Sunday, April 28, 2013

Medications May Contain Hidden Gluten: Cytomel "Very Likely Contains Gluten"

Many people assume that medications are free from major allergens like wheat. People who follow a medically prescribed gluten free diet are told (by doctors and in support groups) to look up online whether a particular medication is gluten free. When I was first prescribed Cytomel, I confirmed it was gluten free by looking it up on the website and speaking with my pharmacist. It was on the list and the pharmacist confirmed it being gluten free.

When a friend, who has celiac disease and the same low thyroid issue as I do, called me to tell me how upset she was when she discovered that this brand name thyroid medication called Cytomel contained gluten, I really didn't know what to think.  Lisa pointed out "I am just so upset--every can of soup has to be labelled with ingredients and you can see if it contains wheat. But prescription medicine doesn't have to be labelled? How is this possible?"

To get more information about whether Cytomel contained gluten, I spoke to Christine with customer service at Pfizer 1-800-438-1985, the pharmaceutical company that manufactures Cytomel. Christine looked at database and checked with someone else and reported back that: "it lists as an inactive ingredient "starch" which would be wheat based and likely to be a potential source of gluten"

I was actually shocked to hear that it contains wheat starch. I have been on this medicine for a few years. (A few years, I will add, that I have been doing so-so and thought that my thyroid problems were causing me problems--never thinking it might be from gluten in my doctor prescribed thyroid medication.) After hearing that Cytomel contains wheat starch, my doctor replied "I am stunned and speechless."

In an informative article titled 3 Steps to Choosing the Right Thyroid Hormone, Chris Kesser confirms
"Cytomel, which is a popular synthetic T3 hormone, has modified food starch – which contains gluten – as a filler."
Because thyroid problems and celiac disease/gluten intolerance go together it is disappointing that Pfizer is not using a different type of starch that is not a major allergen. It's not like Cytomel is a bagel or croissant that needs to contain wheat/gluten to be chewy and yummy. There is no reason to not use corn starch or another non-allergenic starch in the inactive ingredients.

But, the bigger issue,  is WHY AREN'T PHARMACEUTICALS REQUIRED TO LIST INGREDIENTS AND MAJOR ALLERGENS like food companies? How can a company like Pfizer get away with listing "starch" as an ingredient and not tell consumers the source of the starch? And how many of their other medications also contain "starch" which is actually wheat?

Unfortunately, the Gluten in Medicine Identification Act of 2012 (House of Representatives 4972 Bill) never passed. Until there is better disclosure, the safest thing to do is to call the pharmaceutical companies directly and ask if there is gluten in the medication.



I confirmed the generic my pharmacy carries of Cytomel, called Liothyronine Sodium,  from Paddock Laboratories is gluten free by speaking directly to customer service at Paddock Laboratories (800) 328-5113. Because formulas change, it is best to check DIRECTLY with the manufacturer about whether a medication contains gluten. (You can look at the back of your prescription label to find the name of the manufacturer--but you might need your glasses because the print is so tiny.)

Paddock Laboratories, who makes the generic my pharmacy sells, is much more transparent with their ingredients (inactive ingredients: Calcium Sulfate, Cellulose, microcrystalline, hypromellose, talc and silicon dioxide) which are listed at the National Library of Medicines Daily Med site page for the liothyronine sodium. The same Daily Meds page for Cytomel does not mention any inactive ingredients so it is harder to know exactly what it contains.

I am happy to report if you switch to a gluten free starch--and if you ever certify your medication to be gluten free!

Thursday, April 11, 2013

How to Get Your Kids to Eat Their Vegetables

From the GF archives...

A mother picked up her daughter from my house today and remarked casually about her two girls "They still don't eat any vegetables!" A few minutes later, she announced again "I just can't get them to eat vegetables." Well, as soon as they walked out the door my daughter announced "Why are we the ONLY ones who have to eat VEGETABLES!"

Four years of hard work to get my kids to eat their veggies went down the drain. "Well," I said, "we eat vegetables because they are healthy--and they taste good. And you do have some friends who eat vegetables--Billie has to eat vegetables, right?" Finally, I asked "Do you want a break from eating your vegetables?" thinking it might be good to lose the battle and win the war. So tonight, my two kids took a break from eating vegetables while I enjoyed a bowl of kale and some out of this world asparagus parmesan.

The truth is, my kids don't willingly eat vegetables. They have to eat some vegetables if they want dessert. And it's usually something green: my son will eat a salad, my daughter will have some peas or green beans or cucumbers. It's completely optional but if you want something sweet at the end of the meal you need to have "vegetables first--dessert second." I don't feel like it is bribery--you just have to do xxx in order to do yyy. Dessert is definitely a reinforcer.

"Fine if you don't eat it but we can't move on to dessert." I say if they don't want the vegetables. And I am truly fine with them not eating any vegetables and skipping dessert.

My kids didn't always eat vegetables with dinner. For a long time, I didn't want to force them to eat vegetables.They would eat whatever they wanted. There were enough rules about eating since they couldn't eat gluten (or dairy) that I really wanted eating to be fun and without additional complications so I held off on forcing the issue. They would eat vegetables in the summer and although they occasionally did eat some vegetables, it was not a routine but a random event.

Then I went to visit a relative who doesn't cook at all but had decided for health reasons her daughter who was a very picky eater needed to eat vegetables with dinner. After years of her saying "She doesn't eat vegetables" she decided that it was imperative that her daughter eat vegetables after a life threatening illness. Since she doesn't cook at all, she had a bag of frozen green beans and a bag of frozen peas and she would alternate them. Peas one night. Green beans the next. She would put a cup of water in an omelet pan and bring it to a boil with a little salt. Then she would boil the vegetables in the water for four minutes. When I returned home from our visit, I was inspired and the kids had been served vegetables every night for almost two week, so we began our routine.

To make it a little more fun I often put the peas or beans in shot glasses and gave them a choice. "Peas or beans?" I would yell for the fun of it as I cooked dinner. It didn't matter to me which they chose. We just needed to start incorporating vegetables into our dinner more regularly. "Do I have to?" they would whine at some point. "No." I would say. "You don't have to eat them. But if you want dessert we have vegetables first. Dessert second." That's it. End of story. Very unemotional.

You need to start somewhere.

"Where is your leverage?" I remember learning at a parenting course. Well, dessert was my leverage. I guess for other people it could be something else. I know the relative who got her daughter to eat her veggies used a second helping of pasta as her leverage. Sometimes you need to finish your veggies, but you never need to clean your plate. Half of whatever is healthy is the unoffical rule at my house.

And gradually, my kids have learned to eat their vegetables. I don't know if they like them. But I am guessing they have learned to not hate them. And I don't make them eat kale--although some kids love it. They eat vegetables that kids eat: carrots, cucumbers, pickles, green beans, peas as well as a few family favorites: artichokes, olives, sauerkraut, and a salad. And they each have the things they will eat and won't. My son will eat a salad but will eat only one pea. My daughter will eat salty peas but won't go near a salad.

It's not easy--it is hard work. But, it's not magic--it's just a moment in your life as a parent when you realize that eating vegetables is important and necessary to health and not something you can opt out of. I was a picky eater so I am completely sensitive to picky eaters, but eating vegetables is too critical to good health to be something kids don't do.

"Rome wasn't built in a day" so it's okay if you move gradually toward having them eat vegetables. Start with one carrot or one pea. Make it unemotional but make it count. One pea at a time. (Or jicama.) Just do it.

Related posts:
My List of all Fruits and Vegetables
Beyond "Eat Your Peas, PLEASE!"--Getting Kids to Eat Vegetables
Fresh, Raw Food--An Important Source of Glutathione
Easy Green Herb Dip
Snack Trays
Going Green with Green Beans

Toastabags for Gluten Free Toast

Toastabags are small bags that you can use to toast gluten free bread and prevent cross contamination of crumbs. I would always prefer a dedicated gluten free toaster--but in a pinch while traveling these bags might be helpful for some people on a gluten free diet. They also might be helpful for people at work. Most gluten free bread needs to be toasted or warmed up to taste like anything. When I am traveling, I end up using the broiler to make toast--but I have a few times burned toast. So, these bags might be a better option. They are sold online on Amazon or at Pip's Place in NYC.

Wednesday, April 3, 2013

A Gluten Free Shopping List

Q: Can you send me an average shopping list for a gluten free family?
Thanks. I am new to this and need a head start.

A: So amazing that you asked for a shopping list. I had a shopping list in my scanner to post today. Below is a list of what I buy at the supermarket. Some other things (like gluten free pasta and gluten free desserts) I usually purchase at a health food store  But if you don't have access to specialty markets you can serve rice and potatoes and corn as starches which are easily found at the regular market. I don't have rice/potatoes/corn on my list because I had some potatoes and rice. Also, things like Lay's potato chips and Fritos are also gluten free (and dairy free.) Regular soy sauce and Twizzler's both have gluten in them so these are things you need to be careful about. But you can buy gluten free Tamari as a substitute for gluten free soy sauce. Let me know if you need more information. 

  • Hormel Pepperoni
  • Boar's Head Pastrami - 1/4 pound
  • Boar's Head sliced turkey - 1 pound
  • chicken sliced thin (organic, raw)
  • organic grass fed beef/meat
  • 2 or 3 small pieces of flounder

  • cucumber (organic)
  • carrots (organic- mini and large)
  • artichokes  (3 or 4) X
  • spinach (organic box or loose)
  • lettuce (organic box romaine)

  • Raspberries (1) organic X
  • Blueberries (1) organic X
  • 2 lemons
  • 6 limes
  • 2 yellow delicious apples
  • 2 green apples
  • oranges

  • Organic juice (1 package of 3 small individual juice boxes Fruit Punch)
  • Kettle brand potato chips - organic
  • 2 Skinny Pop  popcorn (package of 6 mini bags)
  • silk mini vanilla almond milk (package of 4 small individual boxes)
  • Daiya cheese- dairy free cheese
  • coconut milk - 1 can organic
  • eggs 2 cartons
  • Amy's organic lentil soup
  • Black pitted calamata olives