Below is Dr. Peter H.R. Green’s Health Questionnaire from his book, “Celiac Disease--A Hidden Epidemic.” This is a book I highly recommend. It is packed full of information great for anyone who has CD – newly diagnosed or a CD veteran – or anyone who has unexplained symptoms. Also, for anyone who missed Dr. Green speak at the Celiac Disease Foundation's Annual Conference in May 2010 – mark your calendars now for next May and hope that he will be back! He is a great speaker with a real passion for helping people with CD!
Symptoms:
Check each of the symptoms that you have experienced at
least once a week during the past three months:
____Bloating
____Gas and/or stomach cramping
____Diarrhea or runny stools
____Constipation
____Joint pain
____Numbness or tingling in your extremities
____Itchy skin lesions
____Constant unexplained fatigue
____Frequent headaches or migraines
Diagnoses:
Check if you have had or been diagnosed
with any of the above:
____Irritable bowel syndrome
____Eczema or unexplained contact dermatitis
____Fibromyalgia
____Chronic fatigue syndrome
____Nervous stomach (non-ulcer dyspepsia)
Associated Conditions:
Check if you have any of the above:
____Anemia
____Infertility/multiple miscarriages
____Lactose intolerance
____Psychiatric disorders or depression
____Osteopenia and/or osteoporosis
____An immediate family member with an
autoimmune condition or celiac disease
____Peripheral neuropathy
____Autoimmune disorders
Thyroid disease (hyper/hypo)
Diabetes mellitus (Type 1)
Sjőgren’s syndrome
Chronic liver disease
____Non-Hodgkin’s lymphoma
____Small intestinal cancer
SCORING
If you have checked one or more lines in either
Section I or II and have any of the illnesses in
Section III (especially males or women under age
45 with osteopenia and/or osteoporosis) you
should consider testing for celiac disease. If you
have checks in all three sections, you and your
doctor(s) should definitely explore a diagnosis of
celiac disease.
All of the symptoms in Section I all of the diagnoses
in Section II and all of the associated illnesses
in Section III are intimately related to celiac disease.
One in every 100 people in the United
States is affected by celiac disease – and 97% of
them are undiagnosed!
Do not start a gluten free diet before consulting a health care provider. You must be eating a diet containing gluten for accurate test results.
***The Celiac Disease Foundation also has a great brochure (Are You The One?) that you can print and bring with you to your doctor’s office.
***Be patient. Celiac Disease can be difficult to diagnosis. Be persistent. It’s your body and your health!
