This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc. Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease SymptomsWhat testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease ScreeningInterpretation of Celiac Disease Blood Test ResultsCan I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful?The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-FreeIs celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic TestingIs there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and DisordersIs there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients)Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients)Gluten-Free Alcoholic BeveragesDistilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free?Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free DietFree recipes: Gluten-Free RecipesWhere can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.For Additional Information: Subscribe to: Journal of Gluten Sensitivity
@seeking2012 — Heavy metal poisoning is increasingly rare. Decades ago, lead in paint and gasoline were a major issue. Unless you have a particular reason to think you have been exposed, I suspect that your CFS has some other cause.
Some "alternative" practitioners try to promote the myth that this is common, but I recommend that you work with a qualified physician. Likewise, supposed "detox" methods can be dangerous, so you need to work with a pro. I recently was told about a kid whose parents subjected him to a "detox" program. In my opinion, this was unethical medical research on a child who is not old enough to offer informed consent.
kareng — I agree that it's important not to over-sell the potential here. However, since a large number of celiacs heal slowly (or not at all)—possibly because of the effects of trace gluten contamination—I think it would be great to have a pill that could take care of this problem.
I don't claim to be a clinician, and just rely on the published literature and information from celiac disease resource websites. However, it's well known that clinical guidelines are just guidelines. Physicians will use more or less diagnostic resources depending on several factors: particular case, personal preferences, ability to pay for tests. From what I can gather, anti-gliadin serology has poor specificity for celiac disease, and offers little extra value, except in special cases (such as IgA deficiency or diagnosis of infants).
Unfortunately, no test is 100% accurate, and the reliability depends both on the test itself and the particular testing laboratory used. There are several scientific reviews and articles which address the pros and cons of different diagnostic approaches. In general, these reviews are consistent with the two links I posted earlier.
One illustration of current practice would be the University of Chicago celiac disease Research Center, whose website states:
As with everyone else on this forum, I'm here to learn, so please let me know if you have more information.
The guidelines for diagnosis have continued to be refined over the years. No doubt, individual physicians will use their discretion regarding what approaches to use in their diagnosis, and antibody tests are just part of the picture. However, as far as i can tell, serology to measure levels of anti-gliadin antibodies is no longer the preferred approach.
I listed couple of the most recent and thorough reviews of this topic below. They are consistent with the informational found on the websites of several clinical research centers.
1. A consensus-building session held in 2012, resulting in the "Oslo Definitions"
The Oslo definitions for coeliac disease and related terms
Gut 2013;62:43–52. doi:10.1136/gutjnl-2011-301346 = http://gut.bmj.com/content/62/1/43.full.pdf
"After introduction in the 1980s, IgA antibodies against wheat gliadin (AGAs) served as the best serological test for celiac disease for some years. However, the low positive predictive value meant that this test has since been abandoned for the investigation of celiac disease, except for in children younger than 18 months, in whom IgA AGA seems to have high sensitivity. Recently, assays for IgA and IgG antibodies against DGP have been introduced and perform similarly to TTG-based tests."
2. World Gastroenterology Organisation Global Guidelines
Celiac disease http://www.worldgastroenterology.org/assets/export/userfiles/2012_Celiac%20Disease_long_FINAL.pdf
The FDA has stated that there is no validated test for gluten in "hydrolyzed foods" (such as sourdough bread or barley based beer). When I last checked, the Tobacco Tax Bureau had ruled that no beer based on barley can be labelled as gluten-free in the US. The technologies that some breweries are trying are exciting, but unproven.
I can give more detail in a private message.
It is fairly common for a person with one autoimmune disease to also have another. This increased susceptibility is probably genetic. There is no evidence that one causes the other—in other words, gluten has not been shown to be a trigger for other autoimmune diseases, other than celiac disease.
The body produces large amounts of IgA antibodies, and these are thought to provide a protective "coating" to the intestine. Antibodies to different foods and microorganisms are common. There is no evidence that the presence of anti-gluten IgA antibodies is important in celiac disease or gluten sensitivity.
Gemini, can you share some details? I have not found any published research of any test that is effective for testing compliance with a GFD. Such a test would be a huge step forward, since many people continue to have symptoms even after going on a GFD: nutritional counseling can help, but an actual diagnostic would be great.
Physical symptoms are a poor indication of what is actually happening in the intestine. Even people on a strict gluten-free diet can have damage that persists for a long time, even years. While this forum is not intended to provide medical advice, everthing I have read would indicate that if you have had a positive diagnosis you should be avoiding even traces of gluten.
Leaky gut syndrome is not a recognized medical condition and should not be confused with celiac disease. A number of diseases and infections can increase gut permeability, including celiac disease, but the importance of this change in permeability is not clear. Much less is known about non-celiac gluten sensitivity, but early research suggests that this condition is associated with a reduced gut permeability.
While we are all sympathetic to your situation, it's important to stress that interpretation of test results should be between you and your Dr., not by a public group of well-wishers.
The tests that "mushroom" mentioned are presumably FDA-approved, but I personally question relying on over-the-counter self-diagnosis with unapproved tests.