How To Test For Gluten Intolerance
This article was co-authored by Katie Marks-Cogan, MD. Dr. Katie Marks-Cogan is a board certified Pediatric & Adult Allergist at Clear Allergy based in Los Angeles, California. She is the Chief Allergist for Ready, Set, Food!, an infant dietary supplement designed to reduce the risk of childhood food allergies. She received her M.D. with honors from the University of Maryland. She then completed her residency in Internal Medicine at Northwestern University and fellowship in Allergy/Immunology at the University of Pennsylvania and CHOP.There are 7 references cited in this article, which can be found at the bottom of the page. This article has been viewed 56,216 times.
If you’ve been struggling with underlying medical problems, your doctor may recommend that you be tested for gluten intolerance. There’s a spectrum of gluten-related conditions that can affect your body. One is Celiac disease, which is an autoimmune disease that affects the small intestine’s ability to absorb nutrients, which can lead to a variety of symptoms. Other gluten-related disorders include gluten intolerance and a wheat or rye allergy. By narrowing down your issue through testing, you and your doctor can create a plan to help keep you healthy.
What Supplements Are Good For Gluten Sensitivity
Including probiotics, digestive enzymes, and certain herbs and vitamins. Probiotics can help to rebuild the beneficial bacteria in the gut and may help to ease digestive discomfort. Digestive enzymes can help to break down food particles, reducing the amount of gluten that is absorbed, and potentially easing symptoms.
Certain herbs such as ginger, peppermint, and slippery elm can help soothe the GI tract and may help reduce inflammation. Finally, some vitamins such as vitamin D, vitamin B, and zinc may be beneficial for maintaining gut health and reducing inflammation in the body.
Overall, it is important to check with a healthcare professional before starting any new supplement regime as they can advise on safe doses and provide further recommendations.
Check If You Have A Food Intolerance
If you have a food intolerance, you usually get symptoms a few hours after eating the food or ingredient you’re intolerant to.
Common symptoms include:
But there are lots of other possible symptoms, including headache, feeling tired or exhausted, feeling sick, constipation, joint pain or rashes.
Symptoms can last for a few hours or days.
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Testing For Celiac Disease In Children Under The Age Of 3
From the University of Chicago Celiac Disease Center:Generally, children at risk for celiac disease are screened at age 2 or 3 unless symptoms are seen beforehand. In children younger than 3, with symptoms, antibody testing may not always be accurate.
Children must be eating wheat or barley-based cereals for some time, up to one year, before they can generate an autoimmune response to gluten that shows up in testing. A pediatric gastroenterologist should evaluate young children experiencing a failure to thrive or persistent diarrhea for celiac disease.
While a genetic test cannot diagnose celiac disease by itself, it can all but rule it out if neither of the genes are present, and a genetic test can be done at any age.
Is This Test Right For Me
How do I know if this test is right for me?
This test may be right for you if:
- You have digestive problems including abdominal pain, bloating, gas, diarrhea, or foul-smelling stool
- You have unexplained rash, joint symptoms, or anemia
- You have unexplained weight loss
This test may not be right for you if:
- You are on a gluten-free diet
- You are on a gluten-free diet do not introduce gluten into your diet before talking to your healthcare provider
If you experience these more severe symptoms, SEEK IMMEDIATE MEDICAL ATTENTION:
- Blood in your stool or a medical condition requiring immediate medical attention
- Fever, night sweats, or flushing
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Diagnosing Celiac Disease & Gluten Sensitivity In Adults
NYU Langone gastroenterologistsdoctors that specialize in diseases of the digestive systemare experts in diagnosing celiac disease and gluten sensitivity. Celiac disease is an autoimmune disorder in which the immune system mistakenly attacks the digestive tract after a person consumes gluten, a protein found in wheat, rye, barley, and other foods and beverages. Some vitamins, medications, and personal care products such as lip balm contain gluten.
During digestion, food passes through the intestines, where nutrients are absorbed into the body. Most of this absorption occurs in the small intestine, where tiny finger-like projections along the small intestinal lining, called villi, sweep the nutrients from food into the bloodstream.
People with celiac disease, however, have a genetic susceptibility to recognize gluten differently. When someone with celiac disease eats food that contains gluten, it triggers the immune system to attack the small intestine. The body forms antibodies, or proteins, that attempt to remove gluten from the body as if it were a foreign invader. The antibodies also attack the lining of the small intestine, causing inflammation.
Over time, recurrent inflammation damages the villi in the small intestine, and the body doesnt absorb nutrients very well. This can lead to malnutrition and unwanted weight loss. The chronic inflammation also can cause abdominal discomfort.
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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Dna Test For Gluten Sensitivity
The answer lies in your DNA! There are two genes associated with gluten sensitivity: HLA-DQA1 and HLA-DQB1. The NIH estimates that somewhere between 30 and 40 percent of the US population carries one or both genes, but only 3 percent of carriers will actually develop celiac disease. To make things even more interesting: you can be a carrier for celiac disease or NCGS and not know it until an external event causes the gene to turn on. This is known as a trigger, and can be anything from being born , menopause, influenza, or even antibiotic use for a common infection . There are also countless environmental triggers known to trigger celiac disease such as exposure to certain chemicals
So, in a nutshell, there are three factors needed for you to experience celiac or NCGS: be a carrier for the gene, experience some sort of trigger to turn the gene on, and have a diet that contains gluten.
What Are The Risk Factors for Celiac Disease?
While celiac disease is rare, there are a few circumstances that would put you at an increased risk for the condition:
How Can I Find Out If I Have Celiac Disease or NCGS?
What Are The Negatives Of Gluten
The main negative of going gluten-free is the fact that it can be difficult to find enough suitable and nutritious foods to replace traditional gluten-containing options. This makes it hard to maintain a balanced and healthy diet.
For example, gluten-free grains, such as quinoa, buckwheat, and amaranth, are often harder to find and more expensive. Additionally, gluten-free processed and packaged foods can lack important nutrients such as iron, thiamine, folate and dietary fiber.
Also, going gluten-free requires a significant lifestyle change as it requires learning to read food labels and knowing which food ingredients can contain hidden gluten. This can be time-consuming and overwhelming.
Its also important to note that gluten-free does not mean healthy, as many gluten-free items may contain high levels of saturated fat, sugar and calories. Eating a lot of these types of foods can lead to weight gain and other health issues.
Finally, its potentially dangerous to remove gluten from your diet before being tested for celiac disease or another gluten-related health problem. Gluten-free products are not always healthier, and without knowing if you need to be gluten-free, its best to talk to a doctor before making this decision.
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How Many Forms Of Gluten Intolerance Exist
This surprises some people , but there is more to gluten intolerance than celiac disease. While it is still considered the most serious medical condition among them, celiac disease is only one of several significant medical conditions triggered by the consumption of this troublesome protein composite.
- Dermatitis Herpetiformis
Along with gluten ataxia, a growing number of gluten-sensitive idiopathic neuropathies are being diagnosed. Collectively medical researchers now refer to these conditions as gluten-related disorders.
Unfortunately, each of these conditions require a different means for diagnosis and with two of them, NCGS and gluten ataxia, doctors and researchers havent yet agreed upon a consistent and accurate way to perform diagnosis.
In addition, one form of gluten intolerance, dermatitis herpetiformis, requires a skin biopsy, not blood work. Also, doctors and researchers havent yet agreed on how to identify a non-celiac gluten sensitivity in a consistent and accurate manner, other than to rely on a diagnosis by deduction.
In other words, if a gluten challenge reveals a problem with gluten but the patient tests negative for both celiac disease and a wheat allergy, then the patient will be diagnosed as non-celiac gluten sensitive .
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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Why Gluten Intolerance Is Likely More Common Than We Think
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Or lets say you visit your doctor complaining of a headache. Its highly unlikely test you for gluten intolerance, which is unfortunate because headache is a frequent finding in non-celiac wheat-sensitive patients, with one study reporting that symptom in more than half of the participants. That was especially true for people with migraines. Or maybe you visit your dermatologist complaining of eczema or psoriasis or another skin condition. Theres virtually no chance youll be tested for gluten intolerance. But, again, this is a mistake, because people with non-celiac wheat sensitivity can notice a worsening of skin symptoms like eczema, rash, and dermatitis after consuming gluten. The most commonly reported skin lesions include those similar to subacute eczema, as well as the bumps and blisters indicative of dermatitis herpetiformis, or Duhrings disease, which celiac disease is closely linked to. Those who are gluten intolerant may also experience scaly patches resembling psoriasis, and the lesions are typically found on the muscles of the upper limbs, although not always.
Could My Symptoms Be Something Else
If you regularly have diarrhoea, bloating, tummy pain or skin rashes but youâre not certain of the cause, see a GP.
A GP may be able to diagnose the cause from your symptoms and medical history. If necessary, theyâll order tests, such as blood tests.
You can also do some research yourself. It may help to find out about other conditions that cause similar symptoms. For example, find out about:
The bowel is a sensitive organ and itâs common to have bowel symptoms when you have been ill or feel run down or stressed.
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Getting Tested When The Doctor Is Doubtful
You can still get tested if you have trouble convincing a doctor that you might have celiac disease.
According to Beyond Celiac, you can conduct your own at-home with a product from the organization Imaware. They have created a comprehensive test you administer to yourself. The test looks at four biomarkers, including tTG. The only limitation is that you must be 18 years or older to take the test.
How To Treat Gluten Intolerance And Celiac Disease
Eliminating gluten from your diet means 100%. Even trace amounts of gluten from cross-contamination, medications, or supplements can be enough to cause an immune reaction in your body. The 80/20 rule or we dont eat it in our house, just when we eat out is a complete misconception.
A Lancet article published in 2001 states that for those with celiac disease or gluten sensitivity, eating gluten just once a month increased the relative risk of death by 600%.
The outward manifestation of eating gluten may be mild bloating or a headache. Inside your body, your immune system is being stimulated and the effects may last for three to six months.
For many, simply removing gluten completely from their diet isnt enough. The damage that has been caused to the gut lining must also be repaired. Leaky Gut Revive can be a powerful ally in repairing your gut in conjunction with functional medicines 4R program.
Additionally, I often find that there are other infections in the gut that need to be addressed and corrected. Parasites, Candida overgrowth, small intestinal bacterial overgrowth , and other imbalances can all be impacted by the cross-reactivity of gliadin sub-fractions in non-gluten grains.
When in doubt, go without. Youre not missing any vital nutrients by not eating gluten. In fact, you may well be improving your life dramatically!
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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.
What Causes Celiac Disease
In celiac disease, gluten triggers the immune system to damage villi. Villi are finger-like projections lining the small intestine that absorb nutrients from food and send them into the bloodstream. Damaged villi can’t absorb the vitamins and minerals that a child needs to grow.
The cause of celiac disease isnt known. It tends to run in families, so a child with a family history of the condition may be more likely to get it. It also can happen along with other disorders, such as Down syndrome, Williams syndrome, type 1 diabetes, and autoimmune thyroid disorders.
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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:
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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