One of my all time favorite movies is The Matrix. In The Matrix, the protagonist Neo has to choose whether or not to actually know what is going on. He has to choose either the red pill which will tell him the truth, or the blue pill which will allow him to continue to believe whatever he wants to believe. He chooses the red pill, which leads to a series of scary and unpleasant truths about his life. Things he can never again choose to not know or understand. Ultimately it also leads to an amazing new sense of freedom and power. But that middle part is ugly.

People need to choose the red pill in their own time. Yes I get frustrated by people who have so many symptoms they could be photographed for a medical textbook yet insist that nothing is wrong. But I also know that the hardest decision is not the one to eat gluten-free. The hardest decision is to choose to know the truth and find out just how far down the rabbit hole actually goes.

That said, if you want to help people with choosing to know here is the study that made my blood run cold and made me want to punch every doctor who had seen me over the years but never considered this possibility.

This is the often cited Warren Air Force Base blood study. Note that diagnosis was entirely based on blood or the IgA transmutase marker. There were no biopsies.

The blood was drawn when the men were in their early twenties (94.5% of the men were under the age of 25 and the group had an average age of 20) and stored for 45 years. The blood was then tested and a small number of these men had the IgA marker indicating undiagnosed celiac disease. Because the entire cohort tested (over 9000 men) were military their death records were available. So on average these men should have been 65 years old. Of those who tested negative for celiac disease, 23% were dead 45 years later. For those who tested positive, 64% were dead. When they did all the adjustments for age and other factors Celiac disease meant a four-fold increase in the risk of premature death.

Does anybody else want to scream?