulted in the following:

1. My celiac wife experienced what she calls "the flip" within an hour of exposure(i.e., intense GI distress).
2. My five-year-old son went to bed with some wicked reflux.
3. I woke up with some twinges in my lower back and an ache in my football-weary left shoulder. I was also complaining to my wife about fuzzy-headedness that refused to respond to caffeine or hydration. I could only describe it as "carb  flu"...

And then I read your post!

Depression, agitation and brain fog if I get glutened. Some times this comes with abdominal pain and a rash on my back - I think it is dose dependent. Cross contamination with wheat is a big issue when eating out. Needless to say, I eat out infrequently and then try to stick with the restaurants that are the most aware of gluten issues.

Several weeks ago, I started Robb Wolf's 30 day challenge.

The first two weeks were brutal - calling it a withdrawal flu was a massive understatement. So, I thought I would try some wheat and see what happened (could not be worse, I thought). Well, it was.

I still felt extremely crappy, but I was now MASSIVELY GASSY - AMAZINGLY GASSY, for about 48 hours - flatulence on wheels, in spades.  I did not go out at all in those 48 hours - when the gas came on, it went out, LONG, and QUICKLY and LOUDLY.

I am easing back into wheat and grain free. I am gluten free today and tomorrow (Sunday and Monday). I expect to try a small amount of wheat on Thursday, then maybe a little more the following Thursday.

After being wheat-free for almost a year, I have intestinal pain and inflammation after re-exposure to wheat. And higher blood glucose for a day or two (type 2 diabetic).

reading this makes me wonder- how many people with re-exposure symptoms actually have a problem with gluten versus just wheat?

It would be interesting to see if some of you are still symptom free if you ingest say barley, or rye, while remaining wheat free.  
Just a thought...I do agree with all Dr D says about wheat, but it does beg the question as to how many are truly GLUTEN intolerant.

I have limited wheat consumption severely over the last 8 months. I have lost 120 pounds, no longer have bouts of illness, asthma, depression, or low energy. I also take vitamin D and other supplements that have helped (many are from your blog recommendations).

Last week I ate a small piece of cake and dessert pizza. Shortly thereafter I started sneezing, had a scratchy throat, and runny nose. I called off sick the next day for fear of being contagious. My symptoms subsided quickly and I am now attributing them to the processed flour eaten at my work luncheon. I think it was an allergic reaction since I recall having much more severe symptoms fairly regularly in my wheat eating days. Those were attributed to an "allergy" of unknown origin back then.

The comments to this blog post and poll are incredible!

I should re-post them in a blog post to highlight all the varied versions of wheat re-exposure.

The range of benefits with wheat elimination and the effects of wheat re-exposure are truly incredible. Look at what commenter Donald Kjellberg had to say: 120 lbs lost!

Not everybody, of course, loses 120 lbs. But what other food, when eliminated, has the power to do this in select individuals? Then makes them sick on re-exposure?

I suffered from Ankylosing Spondylitis, Iritis, Plantar Fasciits, etc for a number of years. I restricted carbs, especially wheat and I've been symptom free for the past two years now.

The whole story on the KickAS forums here: http://www.kickas.org/ubbthreads/ubbthreads.php?ubb=showflat&Number=427748#Post427748

Lot's of confounders to consider. Lest I be thought of as a wheat apologist troll my wheat and grain consumption is limited (rice less so).

Any food item we omit will shift our gut bacteria away from those that thrived on that food. Others will then pre-dominate;  and so, to re-expose after (say) 3 days some of us won't have the same % protein degrading bacteria to handle the wheat protein fragments and more gaseous fermentative bacteria.

Wheat preparation is another thing and ingredients consumed at the same time can also make a difference. I think of yogurt/kefir and white/brown sugar as modulators; rather than meats/vegetables, which can interact with digestion in their own way and alter the synergy. This is not to contradict individual testimonials of their reactions; nor contest an experiment where wheat all alone is eaten and neither to ignore genetic factors .

Then there is the doseage factor regarding how much at one time is ingested. Some are prone to inflammatory reactions; their threshold may be linked to excessively stimulating co-existant fungii colonizing their intestine.

The breeding of wheat is something this blog has helped me understand. Cutting it out entirely for health reasons is for many a simple strategy I hadn't seen clinicaly used. It won't make sense to third world poor however; largely since the "hygenic" hypothesis implicates our immune systems as part of the problem.


.

My nemesis is processed grains.  Have always tended toward obesity and have only been able to control my weight by minimizing processed foods and by doing a lot of exercise.  Low carb didn't work for me.

My other nemesis is my 92 yr-old mother's sweet tooth.  Don't have the will power to resist all the junk food she demands, yet I'm her caregiver, and don't have the heart to deny her her sweets.  Have gained about 25# since moving in with her.  She may outlive me.

Am now experimenting with substituting chia seed for my usual oat/barley porridge.

I found wheat to be one of the worst things for giving me gas bloating and acid reflux, and I'd had sinus and nasal congestion my whole life. When I ate that cookie, it just re-introduced old problems. I can occasionally eat a gluten-free, grainy goody at my party place without any side effects. I also have a little sprouted rice protein powder every day.

Another odd thing about wheat: it was hard for me to stop eating it once I started. I could go through a whole box of cookies in one sitting, even though I wasn't a binge eater. But I can have a couple of gluten-free cookies and stop.

Except for one slip up this recently past holiday season, I've been sugar-grain-starch free since July 2008.  Mental fog was the most noticable re-exposure symptom I had.

My mom has had the worst acid-reflux for 40-plus years.  It had become so bad that she was on three medications just to deal with the symptoms. After much training and coaxing, I finally got across to her how to totally get off wheat.  Not at all to my surprise, after being wheat free for a few weeks, she lost weight and her acid reflux was GONE!

But she had been addicted to wheat for so long, she relapsed, and the reflux fire soon returned.  Wheat must be akin to heroin with some people.  Even though they know it's very bad for them, they can't help themselves.

Re-exposure often leads to diarrhea for me, or such a heavy feeling of tiredness that all I can do is lay down and pass out. A local pizzeria makes a darn good pie, but since I started practicing wheat-avoidance, I can't keep my eyes open after eating there. I can't say for sure that it's the wheat causing it, but definitely something in the crust. Diarrhea, on the other hand, is definitely triggered by the wheat for me.

My mom complained of gastric reflux for years, but never filled the prescriptions that her doctors would give her. I suggested wheat-avoidance- gastric reflux disappeared within 3 days and hasn't returned (has been 6 months now). I've already commented elsewhere on this blog about how much weight and bloating she has lost...

Some readers have suggested that changes in gut bacteria play a role here, and I tend to agree. When my mother stopped eating wheat, her years of gastric reflux symptoms ceased. Yet, her blood test for H. Pylori, taken one month after stopping wheat and cessation of symptoms, was positive for antibodies (indicating past or present infection) and her subsequent breath test was positive for current infection.

So, for my mother, H. Pylori + wheat = gastric reflux symptoms, and H. Pylori without wheat = no symptoms. It would be interesting to know if the H. Pylori would have disappeared after a longer period without wheat as her intestinal bacteria changed...

Interesting that I should sit down, turn on my computer and find your poll. Having gone several weeks, maybe months, avoiding gluten, I took my daughter and her boyfriend out to eat because my wife has been working late at the office lately. Although I was thinking I would just eat my steak and chicken, I succumbed to the temptation of eating about a dozen greasy, breaded shrimp that my daughter and her boyfriend ordered. It's 1:39am and I still do not feel sleepy. My left nostril is completely blocked, my stomach feels bloated, really, really full and I've been burping. In your poll I checked sinus problems but could have chose gastrointestinal or nervous problems just as well. A few weeks ago my daughter brought home a pizza and, once again, despite my knowing that I shouldn't, I ate a couple of pieces. I was sick for two days. The pain in what I think was my transverse colon was so bad I thought I might have to go to ther emergency room. Before I ate the pizza I had never gone grain-free that long before. I did this after reading Robb Wolf's book. I AM CONVINCED. No more wheat for me! Please, Lord, give me strength.

It is very interesting to read the comments here.  I have been LC for almost 4 years but have cheated sometimes (at restaurants).  I have had intestinal distress but never considered that it was from the wheat...

RE: Pizza - Just don't eat the crust.  We still get pizza and eat the toppings with a fork!

"Still others say there is no such thing."

Really?  I hadn't noticed anyone saying that.  I, like a few others, reported that I, myself, did not experience symptoms from very occasional wheat re-exposure.

When I eat wheat, I often have diarrhea the next day. And I am hungrier, I believe.

Again, 90% of this is pure mental.

Interesting the vote results are mostly on GI distress.

I'd suggest a couple additional matrixes:

1:  How long have you gone without wheat
2:  How much wheat did you consume?
3:  How neutrotic are you?

I went without wheat for 2-3 days last week.  Had a bad day on Thursday -- stuck at home with little food to eat, so had some WASA whole wheat crackers. Yuck.  Noticed some gassiness but nothing rising to the level of pain.

I do suspect it mostly is internal flora, but that shouldn't change in 2-3 days.  If you are cramping and shitting after eating some breadcrumps, you either have celiac or some severe mental problems.

Remains a good idea to advise people to give up wheat -- so prevalent is US diet and easy way to lose weight.  Hard to see it being a long term problem if not abused.

I remember stories of Indians during 1940's famine being unable to eat wheat while starving. Extreme example -- people who didn't eat wheat for 6000+ years being forced into it.  However, 50 years later common diet item.  Obesity is out of control but that is as much from 10x as many caloric units being available as in the 1930 (i.e. people don't starve to death like they used to)

"Effects not listed" for me.  I am OK on minimal wheat but when I cross a certain threshold, my eczema flares a week or two later, and my asthma sometimes returns.

On January 31, 2011, Charlie said... "Again, 90% of this is pure mental."

Your psychic ability or your plain old unfounded, indeed unfoundable, presumptuousness would be really funny - if you were trying to be funny.

But, I think you really mean "Again, 90% of this is pure mental."  Even though you do not have a clue as to whether or not anything described by others on this or any other blog really is, "90% of this is pure mental."

I think the main question you should ask yourself is, "3: How neutrotic are you?" Charlie, can you figure out how to use a spell checker? "neutrotic". HAH.

Charlie, you actually made the statement, "Again, 90% of this is pure mental." You know NOTHING about most, if not ALL, of the people who comment here. Yet, that you actually think you know what goes on in their minds! Do you use a crystal ball to make your divinations, Charlie?  

You even made the more ridiculous statement that, “you either have celiac or some severe mental problems.” Your POMPOUS, SELF-RIGHTEOUS PRETENTIOUSNESS is risible, Charlie, RISIBLE!  If anyone on this post has “severe mental problems” Charlie, it is you, and only YOU.  

I expect you are the same “Charlie” who made a complete fool out of himself on Stephan Guyenet’s blog by spewing similar complete and utter nonsense about “honesty”.

What you are doing here, as on SG’s site, is called “projection”. What you do not like about yourself, but are afraid to acknowledge in yourself, you project onto others, and claim it is they who have  â€œsevere mental problems” and that “90% of this is pure mental”. So, Charlie; it is YOU who should deal with YOUR mental state, and stop projecting it onto other people, whom you know NOTHING about!

Just like Might-o'chondri-al (what a mouthful!) mentioned, it's hard to tease out the confounders. I don't sit down and munch on some wheat stalks on my off days. These are the occasions when I allow myself to indulge in delicious croissants, scrumptious shortbread tarts and traditional Australian carrot cake (if you do something bad, you might as well be good at it). These very occasional indulgences, apart from containing wheat, also have other NADs, to use Dr Kurt's phrase, that I routinely avoid: sugar, maybe HFCS, maybe some trans fats, maybe some other additives/chemicals I'm not aware of. I know the fall-out: pimples within 24 hrs, flatulence, ankle oedema and headache. I would be hesitant to blame just one ingredient as tempting as it is to indict wheat. But I am not prepared to run an experiment involving me, wheat husks and gluten-free cookies

I'll submit "other".

No overt symptoms, but since limiting
carbs generally, wheat specifically,
my A1C stays in the low 5s, and my
insulin requirement is half what it was...

Suits me.

Jack

What if you have multiple symptoms? Grains are a disaster for a lot of people I know: http://www.cutthecarb.com/your-daily-bread-pasta-and-pizza-are-killing-you/

For those worried about their blood sugar levels, may I recommend this: chana dal

And here is an interesting article on this food:

http://www.mendosa.com/chanadal.html

From: http://www.mendosa.com/chanadal.html

"Tim writes, "While I was in Tesco ( Britain's largest supermarket) I checked on the nutritional information panel on the back of a packet of Chana Dal. It was:

        "100g = 1404kj or 332kcal
        protein 23.1g
        carbo 48.2g
        fat 6.5g
        fibre 10.0g""

But the Chana Dal currently on sale states the nutritional composition as:

Energy kCal 298kCal
Energy kJ 1,264kJ
Protein 24.0g
Carbohydrate 59.7g
of which sugars 2.2g
Fat 3.1g
of which saturates 0.3g
Fibre 16.1g
Sodium Trace


http://www.mysupermarket.co.uk/tesco-price-comparison/Rice_Pulses_And_Grain/Natco_Chana_Dal_2Kg.html

What don't I experience!  I typically avoid wheat (and gluten for that matter) as I'm pretty sure it makes me sick, but when I slip (or someone else slips me some) I end up with massive amounts of joint swelling and tenderness, diarhea, cramping, gas, bloating and brain fog.  I'm absolutely miserable.  Just that alone is enough to keep me off gluten. I have RA, so if I have repeated exposures I'll have a flare which SUCKS!

Like clockwork, I get massive pain in one or both hips with certain movements when I deviate from a low-wheat regimen. I also get heartburn, and difficulty sleeping as well. All are very good reasons to stay off the grain, for me.

depends if it is a fleeting re exposure of prolonged. no symptoms in former and in latter i get weight gain and a crackling but not painful back but im young so that explains the the painlessness. 26 yo.quiv

The varied responses to wheat re-exposure could literally fill a book.

What is amazing is that this is just a "food"--it's not a poison, medication, or some foreign chemical like a pesticide. It's just wheat.

I know that someone like Charlie would come on and say something like "it's all in your head." I hear this all the time.

I'm wondering your views on wheat products contained in cooking flavorings such as soy-sauce etc.
I've cut out wheat from bread and flour however going through all my condiments there is a small amount (~4-8% ) of wheat in these.  The physical amounts are obviously quite small in cooking so for example 8% wheat in soy-sauce would translate to about 1.5 grams out of a 20ml tablespoon serving.
It would be very hard to go the extra step and cut out my cooking condiments.
I’m not wheat intolerant, obviously.  Your thoughts?
Thanks

I have severe joint pain, especially in my knees and hips, when reexposed to gluten.  I also had GI issues in the form of slowing things down.  I went gluten free last April 2010 and had 1 exposure in September and that was enough for me to cut it out for good.  All my tests show no reaction to gluten (blood/stool), but I know there is something there my body does not like!

ps:  I agree with others who wrote about gastrointestinal flora.  I believe we need to address these issues in a broader way.   A person could have a bacterial or parasitic overgrowth (or yeast for that matter) that are "carb" feeding, causing GI distress when wheat is consumed.

Dr. Davis,

Your blog has been educational and inspirational to me as a medical professional.  I have been lurking for several months, perusing old blogs and waiting for new ones.  The conversations in the comments are interesting, sometimes heartbreaking with the illness that people have suffered before the true cause has been found.

I write now because the improvements in health the removal of wheat, and various reactions with the re-introduction of it is something that has been known in the field of Environmental Medicine for over 40 years.  

Foods other than wheat, as well as environmental chemicals, can cause similar problems with ill health.  An older, but still useful, book on the subject is 'Alternative Approach to Allergies' by Theron Randolph, MD.  In it, Dr. Randolph describes his work with food and chemically sensitive patients, his theories on why this happens, and his observations on treatment.  Because these sensitivities are highly individual, the gold standard multi-centered double-blinded placebo-controlled studies are impossible to do.

As with many doctors who practice outside the 'normal' medical paradigm, I have family and personal experience with food and chemical sensitivities.

My father had had cluster headaches since he was a young man.  He saw Dr. Randolph in the early 1980's, when I was a freshman in medical school.  Dr. Randolph diagnosed sensitivity to wheat and corn (not sure of the technique).  My father also found orange juice triggered headaches.  

When he removed these foods from his diet and went on a strict four day rotation diet, his headaches quit.  That is not the natural history of cluster headaches.  When I mentioned this to anyone at school, I was told that it was the wrong diagnosis, or it was a coincidence.  It is best to not rock the boat, so I kept quiet after a while.  

The next year, as a sophomore, I had a chemical exposure from new carpet in my apartment.  Whether it was the glue or the finish, it made me very ill.  I became confused, developed nasal allergies, couldn't do simple drug dose computations, and depressed.  My mother had to come and help me move.  Very embarrassing for a 20-something to need mommy, but I did.  

I eventually recovered almost back to normal, but even now my memory and ability to concentrate on technical materials is not what is used to be.  

My dad went back on a conventional diet after 4 years, and his headaches did not return.  He has developed diabetes, arthritis, and balance problems.  I suggested his diet might have something to do with all of this, but he is unwilling to change.  It is hard to convince an 87 year old man that he shouldn't eat his wheaties!

Extrinsic Asthma is triggered by pollen, chemicals or some other external agent; Intrinsic Asthma is triggered by boggy membranes, congested tissues, or other native causes… even adrenalin stress or exertion.

I really wish that I had tangible reasons to avoid wheat, but after a fast-food experiment at the end of last year, I had no problems to report whatsoever. So I have to rely on the theoretical information I have to motivate my avoidance of wheat.

My goodness, I didn't even know wheat can cause these. I just found ways to cure arthritis. Anyway, prevention is better than cure.

Dr. Davis,

My name is Barbara and I have been going to you for several years.  I have been using benecol light on my husbands sweet and white potatoes.  After seeing your blog on plant sterols I am worried that I am giving him something thats not in his best interests.  Would you please comment.

My son and I both have asthma, and we manage with a combination of conventional medicine and some alternative treatments like respitrol for asthma.

Nin Jiom Pei Pa Koa (http://ninjiom-hk.cwahi.net/) may be another choice. i know alot of people use it, its also non alcoholic, though it's effectiveness is not as good as alcohol based cough medicine, but it's still good to use on not so serious scratchy throat.

I started gluten/wheat free 5 days ago. But two days in and I started having terrible flatulence and loose stools. Are they connected?? Patellofemoral arthritis in both knees feeling great tho.

there are hundreds of centers for research on heart, cancer, aids etc. etc. Thyroid has been over looked for some strange reason by all of the medical authorities. This is a disease which incapacitates one socially, physically, mentally and economically. this disease is a silent killer which kills the patient slowly through using other diseases such as high blood pressure, cancer, cholesterol,memory loss,eczema, hypoadrenia and list goes on and on. the sad thing is that this is curable with simple and cheapest available medications and minerals. thyroid is one of the biggest overlooked, stubbornness by our medical system which is costing the governments and population billions economical and lots of grieve socially because this disease also effects one's decision making ability too. i and my family has suffered with hypothyroid conditions. we have been to many doctors but no help. every doctor failed to recognize the symptoms because of the stupid TSH test excuse. finally when i started getting heart problems problems despite the facts that i was in the gym 7 days a week and still gaining weight. i took some time off and started to educating my self through the internet and books. changed my family's doctors. now, every body in the family feels normal. no more quick temper, sleepless nights, weight gain, skin problems, cholesterol,blood pressure, menstrual irregularities, flu,hair loss, too much calcium in the blood, eczema to name a few. even my 8 year old dog is stopped shedding hair and is less scared of the thunder now after D3 and kelp. my 74 year old mother says that she never felt this way in her entire life. my university going son feels 100 times calm now. kelp, iodine, tyrosine, multi vitamins, liquid thermometer and dessicated hormones are not that expensive. my favorite doctors are Dr. david Derry (retired), Dr Star, Dr. william Davis, Dr. Lowe, Dr. Rind to name a few who have the balls and soul to say the way it is. I just want to say that thank you Dr. William and please keep it up.

You know, now that I am "tuned into" hypothyroidism, I see people all the time that I think have a slight or even obvious goiter or enlargement of the thyroid gland, both in person and on TV.  And I don't mean fat necks, I mean a goitrous neck, often on relatively thin people (though not always).  One of the TV people that stood out to me was a reality show former model (with a really narcissistic personality) who has a clothing line.  I think her name was Kimora and her clothing line was Phat, but don't quote me -  I was watching her neck more than the show (I was channel surfing and her swollen neck caught my attention).

On the rare occasion when I have a chance to talk about thyroid conditions with someone who has  what looks like a slight goiter to me (if we are talking about health or I mention my low thyroid condition), I don't ask outright or suggest they look like they have a goiter, but invariably they say they don't have a thyroid problem because their doctor suspected it, checked it out, and the lab says it's fine (I don't mention what I see on their neck, of course, but my tongue is black and blue later from biting back how my doctors missed my thyroid condition for so many years    ).  

Between people reducing salt (iodized salt); eating processed soy ingredients on a regular basis (soy's a goitrogen - thyroid inhibitor);  constantly stressing (running on adrenaline, burning the candles at both ends - which skews all the other hormones); and the poor state of thyroid treatment with conventional medicine, it's not surprising to see goitrous necks commonly around town on a regular basis.

This book can be found online at Project Gutenberg www.gutenberg.org/etext/18467

Dr. Davis, Your goiter blog posting brought to mind the issue of evolution of the medical profession from "art and craft" to "science based.......".

I can better understand a comment read long ago. It said that until about the 1930's and the advent of sulfa drugs, you stood less than a 50% chance of benefiting from a visit to the doctor's office.

Somewhere in the past, we did pass that threshold (I hope), and I wonder what decade would you attribute that to, and what thing or things put it over the mark.

Dr. Davis, can you comment on why you are using images of people from istockphoto to represent the faces from your TESTIMONIAL sections on the TYP website?

Isn't that unethical? I mean, these are supposedly "real" accounts from "real" people, using the TYP program. If they are real, then why do you feel the need to use stock photo images as the pictures of them?

You can find my links to these cases on todayiatea.blogspot.com/2009/05/dr-davis-heart-scan-blog-and-russian.html or simply go to www.todayiatea.blogspot.com and search for the May 17th post.

Pooti--

Simple.

In past, when I approached people to allow us to use their photos, they would not grant permission. Most cited reluctance to let everyone know they had heart disease. Same with their names. This happened time and again. Obviously, we cannot go against their wishes for both ethical reasons and the HIPAA privacy act. In fact, posting private health information is a violation of the law which can even lead to jail time. The government means business.

In short, we gave up trying to obtain permission to allow people to use their real names and photos. So the photos and names are fake. The stories are very real, though all--ALL--potentially identifying information has been changed. If, for instance, someone's Lp(a) is really 167 nmol/L, we might say it's something like 157 nmol/L, so that nothing can be personally tagged.

This is just the reality of this project. Unlike weight loss testimonials in which people are thrilled to have their before and after pictures posted, such is not the case with heart disease.

Does anyone here volunter to be the first to allow your photo and name, along with details of your health, to be posted?

Dr. Davis I have a serious problem with this unethical behavior. You can not LEGALLY nor ETHICALLY call it a "testimonial" if you've changed every fact and nothing about the entire story is actually based on truth. The most you can call each of these examples (note they are not "testimonials") is a "recreation based on similar patient accounts" (i.e. fictional account). You would then need to follow that with your disclaimer that individual results may very dramatically among each person.

Dr. Davis I think you do your patients a disservice. You can tell "stories" of success. But you cannot call them Testimonials. It's misleading advertising practises. In short it's called lying for gain.

BTW, Heidi Diaz aka Kimkins did the same thing on her website and she has a class action lawsuit going against her right now. You may argue she lied about more than her testimonials and testimonial photos. However...you are doing no better. And so you have now corrupted your message as a healer.
Not good, doctor. Whomever it was who advised you to take this path on your website should be given the boot and a big fat "your fired." It's indefensibly poor advice.

www.todayiatea.blogspot.com

BTW, Dr. Davis? I can tell you that if I were one of your patients, and you helped me reduce my atherosclerotic plaque buildup in my arteries by 63%, I would be your best advertising. Not only would I allow you to use my story and my image to help others realize this type of incredible result, but I would be a marketers' dream child.

In advertising and marketing - rule 101 is to convert an interested prospect into a client, and from a client into repeat client, and from a repeat client into an advocate.

An advocate is someone who takes your success personally and will go beyond the norm in order to help ensure your success. In other words they have a personal interest in your success. So they do things like speak highly of you every place they can. They recommend you to friends. They send you members of their family. They are gold. Priceless beyond measure.

That is a universal truth, regardless of the industry. Hell, look at Farah Fawcett and she has the most physically embarrassing problem in the world and she's out there shouting from the roof about it. So I really fail to see how your patients whom you have helped so dramatically, could possibly resist an appeal to use their true testimonial in order to help others live...

pooti,

These are interesting points that you bring up, and perhaps worthwhile exploring.  

There are numerous reasons why someone might allow their story to be told, but not want to be personally identified on the WWW.  At the same time, he/she might be very open with family, friends, neighbors, etc., but that's at his/her discretion.  That's the way I am about some health issues, very open when it feels right, but clammed up on other occasions.  It's my choice.  

I can't help feeling this issue is more of a molehill than a mountain...but obviously you feel differently.

@Anne,
Well spotted! The clothes line is called Baby Phat.
Follow the link below and click on the thumbnail of the front view, zoom in all the way by double clicking on the image and observe the inept Photoshopping round her neck to hide the goitre!
http://idn.efashionsolutions.com/asset/imageset/id/BP-D2G00134_H09_zoom
Had Google this one after your description.

Michael,

Here's a photo of Kimora Lee that is probably not Photoshopped and shows the front neck swelling more noticeably (at least I hope it isn't Photoshopped, because I've never seen her on the TV show with the skinny arms that appear in the fashion shoots).

www.babyphat.com/landingpages/landing.php?page=maternity&dept=plus

Google Kimora Lee goiter and the search results show I'm not the only one speculating that she has a goiter...oh jeeze, I need to get a life.  I  can't believe I'm googling celebrity necks now .  But I see necks like this ALL the time around town, on women of all sizes.  It's like a traffic wreck, so hard NOT to sneak a peek!

Anna, with all due respect, it really doesn't matter so much what either of us think about it. Dr. Davis actually risks his license by making these types of claims without proper designation of them as "dramatizations" or "actors" or "advertorials". Because the FTC (Federal Trade Commission) clearly outlines the rules for the use of Consumer Testimonials and Endorsements:

Part B is the relevent portion but they skirt dangerously close to the other rules as well:

http://www.ftc.gov/bcp/guides/endorse.htm

§255.2 Consumer endorsements.

(a) An advertisement employing an endorsement reflecting the experience of an individual or a group of consumers on a central or key attribute of the product or service will be interpreted as representing that the endorser's experience is representative of what consumers will generally achieve with the advertised product in actual, albeit variable, conditions of use. Therefore, unless the advertiser possesses and relies upon adequate substantiation for this representation, the advertisement should either clearly and conspicuously disclose what the generally expected performance would be in the depicted circumstances or clearly and conspicuously disclose the limited applicability of the endorser's experience to what consumers may generally expect to achieve. The Commission's position regarding the acceptance of disclaimers or disclosures is described in the preamble to these Guides published in the Federal Register on January 18, 1980.

(b) Advertisements presenting endorsements by what are represented, directly or by implication, to be ``actual consumers'' should utilize actual consumers, in both the audio and video or clearly and conspicuously disclose that the persons in such advertisements are not actual consumers of the advertised product.

(c) Claims concerning the efficacy of any drug or device as defined in the Federal Trade Commission Act, 15 U.S.C. 55, shall not be made in lay endorsements unless (1) the advertiser has adequate scientific substantiation for such claims and (2) the claims are not inconsistent with any determination that has been made by the Food and Drug Administration with respect to the drug or device that is the subject of the claim.

@Anna,
spot on! But it's still a "goitre" for me and the rest of the world. Same as "centre" and "metre". One cannot honour Yankee spelling!

@Pooti,
It's a bit over-the-top to compare Dr Davis with Heidi Diaz! Can you state, hand on heart, you're not a drug company troll?? Just wondering.

BTW, having looked up Pooti's website, he does not appear to be a drug company troll.
While I'm on Dr Davis' side here, I think that no harm is done shining a light on the issue of before & after stories. But on balance, I think Pootie is over-reacting here. For example change 160 to 157 is not falsifying the data within the error range of the measurement. However, labelling stock photos as such would probably be a good idea.

I'm with everyone that thinks Pooti is overreacting. All that need to be put on the site is something along the lines of "photographs and medical details have been changed in the interest of patient privacy". Maybe even throw something in about HIPAA. It happens all thin time with things involving medical information - the stories are real, but the details have been altered a bit to protect the privacy of the people involved. I don't see anything wrong with that. I'd have to think long and hard before putting my real face, name, and medical conditions on the internet. I did it once before in a place, much to my eventual detriment.

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