Understanding Your Test Results
The normal reference range may vary depending on gender, age, health history, etc.If your test result shows the presence of immunoglobulin A and immunoglobulin G antibodies in the blood it may indicate that the person is most likely to have a celiac gluten sensitivity.
The absence of immunoglobulin A and immunoglobulin G antibodies or if not detected in the blood may indicate that the person is unlikely to have a celiac gluten sensitivity.
Based on the test results, your doctor may advise appropriate medical treatments, lifestyle modifications, or further diagnostic tests
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Why This Test Is Performed
This test is performed when you are suspected to have a celiac gluten sensitivity. Your doctor may ask to perform this test if you experience signs and symptoms of celiac gluten sensitivity such as red, itchy bumps, foggy brain, pounding headaches, stomach bloating, fatigue, diarrhea, constipation, rashes, depression, anxiety, pins, and needles problem in the hands and feet etc. This test may also be performed to evaluate the effectiveness of the treatment, if already diagnosed.
Understanding Specificity And Sensitivity In Blood Tests
Different conditions rely on tests with different degrees of specificity and sensitivity. These terms are important to understand:
Specificity is defined by what possible conditions can cause a positive result for a test. If only one single condition or disease can cause a positive result, than that test is considered 100% specific to that condition.
But if more than one condition might change the antibodies measured by the test, than it is not a 100% specific test.
Sensitivity is defined by how often a test identifies people with a condition. Some tests will only show a positive result for 90% of people who take the test. So that test would be considered 90% sensitive.
Unfortunately, it isnt very common for tests to be 100% specific and 100% sensitive. This is why most blood tests involve a combination of tests. Sometimes the result is determined by both a combination of tests and the doctors interpretation of your overall medical profile.
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Which Foods Are Good For A Gluten
To ensure you maintain a balanced diet which provides the carbohydrates, fibre and vitamins you need, you can supplement your meals with a variety of other grains such as:
In baking, to replace ingredients containing gluten, you can use the following substitutes:
- Agar-agar thickening and binding agent made from seaweed
- Guar gum a thickener made from the seeds of the guar plant
- Carob flour a thickener made from the ground kernels of the carob fruit
- Potato flour a starchy thickener used in sauces, soups and dumplings
Managing A Severe Food Reaction With Epinephrine
A wheat allergy reaction can cause symptoms that range from mild to life-threatening the severity of each reaction is unpredictable. People who have previously experienced only mild symptoms may suddenly experience a life-threatening reaction known as anaphylaxis. In the U.S., food allergy is the leading cause of anaphylaxis outside the hospital setting.
Epinephrine is the first-line treatment for anaphylaxis, which can occur within seconds or minutes, can worsen quickly and can be deadly. In this type of allergic reaction, exposure to the allergen causes the whole-body release of a flood of chemicals that can lead to lowered blood pressure and narrowed airways, among other serious symptoms.
Once youre diagnosed with a food allergy, your allergist will likely prescribe an epinephrine auto-injector and teach you how to use it. Check the expiration date of your auto-injector, note the expiration date on your calendar and ask your pharmacy about reminder services for prescription renewals.
If you are uncertain whether a reaction warrants epinephrine, use it right away, because the benefits of epinephrine far outweigh the risk that a dose may not have been necessary.
Your allergist will provide you with a written emergency treatment plan that outlines which medications should be administered and when . Be sure that you understand how to properly and promptly use an epinephrine auto-injector.
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What Is A Celiac Gluten Sensitivity
A celiac gluten sensitivity is an allergic reaction to the gluten in individuals with celiac disease. Gluten is a major group of proteins found in wheat, rye, and barley. Gluten consists of two proteins namely glutenin and gliadin. Among these two proteins, gliadin is responsible for the negative reactions in the body. Most of the people are free from a gluten allergy. If you have a family history of celiac disease, then you are at high risk for developing celiac gluten sensitivity.
Individuals with a health condition called celiac disease may have a gluten allergy. This condition is called celiac gluten sensitivity. Celiac disease is an autoimmune disorder, where the body causes an abnormal immune response to gluten. Individuals with this condition when they take gluten-containing foods can lead to damage of intestines. The signs and symptoms of celiac disease in children are constipation, stomach pain, severe diarrhea, nausea, vomiting, pale colored and foul stool. Adults with celiac disease may show signs and symptoms such as fatigue, headaches, anemia, joint pain, missed menstrual periods, infertility, miscarriages, tingling in the hands and feet, etc.
Individuals who show the presence of antibodies like immunoglobulin A and immunoglobulin G against the gluten protein in the blood may have a celiac gluten sensitivity.
Is Oit A Cure
OIT is not a cure for food allergies. It is a desensitization. In order to maintain desensitization, a patient needs to continue to eat the foods they have been desensitized to on a regular basis.
Research shows that OIT is approximately 85% effective when supervised by an expert care team who specialize in food allergy treatment. At Latitude our success rate is in line with this. While there are a small number of clinical reasons a patient may need to stop therapy, the remaining 15% of patients primarily pause treatment due to the time commitment or other lifestyle demands.
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What Are The Signs And Symptoms Of A Food Allergic Reaction
Anaphylaxis is a serious, life-threatening allergic reaction and can present with wheezing, chest tightness or trouble breathing, loss of consciousness, or feeling faint.
If two of the following symptoms occur, consider anaphylaxis and inject epinephrine, and seek emergency care:
- Hives Rash, or red, itchy skin
- Stuffy or itchy nose, sneezing, or itchy and teary eyes
- Vomiting, stomach cramps or diarrhea
- Angioedema or swelling
- Hoarseness, throat tightness or a lump in the throat
FARE has an excellent list of words children may use to describe a food allergy reaction that can befound here.
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Symptoms Of Gluten Intolerance
Gluten intolerance comes with a slew of symptoms similar to those with celiac disease. While a lot of people experience classical symptoms, like gastrointestinal symptoms triggered by the consumption of gluten, a large number of people dont experience any chronic GI issues at all.
Its important to note that just because you dont have GI symptoms such as bloating, gas, constipation, and/or diarrhea, it doesnt mean you dont have an issue with wheat. Some of the more common non-GI issues associated with a gluten intolerance include:
On top of it all, anyone with an autoimmune disease, more likely than not, has an issue with wheat. Dr. Tom OBryan says in his pioneering book about autoimmune disease, The Autoimmune Fix, that gluten sensitivity is simply a precursor to celiac disease, autoimmune disease, diabetes, cancer, heart disease and other serious conditions.
He says, Excessive inflammation pulls on your chain, and wherever the weak link in your health chain is, thats where the tissue damage will occur. In other words, if your skin, for example, is where youre genetically predispositioned for disease, a gluten sensitivity will rear its ugly head in the form of a skin condition.
Dr. OBryan also says that anyone who has an autoimmune disease, or early symptoms of an autoimmune disease, likely has a wheat sensitivity that will only worsen until the person removes gluten and wheat from their diet.
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Unfortunately A Traditional Gluten Intolerance Test Is Often Incorrect
Why? They only measure a fraction of how a persons immune system can react to gluten. Add to the problem that different grains contain different types of gluten. Blood tests only measure the gluten found in wheat . The other problem is that people react to gluten in different ways. Some people have immune reactions, some have intestinal problems, some develop psychological problems, some suffer from migraine headaches, psoriasis, osteoporosis, fibromyalgia, chronic fatigue, multiple sclerosis The symptom checklist is over 200 diseases long. I cant even begin to tell you how many patients have come to my office after they were already biopsied or blood tested and told that they did not have gluten intolerance only to find out that their gene DNA tests for gluten sensitivity or celiac disease were positive.
Gluten Intolerance Vs Coeliac Disease
Since coeliac disease and gluten intolerance both result in unpleasant symptoms after eating foods that contain gluten, you may find differentiating between the two to be confusing. To help you better understand the difference, here are the main points that put the two apart:
- Coeliac disease is an autoimmune disease and gluten intolerance is not
- Gluten allergy, unlike gluten sensitivity, causes damage to the lining of the small intestines
- Coeliac disease causes more severe symptoms, including anaphylaxis and even death gluten intolerance doesnt
- The symptoms of gluten allergy can have long-term effects while the symptoms of gluten sensitivity are only short-term
Also, there are some less common symptoms of coeliac disease that are NOT usually associated with non-coeliac gluten sensitivity. Those include itchy skin, mouth ulcers and seizures.
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How To Make: Gluten
Celiac Disease Vs Non
The first and most serious condition related to gluten is a condition known as Celiac disease .
Celiac disease is a condition in which your body creates antibodies to gluten particles.
Upon consumption of gluten, your body reacts to various portions of the gluten molecule which results in immune-mediated damage to the intestinal tract .
Damage to the intestinal tract results in blunting of the intestinal villi which may result in malabsorption of both nutrients and calories leading to many different problems.
This damage may also cause increased intestinal permeability and allow the absorption of pathogens and particles that would otherwise not have been absorbed.
This mechanism is what many believe may be the link between the development of further autoimmune diseases and Celiac disease and is known as molecular mimicry .
Celiac disease results in symptoms in both the intestinal tract and outside of the intestinal tract.
The diagnosis of Celiac disease is made by assessing serum levels of certain antibodies, the presence of which may indicate the disease state in your body .
You can see an example of a positive test below:
The gold standard for diagnosis of Celiac disease is an intestinal biopsy which shows immune-mediated damage and intestinal damage.
In most cases, this is NOT necessary as the presence of positive antibodies in the serum should be enough to make the recommendation to alter your diet.
This is where things can be confusing .
The main question is this:
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New Study Confirms This Theory
A new Norwegian study published in Gastroenterology looked at 59 people who did not have celiac disease yet found digestive relief with a gluten-free diet .
Subjects were randomly assigned to eat seemingly identical muesli bars with either gluten, fructans, or neither for seven days.
They then crossed over into a different group, until they had completed all three bar diets and recorded their digestive symptoms.
Researchers found that symptoms of IBS, especially bloating, were 15% worse after eating the fructan muesli bar compared to placebo.
Interestingly, the gluten bar had no effect on symptoms, which suggests gluten is not the culprit after all.
Lead author Gry Skodje believes these findings strongly support the idea that fructans in wheat are the trigger of digestive symptoms, not gluten.
It also helps explain why researchers have been left stumped trying to figure out how gluten causes issues for non-celiacs.
Ideally, the next step would be a larger study that controls the participants outside food intake as well.
Summary: Research shows 4 in 5 people who believe they are sensitive to gluten are actually not. A new clinical trial suggests the likely cause of their digestive symptoms are fructans, which are also found in wheat.
How Is Coeliac Disease Managed
Coeliac disease can’t be cured, but it can be controlled with a strict, lifelong gluten free diet. Your sensitivity to gluten will never go away. The only way your small bowel can heal, and then stay healthy, is by removing all gluten from your diet, even if your symptoms are mild. Mild symptoms dont mean you have a mild disease.
You can expect to have a blood test at 6 months and 12 after you are diagnosed, and then yearly after that, to check if you have been exposed to gluten. Your doctor may also request another small bowel biopsy about 18 to 24 months after you are diagnosed to make sure your bowel is healing. You will also need a medical review every year.
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For A Person Already On A Gluten
- The antibody testing is not accurate on a gluten-free diet.
- A genetic screen for celiac disease can be done on a gluten-free diet. If it is negative- it eliminates the chance of ever having celiac disease.
- If it is positive, it does not mean you have celiac disease.- this is because forty percent of the general population carries one of the genes for celiac disease only about 3% of them have celiac disease. Because of this, a positive genetic screen does not mean you have celiac disease. It only means you are susceptible to getting it.
- The genetic test is called HLA DQ-8, And HLA DQ-2 genetic test for celiac disease or Celiac Disease genetic screen.
- If someone has been on a gluten-free diet, a gluten-challenge can be done. If a gluten-challenge is done, antibody testing and possibly a biopsy will be needed at the end of the challenge.
Genetic Testing For Celiac Disease
The most established genetic test is specific to celiac disease and not necessarily for a wheat allergy, a non-celiac gluten sensitivity or a broader intolerance. But it can help either verify the presence of celiac disease or identify people who may be predisposed to developing celiac disease. Because it can be done in a non-invasive manner , this celiac disease genetic test is often done for at-risk children.
The test looks for the HLA-DQ2 and HLA-DQ8 genes. If one or both genes are present and the patient has a family history of digestive concerns, the individual is at a greater risk of developing celiac disease at some point in his or her life.
Please note, however, that it is still possible to have these genes and not develop celiac disease. In fact, around 35% of the general population has these genes while around 1% of the population has celiac disease. That means millions of people have the so-called celiac gene but do not have celiac disease.
So this test is usually either to take preliminary steps in identifying and helping at-risk individuals or to help confirm a diagnosis begun with some of the tests listed earlier in this lesson.
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Diagnostic Tests For Celiac Disease
If you experience digestive symptoms or signs of poor vitamin and nutrient absorption, such as unexplained weight loss, an NYU Langone gastroenterologist can perform diagnostic tests to determine whether celiac disease may be the cause. For adults, doctors typically recommend both blood tests and biopsies, in which tissue samples are examined under a microscope, to confirm the diagnosis.
You Have An Autoimmune Disease
An autoimmune disease is the term given when your immune system mistakenly attacks and damages your own tissue.
There are more than 80 types, characterised by which tissues or organs in the body are damaged.
Gluten intake is consistently linked with numerous types, but whether its the cause remains to be seen. Its influence in Celiac disease is the obvious example, but research indicates gluten likely affects Hashimotos hypothyroidism and Graves disease, to name a few.
Some researchers speculate the potentially negative effect of gluten is to do with the effect that gliadin may have on gut health and function .
In any case, it seems gluten intolerance is more likely in those with an autoimmune condition.
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What Is Coeliac Disease
Coeliac disease is an autoimmune disease. In people with coeliac disease, the lining of the small bowel is damaged by even tiny amounts of gluten. Gluten is a protein found in grains such as wheat, rye, barley and oats.
Coeliac disease affects people of all ages and genders. It runs in families and can develop at any age from infancy to adulthood. Currently, the only available treatment is with a gluten-free diet.
Early diagnosis and treatment of coeliac disease significantly reduces the risk of most complications.
You should tell family who share your genes that you have coeliac disease. They can also be tested.
