Iga Deficiency And Celiac False Negatives
To be on the safe side for my own blood work, I started with a total serum IgA test to rule out a false negative on the rest of my celiac blood work, and this is probably a prudent first step for those who suspect an issue with wheat, but have had negative tTG IgA tests.
I was able to get my total IgA test done at Any Lab Test Now in Austin for $69 and the results were normal. This rules out a false negative for me and puts me into the gluten sensitive camp.
To quote Dr. Crowe again:
In some cases, the TTG IgA test result can be false negative that is, results come back negative, even though celiac disease is actually present. False negatives can occur for various reasons, but the best known cause is a condition called IgA deficiency that people are born with. This immunodeficiency occurs in about one in 600 healthy individuals but is much more common in those with celiac disease.
Interesting that the mother in the forum thread above says her son had small intestine damage despite having normal IgA levels, and only positive IgG markers for tTG. Dr. Crowe only briefly touches on tTG IgG tests in her NYT piece:
Occasionally your doctor may order other blood tests, such as TTG IgG or DGP IgG, if they are available.
This study analyzed tTG IgG levels in IgA deficient patients. The authors believe positive tTG IgG results, combined with negative IgA results, is evidence of IgA deficiency, and potentially of celiac disease.
Celiac Disease Vs Gluten Intolerance: What Do You Have
Celiac disease and gluten intolerance are different yet similar disorders. In this article, Ill discuss each disorder and help you understand why people often confuse the two. This post contains affiliate links and information you can discuss with your healthcare provider. Please see my disclosures.
Millions of people in the U.S. and worldwide are avoiding gluten, a protein found in wheat, barley, rye and derivatives of these grains, either due to a celiac disease diagnosis, or because they innately feel like gluten is making and keeping them sick.
With the spotlight on gluten and gluten-free diets, you might be wondering if gluten might be behind what is making and keeping you sick.
Firstly, I want you to know that reliable studies show that all humans regardless if they celiac disease or gluten sensitivity experience some sort inflammatory response upon consumption of gluten. This doesnt mean everyone has an issue with gluten but it may mean gluten could be the root cause of diseases that begin in the gut.
The sad truth is that 60 percent of American adults live with at least one chronic condition and 42 percent have more than one. These diseases bring about great emotional and physical costs, and put unsustainable financial burdens on the private and public sector. For most of these adults, they dont know the root cause of their suffering.
Currently The Only Treatment For Cd Is A Strict Lifelong Gluten
Pharmaceutical treatments currently in clinical trials may aid in the digestion of gluten or in decreasing intestinal permeability seen with celiac disease. None are currently on the market but Larazotide is in Phase 3 clinical trials . Larazotide is aimed at decreasing celiac disease symptoms that occur when someone is accidentally exposed to gluten. It will not cure celiac disease or allow someone to eat a regular diet.
Current over-the-counter digestive enzymes marketed for digesting gluten are not appropriate for people with CD.
Some of the most promising pharmaceuticals under investigation are aimed at decreasing the symptoms that occur from cross-contamination, such as when dining out. They will not be a cure, but their development will be helpful in addressing the social and psychological issues surrounding CD. The social aspect of celiac disease is not commonly discussed in the medical community. Amongst patients, however, it comes second to their symptoms in overall concern regarding the disease.
The use of nanoparticle technology is currently being evaluated as a treatment for celiac disease. Early results are promising.
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So What Is A Gluten Sensitivity
Some people test negative for celiac disease and show no signs of the intestinal damage that is associated with the auto-immune disease. However, they still react badly to eating wheat with symptoms such as abdominal pain, fatigue, and headache. Such people are said to be gluten-sensitive or intolerant.
Some people are more sensitive to gluten than others, so not everyone reacts the same way to different amounts or types of gluten. Recent evidence suggests that people with gluten sensitivities may also be reacting to other proteins or carbohydrates that are typically found in in wheat, which is why wheat sensitivity or wheat intolerance are commonly used terms for those who suffer sensitivities from products that typically contain gluten.
People with wheat or gluten sensitivities may experience equally debilitating symptoms as someone who has celiac disease, however, they will not suffer damage to their intestinal walls as a result of eating gluten.
Commercial Development Of Gluten
If our digestive enzymes that break down proteins, called proteases, could break down gluten more effectively, we could eat it with fewer problems. That is why proteases that can digest even the trickiest parts of gluten are being developed for commercial use. A product from ImmunogenX, called Latiglutenase , contains two enzymes that are genetically engineered versions of proteases from barley and bacteria. This product appears to be promising, as it prevented damage to the intestine when people with celiac disease were fed 2 grams of gluten daily for six weeks . This is about a hundred times as much gluten as a gluten-free diet should contain, and about one tenth as much as might be eaten in a typical diet. Latiglutenase also appears to be useful for people with celiac disease who are on a gluten-free diet but still not well. People with celiac who were trying not to eat gluten but who did not have their disease under control reported significantly less abdominal pain and bloating after twelve weeks of taking the enzyme with every meal . See the clinical trials section of this article for an additional clinical trial that is currently recruiting.
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When Should I Call My Doctor
Some symptoms of gluten exposure can be severe. Seek medical attention if you experience diarrhea or vomiting. Dehydration can lead to dangerous electrolyte imbalances.
A note from Cleveland Clinic
Gluten intolerance may make you feel sick after eating gluten. You might get bloated, nauseous or gassy. Gluten intolerance causes a lot of the same symptoms as celiac disease, but its not the same condition. Celiac disease is an autoimmune disorder that leads to damage to the digestive tract. People with gluten intolerance usually find relief from their symptoms by following a gluten-free diet. Gluten-free diets do have some health risks. Its important to work with your healthcare provider and a dietitian to build the right treatment plan for your needs.
New And Promising Research On Celiac Disease And Gluten Sensitivity
Current research is aimed at trying to understand the causes of celiac disease and identify therapies that can help people. And the newest research is looking at gluten intolerance, why it occurs, and what can alleviate symptoms or resolve the root causes.
The results of clinical studies are described throughout this article, and you may wonder which treatments are worth discussing with your doctor. When a particular treatment is described as beneficial in only one or two studies, consider it of possible interest or perhaps worth discussing, but its efficacy has definitely not been shown conclusively. Repetition is how the scientific community polices itself and verifies that a particular treatment is of value. When benefits can be reproduced by multiple investigators, they are more likely to be real and meaningful. Weve tried to focus on review articles and meta-analyses that take all the available results into account these are more likely to give us a comprehensive evaluation of a particular subject. Of course, there can be flaws in research, and if by chance all of the clinical studies on a particular therapy are flawedfor example with insufficient randomization or lacking a control groupthen reviews and meta-analyses based on these studies will be flawed. But in general, its a compelling sign when research results can be repeated.
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Could Fodmaps Be To Blame
Although there’s much to be uncovered about celiac disease and gluten sensitivity, recent research indicates that the ingestion of gluten isn’t the only culprit. Apparently FODMAPs may be partly to blame for gluten sensitivity. FODMAPs are sugar alcohols and short-chain carbohydrates that the body has a difficult time digesting. And guess what’s high in FODMAPS? The gluten-rich grains wheat, barley and rye!
Eating a low-FODMAP diet of the following foods may help ease the symptoms of gluten sensitivity.
Keep in mind that when we restrict certain foods from our diets, it can lead to nutritional deficiencies. If you decide a low-FODMAP diet is for you, be sure to meet your protein needs with a balanced essential amino acid supplement.
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Are Gluten Intolerance And Celiac Disease The Same Thing
Gluten intolerance and celiac disease are different. People with celiac disease have an autoimmune response to gluten. This means their bodies try to fight against gluten as if it were a virus. This reaction causes inflammation and damage to their digestive tracts. Celiac disease is the result of an abnormal gene. People with celiac disease also have high levels of certain antibodies in their blood, which are substances that fight gluten.
Gluten sensitivity and celiac disease cause a lot of the same symptoms. But people with gluten sensitivity dont have an abnormal gene or antibodies in their blood.
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What Is A Wheat Allergy
Gluten is just one of the hundreds of proteins found in wheat. A wheat allergy is an immune reaction to any of those proteins. When someone who has a wheat allergy consumes wheat, a certain group of white blood cells called B-cells begins to produce immunoglobulin E antibodies which attack the wheat molecules as if they were foreign invaders. While this is happening, other tissues in the body send out chemical messengers that alert the rest of the body to the presence of a threat. The speed with which this reaction occurs can range from a few minutes to a few hours after consumption and may be accompanied by a variety of symptoms including nausea, itching, abdominal pain, swollen lips or tongue, difficulty breathing, and anaphylaxis.
A person who is allergic to wheat must avoid all forms of wheat this is the only known treatment available for wheat allergies at this time. They may, however, be able to consume gluten from non-wheat sources such as barley or rye. It is entirely possible for someone to have a wheat allergy as well as celiac disease or a gluten sensitivity, so additional testing may be warranted if youve been diagnosed with a wheat allergy. Wheat is one of the 8 most common food allergies in the United States and, while children can sometimes grow out of it, wheat allergies that develop in adulthood are typically permanent.
Fodmaps And Gi Symptoms
A gluten-free diet cuts out a lot more than just gluten. Wheat contains other potential irritants, including fibers called FODMAPs. We dont digest these, but our intestinal bacteria do, sometimes with adverse consequences. FODMAPS include fructans in wheat, inulin, and some vegetables fructose in fruit lactose in dairy products oligosaccharides in beans and some vegetables and sweeteners such as sorbitol and xylitol, which are used in sugar-free foods. It has been proposed that in some cases cutting out FODMAPs may be more important than cutting out gluten, but clinical results are not yet convincing . The bottom line is to listen to your body, and if it reacts poorly to wheat, believe it.
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How Celiac Disease Is Diagnosed
It isnt always easy diagnosing celiac disease. In the past, people lived with symptoms for many years before being diagnosed, and even now it can take years before a diagnosis is made. Clues may include a family history of the disease, diarrhea, nutrient deficiencies, anemia, osteoporosis, an itchy skin rash, and especially in children, spots on the teeth. There may not be intestinal symptoms at all . Diagnostic tests include measuring antibodies in blood samples or skin, a blood test for gene variants, and an intestinal biopsy. Tests may turn up negative if gluten hasnt been consumed for a while, so its best to carry out as many tests as needed to confirm the diagnosis before excluding gluten from the diet .
Who Should Be Tested for Celiac Disease?
The University of Chicago Celiac Disease Center says that anyone with any autoimmune disease or with a close relative with celiac should be tested even if they dont have obvious symptoms. Children who are not thriving or have persistent diarrhea should be tested. The standard antibody test might not work in young children who havent been eating gluten long enough to generate antibodies, and they should see a pediatric gastroenterologist .
Potential Causes Of Celiac And Gluten Sensitivity And Related Health Concerns
The causes of gluten intolerance are poorly understood. There is an inherited predisposition, and the chances of developing celiac disease are one in ten in someone with a first-degree relative with diagnosed celiac disease. Celiac is also more prevalent in people with other autoimmune diseases, such as diabetes or an autoimmune thyroid disease.
Having celiac disease is associated with a higher likelihood of developing heart disease, small intestinal cancer, and other autoimmune diseases, such as type 1 diabetes and multiple sclerosis. The sooner celiac is diagnosed the better as far as reducing the risks of developing other autoimmune diseases .
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I’ve Been Diagnosed With Celiac Disease Or Gluten Sensitivity Now What
Treatment for both celiac disease and gluten sensitivity is mainly focused on eliminating gluten from the dietavoiding foods with wheat, barley, and rye.
“Wheat is an ingredient that must be listed on processed foods sold in the US, so this is usually a good place to start when reading a nutrition label,” says registered dietitian Katherine Goebel.
Foods like bread, pasta, and beer are commonly recognized as containing gluten, but it can also be found in soy sauce, cream sauces, meat substitutes, salad dressings, marinades, and battered foods.
Pay attention to notes about processing facilities on food packaging too. Oatmeal, which doesn’t contain gluten, is often processed in the same facilities as foods with gluten and can be contaminated.
Gluten-free foods can also pick up micro-particles if they touch gluten-containing foods or were prepared using the same utensils.
“You can pick the croutons out of a salad, but they’ll still leave behind trace amounts of gluten. Therefore, a new salad should be made, using different utensils and serving bowls,” Goebel says.
“Separate sponges and fresh water should also be used to clean all the cookware. I always urge my patients to thoroughly vet restaurants and to bring their own foods to social functions such as BBQs or holiday parties.”
There isn’t currently a cure for either celiac disease or gluten sensitivity, but adhering to a gluten-free diet can keep you feeling well.