Testing

This article focuses on the two main antibody blood tests for celiac disease. It will tell you what each test looks for and what the results mean.

The two blood tests recommended when testing for celiac disease are the AGA-IgA test for gliadin (wheat proteins) as well as the tTG-IgA test for tissue transglutaminase.

Recent research indicates the blood tests most doctors are using, tTG & EMA, are not as reliable as first thought. Young children, elderly, smokers, the very ill and the not very ill can be missed. EMA, or endomysial antibodies has fallen out of favor so they will not be discussed.

Preparation for Testing

Make sure when being tested that you are on a gluten-containing diet, because the antibodies the tests look for would disappear if you are were gluten-free. Once you go gluten-free, future testing is unreliable.

AGA – The Test for Gluten Sensitivity

The AGA-IgA has fallen out of favor for CELIAC DISEASE, but it tests whether an immune reaction against GLUTEN (gliadin) is present in the system – it detects a GLUTEN SENSITIVITY reaction. You can have gluten sensitivity without developing the lesion that is characteristic of celiac disease. That is, you can have gluten sensitivity without celiac disease.

tTG – The Test for Celiac Disease

tTG tests for tissue transglutaminase antibodies, or antibodies against your own tissues. The tTG blood test does NOT tell you if you have celiac disease per se. It tells you the likelihood that villous atrophy will be discovered if an endoscopy with biopsy is performed. The higher the number, the more likely you have enough damage that one of the samples would show villous atrophy.

One thing to consider is that you have over 20 feet of small intestine. Biopsy samples are tiny and only about 5 are taken. How much damage is required before a positive biopsy sample is found?

Also, you can also have the beginning stages of celiac disease and the test results will be “negative” now, but if you were tested at a later date they could rise, making you positive. That is, the levels of antibodies now may not indicate probable intestinal damage enough to be found on endoscopy with biopsy. But they can rise over time – one month, six months, a year.

In one study we reviewed while creating the medical manual, Recognizing Celiac Disease, of the children who tested positive in the study, 40% had tested negative 5 years previously.

No test is 100% accurate. Determining celiac disease is still a judgment call. Even if the tests come back negative, try a strict 100% gluten free diet to see if symptoms improve. If they do, ask your doctor to take multiple vitamin and mineral levels to determine whether deficiencies exist.

Page 30 in Recognizing Celiac Disease lists the vitamins and minerals the NIH recommends checking: vitamins A, D, E, K, B12, folic acid and minerals calcium, iron, phosphorous.

The symptom charts in the book list which deficiencies cause which symptoms so you can determine which nutrient levels to test and give your doctor reasons to test for them. (Doctors will not take nutrient levels unless there is a reason to take them.) Correct the nutrient deficiencies and you will correct the symptoms in many cases.

A diagnosis is just a diagnosis. Good health is the most important thing.

For more information on the tests click here.

For more information on Recognizing Celiac Disease click here.

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Author Information: John Libonati, Philadelphia, PA
President-elect, Celiac Sprue Association (CSA).
Publisher, Glutenfreeworks.com.
Editor & Publisher, Recognizing Celiac Disease.
John can be reached at john.libonati@glutenfreeworks.com.

There are 3 weeks until the free Celiac testing event at the University of Chicago, Saturday, October 10. For complete details please read here.

Please call to set up an appointment as the event is expected to fill up fast..

For more info: Call The University of Chicago Celiac Disease Center at 773.702.7593.

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Author Information: Anne Steib, Chicago, IL
Anne Steib
gfreegurl@yahoo.com
http://www.examiner.com/x-13312-Chicago-GlutenFree-Food-Examiner

With Celiac awareness on the rise, more and more people are getting tested and properly diagnosed. Many people have lived with troubling symptoms for years before getting a doctor to order the correct tests and give a formal diagnosis. Once people receive their diagnosis, they can cut gluten from their lives, allow their bodies to heal and feel better than they have in years.

Current studies predict that 1 out of 100 Americans have celiac, that is over 3 million Americans, and of those, 97% are undiagnosed. The longer an individual goes with undiagnosed celiac, the greater their risk to develop other serious illnesses.

On average, a child will visit 8 pediatricians before being correctly diagnosed with celiac disease.

As a result The University of Chicago Celiac Disease Center offers a free blood screening every October. This year, it will be held October 10, 2009. Pre-registration is required, and opens September 1, 2009. Please call 773.702.7593 to register. The free blood screening will take place on the 4th floor of The University of Chicago Duchossois Center for Advanced Medicine. Read More »

The news release below is timely because anti-gliadin antibody blood tests are losing ground while the reality of gluten sensitivity looms far larger than is now appreciated by many doctors!  These blood tests are absolutely necessary to investigate health problems caused by gluten itself, yet they are being dismissed by doctors who look only to diagnosing celiac disease.

Positive anti-gliadin antibody tests show undigested gluten peptides in the bloodstream.  This abnormal finding tells the story that gluten has passed through the tight barrier defenses of the small intestinal lining into the body where it can wreak havoc, with or without celiac disease.  Gluten is a food protein in wheat, barley, rye and oats.

In screening for celiac disease, an inherited immune response to gluten entering the small intestinal lining, doctors rely on the celiac specific antibody tests, anti-endomysium and anti-tissue transglutaminase.  However, the investigation to find these auto-antibodies must not exclude the anti-gliadin antibodies. 

“Doctors Slow To Recognise Gluten Harm.” Dr. Rodney Ford, Leading New Zealand Paediatrician And Allergist Challenges Medical Stalwarts With Revolutionary Gluten Thinking

There is more to gluten problems than just coeliac disease. Gluten sensitivity is ten times more prevalent than celiac disease in New Zealand and mostly undiagnosed. This is the message that Christchurch-based paediatrician, allergist and author, Doctor Rodney Ford wants to get across to the public and the ever conservative medical fraternity.

The practice of medicine is restricted to the knowledge, experience, attitudes and politics of the society it functions in. Medicine is an inexact but evolving science, thus current standard medical practices are often disproved. The validity of medical opinion, long held to be the gold standard of diagnosis and treatment, are constantly challenged. This is a healthy dynamic, one that enables the pursuit of excellence and the evolution of better forms of practice, resulting in better outcomes for patients. Why, then asks Dr Ford, is there such resistance to his new Gluten Syndrome hypothesis recently published in a book and supported by years of clinical experience and research.

In the absence of coeliac disease, his latest research shows that the simple gluten test (IgG-gliadin antibody) is a sensitive indicator to detect those people who get sick eating gluten but who have tested negative to Celiac Disease. However, this test is rarely ordered by general practitioners or specialists. He says “This is because of an illogical rejection of gluten sensitivity as a valid diagnosis. Ignoring gluten flies in the face of all of the evidence and is also alienating doctors from their patients.”

Picture this, if you will: a six year old girl, Elizabeth, small for her age, a distended stomach, gas and suffering from gastric reflux. Her teachers reported a lack of attention at school and early learning problems. Elizabeth had been thoroughly investigated by the medical profession: blood tests, bowel biopsies, colonoscopy, endoscopy. Celiac Disease had been ruled out, various medications had been tried and doctors had started to question her mother’s parenting skills. Elizabeth’s parents had gone beyond frustration and fear for their child, they were at the point of desperation.

This is a common story in Dr Ford’s practice. It is also one of the many success stories he has to share. After seeing Dr Ford, a positive IgG-gliadin antibody test and being put on a gluten free diet, Elizabeth improved within a few days. Within weeks she made a remarkable recovery and was in essence cured. Gluten was no longer a choice for her and accidental intake still causes her a reoccurrence of symptoms. Adhering to a gluten free diet has enabled Elizabeth to grow into the healthy, happy and successful young woman that she is today.

Common stories such as this, along with the increasing research and evidence of gluten based harm, should be enough to spur the medical profession into action in an effort to save the current generation of children from the long term health, social and financial consequences of what is an easily diagnosed and treatable condition.

The shocking truth is that this terrible scourge of gluten is being ignored by most medical practitioners. Even worse, the blood tests that can diagnose it are being abandoned by many medical laboratories. For instance, Medlab Diagnostics in Auckland no longer offers gliadin antibody tests.

The medical professions reluctance to act on the gluten problem is costing New Zealand billions of dollars each year with long term and far reaching consequences. From a dollars and cents point of view it makes no economic sense. From a patient care point of view it is bordering on negligence.

Source: Scoop Independent News, New Zealand, Thursday, 19 June 2008, 9:49 am
You can find this news release at http://www.scoop.co.nz/stories/GE0806/S00059.htm