Why Doctors Want You Tested Before You Go Gluten Free
A gluten-free diet can reduce the biomarkers doctors use to confirm the presence of celiac disease, making a complete diagnosis very difficult. Doctors dont like to have an inconclusive diagnosis because celiac disease is a serious medical condition that should be in your official medical profile.
Basically, once you remove gluten from your diet, your body produces less of the harmful antibodies triggered by gluten and the villi along the wall of your small intestine begin to heal. If your villi are healthy and you dont have raised antibodies in your blood, you may test negative for celiac disease. So if you take steps to eliminate a gluten intolerance on your own, you may also make it difficult to have your condition accurately diagnosed.
Because patients are understandably wary about eating food theyre sure is hurting them, doctors and researchers are trying to make testing more sensitive so that a gluten challenge can be shorter and less intimidating.
What Is Measured On The Coeliac Profile
The Coeliac Profile is a blood test that measures important markers to aid in the diagnosis of CD including Total IgA, Anti-Tissue Transglutaminase IgA and IgG , Anti-Deamidated Gliadin IgA and IgG , and reflex Anti-Endomysial IgA . Along with these results, Genovaâs unique report configuration provides a simple diagnostic algorithm to aid clinicians in assessing likelihood of disease.
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The Best Test For Gluten Intolerance
I believe that people are becoming increasingly aware that gluten is not the best food ingredient for us it can be very difficult to digest, and can promote significant inflammation both in the gut and in the body as a whole, resulting in chronic pain, fatigue, brain fog, skin irritation, mood imbalances and more. There are a variety of labs that offer testing for gluten intolerance- in fact, all the big commercial labs offer the tests. I have found, however, that sometimes those blood tests are not as sensitive as some others. In my view, the best test for gluten intolerance is a stool test offered by a lab called Enterolab.
The markers that are tested for gluten intolerance are anti-gliadin antibodies and anti-tissue transglutaminase antibodies. Both are looking for auto-immune reactions in the body that are caused by the ingestion of gluten. These are the markers that are assessed in blood testing too.
Enterolab uses a stool sample to look for those markers. I have found this to be a more sensitive test than standard blood tests . In several of those cases, the bloodwork showed negative where the stool results showed positive. Can we rule out false positives 100%? No, we cant, but I can say that the results were reflective of the health issues of those patients, and all those patients felt better when adopting a gluten-free diet.
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Tests To Determine Wheat Sensitivity
1. A standard allergy scratch or intradermal test can give you some insight, though often people who have problems with wheat dont react to this test. Surprisingly, this is one test I DID react to. Prior to this test I had been mostly gluten-free, but I splurged from time to time. Now, I dont knowingly consume wheat and Ive found since Ive given it up when I do consume it my body lets me know it does not like it. This is normal for your body to be more sensitiveit means your body has begun the healing process.
2. Antibody blood tests look for immune system reactions. It may or may not mean you have a problem with wheat, but it would be a clue if your levels were elevated. I also had this test done, but my levels were not elevated.
3. HLA-DQ is a genetic test. Its much more sensitive and picks up problems in many more people than the antibody tests.
5. There are also some new saliva and blood tests from Cryex Laboratories that sound quite promising at detecting gluten sensitivities. From initial reports it sounds as if they are much better at detecting problems with gluten, but only time will tell if they can truly do the job. The biggest problem with Cryex tests is its doubtful that your insurance will cover them.
Ncgs Vs Celiac Disease
Q. If someone is told they have NCGS after an endoscopy determines it is not celiac disease, what are the symptoms?
A: The symptoms can be the same as for celiac disease but without intestinal damage. To diagnose NCGS, one must rule out celiac disease, wheat allergy, and other possible causes of symptoms.
Q: Do some people who have celiac disease have greater sensitivity to gluten?
A:According to Dr. Green, there is some individual variability, but it is not possible for an individual to know their level of sensitivity since the absence of symptoms is not the same as the absence of damage caused by gluten.
Q: If a family member tested negative for celiac disease, had bad symptoms which went away with a gluten-free diet, and has first-degree relatives who have been diagnosed with celiac disease, do they have celiac disease or NCGS?
A: This person has a greater likelihood of having or developing celiac disease due to family history, but it is not definitive. Genetic testing could be useful. If the results are positive, this means that celiac disease could develop at some point, and frequency of future testing should be discussed with a physician. If the genetic test yields negative results, then celiac disease will never develop.
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What Causes Gluten Intolerance
The exact causes of gluten intolerance arent well understood. Some research shows that people may not be sensitive to gluten, but to a certain carbohydrate found in many foods. Their bodies dont absorb the carbohydrate as they should. It stays in their guts and ferments, causing sickness.
Other research suggests that wheat might affect the lining of some peoples digestive tracts. This lining usually keeps bacteria from leaking out of your intestines. But in people with a gluten intolerance, the lining may not work as it should, allowing bacteria into their blood or liver and causing inflammation.
Symptoms Of Celiac Disease
Although digestive issues are common in children with celiac disease, most adults do not experience these symptoms. Instead, the following signs are often a red flag for celiac disease in adults:
- Liver and biliary tract disorders
- Osteoporosis or osteopenia
- Peripheral neuropathy
- Seizures or migraines
- Unexplained iron-deficiency anemia
Whether or not you are experiencing any of these symptoms, it is crucial to undergo celiac disease testing if you have a first-degree relative with the condition, as this puts you at a one in ten risk of developing celiac yourself.
However, if you suspect that you have gluten intolerance rather than celiac, the single best way gluten intolerance test is to remove it from your diet, note how you feel without it, and how you feel when you add it back in.
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Glutencheck Gluten Intolerance Test By Nanorepro
This is an at-home test for celiac disease that looks for antibodies related to the condition.
To take the test, a person needs to provide a blood sample via a finger prick. Next, a person mixes their sample with a solution and compares the color of the mixture with the shades on a color chart. Any changes in the color of the sample mixture can indicate that a reaction has occurred.
Unlike other tests, the GlutenCHECK test does not require a person to return their sample to a lab.
Can I Have Oats In My Diet
This is somewhat controversial. Some experts feel that oats should be avoided by those with celiac disease while others believe that most people can tolerate small amounts. They feel that the proteins found in oats are not contributing significantly to celiac disease. This is something you should discuss with your health care practitioner and a nutritionist.
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Gluten Intolerance: Foods To Avoid
Gluten is found in wheat, rye, barley and any products made with these grains. It can be difficult to cut out wheat products as gluten proteins can also be found in processed foods, sauces and even meat products which use those grains as thickening agents. It is important to thoroughly check labels for ingredients. Heres a list of ingredients to eliminate if you suffer from a gluten intolerance:
What Is A Gluten
Gluten-free diets have surged in popularity in recent years. Supermarkets devote whole aisles to products, and restaurants have entirely gluten-free options on the menu to cater for customers dietary requirements.
Gluten-free is one of the biggest revolutions in the food industry since vegetarianism. From vodka to popcorn, there doesnt seem to be a food that isnt available free-from if you want it.
Following a gluten-free diet consists of cutting out all foods that might contain gluten such as wheat, rye or barley which could appear as wholegrains or thickening agents in processed foods. Couscous, bulgur, spelt and matzo are also commonly removed.
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Gluten Intolerance Testing At Home
I have found the single best way to determine if you have an issue with gluten is with an elimination diet. This means you remove gluten from your diet for at least 30 days and then reintroduce it. Please note that gluten is a very large protein. It can take months or even years to completely clear from your system. The longer you can eliminate it from your diet before reintroducing it, the better.
Heres the simple advice that I shared with all the patients in my clinic: If you feel significantly better when youre not eating gluten and worse when you reintroduce it, then gluten is likely a problem for you. Remember, to get accurate results from this testing method you must eliminate 100% of the gluten from your diet.
Experts Weigh In Regarding Celiac Disease And Gluten Sensitivity
Gluten Intolerance Group held a panel event in the Fall of 2021, Getting a Celiac Disease or Gluten Sensitivity Diagnosis, that provided valuable information on seeking a gluten-related disorder diagnosis. Since there wasnt enough time to address all the questions raised by attendees, weve compiled some additional answers here.
Our panelists were:
- Peter HR Green, MD Phyllis & Ivan Seidenberg Professor of Medicine Director, Celiac Disease Center at Columbia University
- Dr. Kelly Baker, ND, L.Ac. Naturopathic Doctor
- Nour Zibdeh,MS, RDN Integrative & Functional Nutritionist
Heres what they had to say.
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There Is A Risk Present For A False Positive Result
Not only will some patients naturally test negative on the gluten intolerance blood test, certain co-existing medical conditions can create false results. People with liver disease, Type 1 diabetes mellitus, rheumatoid arthritis, or certain heart conditions can also test have negative test results on the first gluten intolerance blood test.
Thats why there are 3 additional tests which may be ordered and then compared with the first initial results to help come up with a diagnosis.
The EMA blood test looks for specific antibodies that are created when gluten is consumed as well. The specificity of this test is nearly 100%, although up to 10% of people who do have Celiac disease will have a negative test result. This gluten intolerance blood test is usually reserved for those who have a difficult diagnosis because it is relatively expensive and requires cord blood to complete.
The IgA total serum blood test is a second option when trying to screen out the possibility of Celiac disease. When Celiac disease is present in the body, it may naturally produce a false negative on the EMA blood test because of an IgA deficiency. This test can determine if that deficiency is present. If it is, then a third and final blood test may be ordered.
The DGP IgA or IgG blood test is used as a further screen to test for antibodies. The results of these tests will then be compared to each other in order to determine if there is the possibility of Celiac disease present.
How Do I Manage It
If you’re confident you are intolerant to a particular food, the only way to manage this is to stop eating the food for a while and then reintroduce small quantities while monitoring how much you can eat without causing symptoms.
Check food labels to see which sorts of foods to avoid.
If you think your child may have a food intolerance, check with a GP or dietitian before eliminating foods from their diet, as a restricted diet could affect their growth and development. Cows’ milk, for example, is an important source of calcium, vitamin D and protein.
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And The Diy Route To Decoding Your Symptoms
The problem with medical tests? They aren’t always 100 percent accurate, and they can also be very costly. Another option is a good old-fashioned elimination dietbasically, that means you just stop eating iffy foods and see how you feel.
“If you strongly suspect your symptoms may be related to either lactose or gluten, then eliminating the individual categories may be okay,” says Yeung. “If youre unable to see patterns in the foods you eat and your symptoms, then Id recommend a full elimination diet,” she says. While elimination diets vary, they often rule out foods like dairy, gluten/wheat, eggs, soy, nightshades, and more.
Unfortunately, this is probably the most time-consuming and restrictive plan of action. But if you’re diving into the challenge, here’s how it usually goes down. “Typically you begin by eliminating all sources that may be causing adverse effects for at least one to two weeks,” says Yeung. “After the initial phase, you begin reintroducing foods from one category at a time while continuing to eliminate the other categories.”
You might find that you feel more tired with gluten in your diet, or that foods made with milk mess with your bathroom habits. Or maybe, you find another result that’s completely unexpected. Yes, the quest to uncover food sensitivities can be toughbut if it comes with a calmer gut or more energy, isn’t that totally worth it?
Keep Eating Gluten Throughout The Diagnosis Process
If you think you may have coeliac disease, its essential to continue eating gluten until your doctor makes a diagnosis.
The diagnostic tests for coeliac disease look at how the body responds to gluten.
Some people may start to reduce or eliminate gluten from their diet because they feel ill. Unfortunately this is very likely to cause an inaccurate result for both the blood test and the gut biopsy.
Therefore, its very important to keep eating gluten throughout the diagnosis process.
If you’ve already reduced or eliminated gluten from your diet, you will need to reintroduce it to make sure you get the most accurate test results. While it may be difficult and uncomfortable, its essential for your long term health.
As a general guideline, the recommendation is to eat some gluten in more than one meal every day for at least six weeks before testing.
For children, you can mix wheat flour into foods such as yogurt or baked beans to add more gluten into their diet.
If you are reintroducing gluten into your diet, you should discuss how best to manage your symptoms with your GP. Your GP will be able to arrange for you to be tested for coeliac disease as soon as it is appropriate.
Norma McGough, Coeliac UK’s Director of Policy, Research and Campaigns, discusses why gluten must be in the diet throughout the diagnosis process for coeliac disease:
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