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Second Guessing Diagnosis


Jrg

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Jrg Newbie

A week ago my Dr called me in for my blood work results. I was severely low on vitamin D, iron & b12. Plus I had a celiacs blood panel done and I came back positive for only 1 of the 4 tests (the deamiated gliadin iga). So off I went to the specialist to schedule my endoscopy. (Also I should note that I have hypothyroidism and have been dealing with that for almost 20 yrs, I'm 26).

Anyways, my normal Dr had me feeling quite confident that I had celiacs, I had all the deficiencies, the other autoimmune disease, most of the physical symptoms, but my specialist Dr left me second guessing if I really do have it just because only 1 of my blood tests came back positive. He seemed to think that unless the ttg tests came back positive, then it probably was a lab error, getting my one positive.

I'm doing the endoscopy in a week & I know that will make it official either way, but I'm feeling pretty defeated. I honestly was hoping for an end all "cure" (aka just go gluten free, etc) to my situation, but now I'm convinced my biopsy will come back negative. Anybody else go through this?


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GottaSki Mentor

Was this a gasterenterologist that specializes in Celiac Disease? - sadly not all do.

With deficiencies, AI symptoms and a positive DGP I would remove all gluten after the biopsies...regardless of results - then retest the celiac antibodies and nutrients at six months and a year. Sometimes AI symptoms take longer than digestive symptoms to resolve so the blood can show if you are no longer producing antibodies and are absorbing nutrients better.

Hang in there...either way give living completely gluten-free the opportunity to improve your health.

Ps...we do have members that were diagnosed by biopsy with ALL negative antibodies...not everyone produces them and you do produce one very specific to gluten already...I wouldn't wait for the others to become positive.

bartfull Rising Star

Also, make sure they do at least EIGHT samples when they do your biopsy. Some "Doctors" only do two or three, and as the damage is often spotty, they miss the damaged parts.

nvsmom Community Regular

There are quite a few people around here who were diagnosed using the DGP tests, it seems to catch many celiacs that the tTG misses - the tTG IgA misses up to 25% of celiacs.

 

There are also many who were diagnosed using only the IgG version of tests rather than the Iga versions... doctors seem to doubt those too for some reason.

 

From what I have seen, many doctors want all the stars and moons to align before they will give out a definitive diagnosis... I have no idea why.  :rolleyes:  If the doctor thought your DGP lab result was a fluke, did he order a repeat test? If not, I'm guessing he is one of those reluctant to diagnose doctors.

 

Good luck with the endoscopy.  Keep eating gluten until your testing is done.

Jrg Newbie

Thank you everyone! Yes, I'll definitely be chowing down on gluten before my intestinal check! Now that I look back at my labs, my Ttg levels were very low, in the .7-1 so perhaps I just didn't have much gluten in my system? Either way, I feel more at ease with my blood work and will just try and be patient during this last testing phase.

AlwaysLearning Collaborator

Even if your endoscopy/biopsy comes back negative, I say go gluten free anyway and let your body tell you if gluten is a problem for you. If you do have a problem with it, more than likely, when you go gluten-free, you'll notice lots of other changes in your body that you may not have even realize were troubling you before. I'd trust personal experience more than any test or doctor out there. But great that you're doing things in the proper order!

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    • trents
      You might consider asking for a referral to a RD (Registered Dietician) to help with food choices and planning a diet. Even apart from any gluten issues, you will likely find there are some foods you need to avoid because of the shorter bowel but you may also find that your system may make adjustments over time and that symptoms may improve.
    • Ello
      I wish Dr’s would have these discussions with their patients. So frustrating but will continue to do research. Absolutely love this website. I will post any updates on my testing and results.  Thank you
    • trents
      Losing 12" of your small bowel is going to present challenges for you in nutritional uptake because you are losing a significant amount of nutritional absorption surface area. You will need to focus on consuming foods that are nutritionally dense and also probably look at some good supplements. If indeed you are having issues with gluten you will need to educate yourself as to how gluten is hidden in the food supply. There's more to it than just avoiding the major sources of gluten like bread and pasta. It is hidden in so many things you would never expect to find it in like canned tomato soup and soy sauce just to name a few. It can be in pills and medications.  Also, your "yellow diarrhea, constipation and bloating" though these are classic signs of a gluten disorder, could also be related to the post surgical shorter length of your small bowel causing incomplete processing/digestion of food.
    • Ello
      Yes this information helps. I will continue to be pro active with this issues I am having. More testing to be done. Thank you so much for your response. 
    • trents
      There are two gluten-related disorders that share many of the same symptoms but differ in nature from each other. One is known as celiac disease or "gluten intolerance". By nature, it is an autoimmune disorder, meaning the ingestion of gluten triggers the body to attack it's own tissues, specifically the lining of the small bowel. This attack causes inflammation and produces antibodies that can be detected in the blood by specific tests like the TTG-IGA test you had. Over time, if gluten is not withheld, this inflammation can cause severe damage to the lining of the small bowel and even result in nutrient deficiency related health issues since the small bowel lining is organ where all the nutrition found in our food is absorbed.  The other is NCGS (Non Celiac Gluten Sensitivity or just "gluten sensitivity") which we know less about and are unsure of the exact mechanism of action. It is not an autoimmune disorder and unlike celiac disease it does not damage the lining of the small bowel, though, like celiac disease, it can cause GI distress and it can also do other kinds of damage to the body. It is thought to be more common than celiac disease. Currently, we cannot test for NCGS. Celiac disease must first be ruled out to arrive at a diagnosis of NCGS. Both disorders require elimination of gluten from the diet.  Either of these disorders can find their onset at any stage of life. We know that celiac disease has a genetic component but the genes are inactive until awakened by some stress event. About 40% of the general population has the genetic potential to develop celiac disease but only about 1% develop active celiac disease. The incidence of NCGS is thought to be considerably higher. I hope this helps.
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