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Reliability Of Stool Tests For Diagnostic ?


florent

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florent Newbie

Hi,

I'm from Europe, and I've heard about diagnostic based on research of antigliadins,... antibodies from stool that is done by some laboratories in the US. Here a lot of Professors say these tests aren't reliable at all (false positives and false negatives) and only blood tests and biopsies are reliable. Could you tell me about your proper experience with these tests ?

Thanks

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Nancym Enthusiast

Probably the best information is available right here: Open Original Shared Link

and here: Open Original Shared Link

I know that the results of this test changed my life for the better. :)

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Nantzie Collaborator

The enterolab test is totally worth it. I used the test to make sure I was barking up the right tree as far as what was wrong with me. When the test came back showing that I had gluten intolerance, I tried the diet and sure enough it was true.

My kids doctors accepted the Enterolab tests as valid and put them in their charts. Based on the Enterolab tests, the pediatric GI specialist waived the biopsy and we just do follow-up bloodwork (which was borderline, but still negative) a couple times a year to make sure further complications from celiac aren't showing up. My kids and I are treated by our doctors the same way a biopsy-positive patient would be. We are VERY lucky. Most doctors aren't like this at all.

Really, the only test that is completely reliable is trying the gluten-free diet. My advice is to always go through the medical testing though. There are other things that it could be that are more scary than celiac. There are also things that could be going on that you would need to know about in addition to whatever results you get from trying the gluten-free diet; Crohn's disease, diverticulitis, etc.

The problem with tests for celiac is that NONE of them are reliable. The blood and biopsy are unreliable too. Notoriously so.

I think that the point your doctors are trying to emphasize by saying that the stool test is unreliable is that it hasn't been published or peer reviewed. But you can see his credentials and his curriculum vitae (sp?) on the Enterolab website.

Nancy

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CMCM Rising Star

I agree with the above comments about Enterolab. And Enterolab's testing as a viable, solid, perhaps even BETTER alternative has been positively discussed in several recent books about celiac disease.

If you think about it logically, as Dr. Fine says in the article linked above, a gluten reaction begins in the intestines as a reaction to the gluten which has entered the intestines. After all, food doesn't go into the blood when you eat it, it goes to the stomach and then the intestines. In experiments where gluten proteins are put into a petri dish with human tissue, the antibody reactions occur quite visibly! A lot of damage and disease progression needs to be done before the antibody proteins to finally end up in the blood and can be measured there by a blood test--it could be years before that happens....thus, you can only be diagnosed with the blood test if things have progressed quite a lot and you have substantial villi damage. So, since the antibodies first occur in the gut, it makes total sense to test the stool since antibodies would appear there a long time before they would get into the blood. This all makes total sense when you think about it. In fact, it's quite brilliant and the fact that it hasn't become more widespread more quickly is a testament to how slow to accept new ideas and how backwards the medical profession can be.

In any case, remember that the stool test does NOT diagnose celiac disease. That can only be done via biopsy where the actual villi flattening can be directly observed. Many doctors/researchers now say that celiac disease is the most extreme form of gluten sensitivity, and can only occur if you have a predisposing celiac gene (with a very few exceptions....apparently there are still unidentified celiac genes, but very few of them...maybe 1-2% at most). But what about the HUGE numbers of non-celiac gluten sensitive people? The celiacs are called the "tip of the iceberg", but most people are the part of the iceberg under water...the much larger part which cannot be seen.

Look at it this way: If you knew doing certain things would lead to very bad heart disease, would you do those things in order to give yourself a heart attack just so you could get that firm diagnosis? Our modern medical system is biased towards trying to relieve symptoms of existing diseases, and NOT on the prevention of disease so much. With celiac disease AND non-celiac gluten sensitivity, the goal should be to PREVENT illnes and intestinal (and other) damage by not eating any gluten. This means to make the non-celiac gluten sensitive people feel better and ALSO prevent tissue/organ damage, and to make the actual celiac sufferers return to health.

I think there is just way too much emphasis on getting that celiac diagnosis and ignoring the systemic reactions that gluten causes. If you boil it down to something quite simple, I'd say it's this: Accept the fact that a LOT of people are at the very least sensitive to gluten, and in one way or another, it makes them feel sick or gives them any one or more of a huge number of problems in addition to causing internal damage of one sort or another. If these people remove gluten from their diet, they get better, they feel well, usually in a fairly short amount of time. Why get hung up on having the worst case scenario (celiac disesase) and a doctor's diagnosis of celiac disease?

I have recently read that perhaps 80% of Americans are gluten sensitive. And within this group, perhaps 1 to 3% have celiac disease. But ALL of them may be suffering from the effects of eating gluten. There is a tendency to dismiss gluten sensitivity as nothing to worry about, but I keep reading that it can do just as much damage as celiac disease, and the main difference is that celiac disease will cause the villi damage (which can be identified) whereas gluten sensitivity alone generally will not do that. But gluten sensitivity can cause tissue and organ damage, and all the other miscellaneous symptoms one reads about.

Remember that medicine is often slow to recognize things. The first doctor to suggest the idea of tiny organisms the human eye cannot see (bacteria) as a cause of infection and disease....this guy was thought to be crazy, no other doctors believed it. No one believed a heart could be transplanted until it was finally done successfully by one ahead-of-his-time doctor. I'd say the situation is similar with gluten sensitivity and celiac disease, and how to test for it.

I'd say Dr. Fine and his Enterolab (a non-profit organization, by the way) are way ahead of the curve with their ideas about stool testing. And actually, Dr. Fineis not the first to lean towards stool testing, either (he mentions this somewhere on the Enterolab website).

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e&j0304 Enthusiast
I'd say Dr. Fine and his Enterolab (a non-profit organization, by the way) are way ahead of the curve with their ideas about stool testing. And actually, Dr. Fineis not the first to lean towards stool testing, either (he mentions this somewhere on the Enterolab website).

I just wish that he would publish his methods. He is currently losing a lot of credibility because year after year he says he's publishing and he doesn't do it. That is one of the main reasons I am skeptical of him. Also I have a friend who's son's tTG was NEG. through enterolab and he later tested POSITIVE through bloodwork after being gluten-free for 3 months! My children were also tested through enterolab and my son was negative for everything. He reacts to gluten.

I honestly feel as though I wasted my money and that the diet told me exactly what enterolab did (or didn't in my son's case) for much less money. I spent about $800 total to test them both. I wouldn't do it again.

Just thought I would offer another opinion from someone who has had the testing done...

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Judyin Philly Enthusiast

I just love seeing all the people's experiences with the various testing protocol's.

I had a weak positive in blood work 19 months ago before going gluten-free.

First 3-5 months all symptoms went away.

then intolerances appeared..soy, dairy, xanthan gum, and a few others.

Since I wasn't totally 100% better, internist wanted a new GI to take a look again and after waiting 3 months to get an apt it's on March 8th.

I wanted some facts to support my decision not to do a gluten challenge before a endoscopy (never had one done).

So I did enteroLabs and got results last week and proved all I suspected was true and added casein to the list of 'no no's.

I hated to give up dairy but bet it was the dairy + casein that was keeping me from healing. I still think I have an issue with leaky gut.

When I called to discuss my results, the Nurse, Phylis, assigned to answer questions re: test results, was a celiac herself and very knowledgeable. Had lots of good tips. Most I knew but helped with some possible cc. issues I will implement in my program.

I wish Dr Fine would publish also as that is why my internist is skeptical.

We all know however; we know our bodies better than anyone else.

I have battled my obesity all my life and this is the first time I've been able to lose weight and keep it off.

Just my 2 cents worth.

good luck in your journey toward finding answers for your health.

Judy

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Rachel--24 Collaborator

I am another one who is skeptical of Enterolab's methods....and the reliability of Dr. Fines test.

It is definately not diagnostic for Celiac....if you are looking for a diagnosis that is "confirmed".

In my opinion, the diet itself is the best diagnostic tool we have available to us. Many people who test positive with Enterolab feel "somewhat" better or even "alot" better initially removing gluten....but it doesnt seem to answer the overall question and in most cases symptoms persist.

I think a gluten free diet is better for anyone with an illness....especially a gut-related illness. If leaky gut is an issue you will most definately feel better gluten-free.....but this is more related to leaky gut and not necessarily Celiac.....especially when there are no Celiac genes involved.

I honestly believe that Enterolab is actually diagnosisng leaky gut in most cases. In this scenario....the diet will help...but will not usually change the situation and you will go on to develop more intolerances or continue to be symptomatic even while gluten-free. This is what I've seen from my experience on this board and others.

I feel as if Enterolab is "creating" a seperate gluten related disease...which is not Celiac. They have identified "gluten sensitive" genes.....yet these genes are very prevelant....in fact the majority of the population carries these genes. *Everyone* I've ever seen tested through Enterolab has these genes in some combination. There is no real evidence that this has any real meaning with regards to gluten intolerance and/or intestinal damage.

I can give many examples of what I'm trying to say. One example would be Autism. The vast majority of these kids have leaky gut.....they do alot better when on a gluten-free and casein free diet. It can be very helpful for their situation and many times there is very noticeable improvement.

However, most of these kids do not actually have Celiac Disease....some that are genetically susceptible do have celiac disease...but this does not account for the majority of kids with Autism. Yet still, they improve on the diet.....and it is used in their treatment program.

Gluten Intolerance certainly did not *cause* their Autism but they do benefit from the diet because of the leaky gut factor. Anytime there is leaky gut....the immune system will respond to gluten entering the bloodstream.....this does not = Celiac Disease.....it can be an entirely seperate issue.

Autism is just one example of how another illness can lead to a gluten intolerance which is not Celiac...and this illness cannot be resolved with a gluten-free diet....but some symtpoms may be alleviated.

There are many similar scenarios of how an illness unrelated to Celiac can attribute to developing a gluten intolerance....via the leaky gut.

My problem with Enterolab is that when they see these antibodies they are leading people to believe they are sick *because* of gluten when in fact....most times....this is not the case. They are "reacting" to gluten but they are not necessarily Celiac and they are not necessarily experiencing a long list of symptoms simply because of gluten intolerance.

This is most evident when the person only gets *some* improvement from the diet and then is at a loss as to why they are not better. When this happens its most likely because gluten intolerance is only a portion of their problems.

You can actually determine the extent of how gluten is affecting your overall health simply by trying the diet....and this can be done at no cost to you. It is the best test of all.

If you discover that gluten is your primary problem and want to know if its possibly Celiac Disease....the gene test can be helpful in sorting that out. That is the best Enterolab has to offer in my opinion.

The tTG in their stool test is not specific for Celiac....I had positive tTG and I do not have Celiac.

I have never gotten a reasonable explanation (that makes any sense) as to why that is??

It seems that a "reputable" lab would have a decent explantion for such contradictions?? :unsure:

When it comes down to it...Dr. Fine hasnt published anything for peer review. The test results cannot be duplicated in other labs and I am very much in doubt that his test will ever get any real serious recognition due to these facts.

I am prepared to eat my words if the day ever comes that he proves me wrong....and I would gladly do it....but sadly....I dont think its gonna happen. Mainly because I dont think the tests prove anything....on a diagnostic level. I think in many cases it can deter someone from looking for the true cause of illness...by leading them to believe that gluten-free is all they need to be healthy again.

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CMCM Rising Star

Rachel, you do make some very good points about Enterolab. I, too, am getting annoyed about the "imminent" publication of results which hasn't yet happened. However, in defense of Dr. Fine, to get peer review and articles published in the major medical publications is a huge task requiring a lot of analyzed data, samples, controls, etc. I wish I knew what data Dr. Fine is collecting. When I submitted info for the tests, they did ask SOME questions but fewer than I expected. For example, if I were in Dr. Fine's place, there's a whole battery of questions I would be asking AND I would attempt to collect follow-up data from those I had tested. He doesn't appear to be doing that. On the other hand, his Enterolab outfit is listed as being non-profit, for what that's worth. I guess I wonder if he was motivated enough to set this whole thing up as a result of what he felt was a really revolutionary and accurate method of testing certain things, then why does he not put more visible effort into all this and making it known throughout the medical community?

Meanwhile, the Enterolab testing was still of value to me on a lot of levels. I have a celiac mom, I had symptoms, I was getting sicker, yet I did have a negative blood test. What to do? I was really driven to know my genes and see if any antibodies were being produced or if I had any malabsorption. So I got some basic data that helped me psychologically gear myself for the diet, which has been a very positive thing for me. I still have the questions of 1) was celiac disease ever active with me, or was I only suffering from gluten sensitivity, and 2) If celiac disease was not active, and I am only gluten sensitive, how dangerous might it be to continue to eat gluten on a limited basis...what was I risking. No one can answer this....not yet.

I also never felt Enterolab was diagnosing anything. They make it clear they don't diagnose celiac disease...that can't be done without a biopsy. As for the idea that so many people having a gene connected to gluten sensitivity, I just emailed them about that, and they confirmed that if you don't have the DQ4 genes, most of the others ARE connected to gluten sensitivity, only the DQ4 doesn't appear to be connected. But that's really not surprising, because more and more I keep reading that researchers are starting to believe that up to 80% of us are gluten sensitive, hence the prevalence of so many gluten sensitive genes. Since many people with autism and rheumatoid arthritis (to name just 2 things) really can and do improve after eliminating gluten and dairy from their diets (even though they lack celiac genes), that just tells me that these foods perhaps were not intended to be eaten by any humans. Just because we eat something that has become a common food, that still doesn't mean it's good for us. Quite the opposite, I've come to believe.

I've been reading a newly published book "The Gluten Connection", and in the introduction by Dr. Stephen Sinatra (cardiologist), he said his son is not genetically predisposed to celiac disease, but he developed ACQUIRED celiac disease (I'd never heard of this before!!) after being exposed to toxic molds. After much misdiagnosis and searching, Dr. Sinatra finally found a physician who was an expert in environmental biotoxins, and this doctor diagnosed hinm with acquired gliadin allergy. So here's something new for many of us to consider in our search!

When I consider that my mom was diagnosed with celiac disease in 1969, and how LITTLE was known about it at that time, what we know now is huge by comparison. Yet, astonishingly, what is known is actually still quite limited. Celiac disease is still under the radar. Gluten sensitivity is yet more so. And most of the new information on celiac disease has come in the last 10 years or so. I suspect that down the road the conclusion may be something like this: The vast majority of us are gluten sensitive, and in a few genetically predisposed people, this gluten sensitivity can progress into celiac disease if certain triggers occur. And none of us should eat gluten in any form, period. That will be difficult information to sell, unfortunately, since so many people are totally addicted to gluten, love eating it, and won't give it up.

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hathor Contributor

There's an article in the latest Clan Thompson newsletter about the "tip of the iceberg" idea, what the genes mean, and a reference to a recent study in a British medical journal about stool testing. Open Original Shared Link

I personally found the tests useful if only that it confirms that I need to avoid certain things (I tested positive for everything but the celiac genes themselves). Perhaps I don't have a lifetime problem but just a leaky gut. But then I'm not sure what would have caused the leaky gut other than these things I'm reacting to. Plus I had symptoms from childhood on, just never knew what to do about them. Does it make any difference? Once I heal, do I then try to add these foods back in? Or am I better off without them? Perhaps by then the science will be clearer.

It would be useful if he publishes. I have no idea if he is simply busy, the peers who are reviewing are skeptical (or even if his work has been written up yet), or publishing would eliminate his monopoly on the process. I'm just speculating. It would be great if there were some conference or journal issue where advocates of different positions duke it out.

It could be that non-celiac gluten intolerance is medicalizing (is that a word :rolleyes: ) the usual state and most people would be better off without gluten, period. I guess anything that helps the more severely affected get off the stuff is good, though.

I suppose someone can email Dr. Fine and ask him what's up with the whole publishing idea!

Unfortunately, in the real world, you have to make decisions all the time in the absence of perfect information. You still have to act (even doing nothing is an act).

If you have clearcut symptoms that clear up with not eating gluten, just don't eat it and save your money. If you have hazy symptoms and wonder if you are talking yourself into a problem that doesn't exist, like yours truly, the tests can be useful. They also proved helpful in convincing my very skeptical spouse and relatives that I was experiencing what I thought I was experiencing.

I obviously see good arguments on both sides. :unsure:

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nora-n Rookie

The mold thing is interesting.

When I type in mold and coeliac into pubmed I get Open Original Shared Link

nora

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Rachel--24 Collaborator
The mold thing is interesting.

When I type in mold and coeliac into pubmed I get Open Original Shared Link

nora

When you develop a yeast overgrowth....especially one which leads to leaky gut you will tend to become sensitized to molds and yeast.

This is along the lines of what I was saying with regards to Enterolab's testing not being clearly diagnostic of anything...except maybe leaky gut.

For those with a candida overgrowth the tTG which appears to be elevated in the stool test *can* be a direct result of the candida itself....which then triggers a gluten intolerance.

Celiac.com 08/25/2003 – This interesting study compares a specific amino acid sequence found in Candida cell wall protein to a the gliadin amino acid sequence that triggers the immune response in celiac disease. The researchers found that the sequences are “identical or highly homologous to known coeliac disease-related alpha-gliadin and gamma-gliadin T-cell epitopes,” and propose that Candida is the trigger for the onset of celiac disease. Below is the abstract for this study

"Is Candida albicans a trigger in the onset of coeliac disease?"

Nieuwenhuizen WF, Pieters RH, Knippels LM, Jansen MC, Koppelman SJ.

"Coeliac disease is a T-cell-mediated autoimmune disease of the small intestine that is induced by ingestion of gluten proteins from wheat, barley, or rye. We postulate that Candida albicans is a trigger in the onset of coeliac disease. The virulence factor of C albicans-hyphal wall protein 1 (HWP1)-contains amino acid sequences that are identical or highly homologous to known coeliac disease-related alpha-gliadin and gamma-gliadin T-cell epitopes. HWP1 is a transglutaminase substrate, and is used by C albicans to adhere to the intestinal epithelium. Furthermore, tissue transglutaminase and endomysium components could become covalently linked to the yeast. Subsequently, C albicans might function as an adjuvant that stimulates antibody formation against HWP1 and gluten, and formation of autoreactive antibodies against tissue transglutaminase and endomysium."

I would imagine the same type of situation can develop even without Celiac genes....this would be due to the candida invasion on the intestinal wall and the resulting immune response. People would not test positive for Celiac because the immune response did not trigger the genes linked to Celiac....because the genes arent there. However....there is an immune resonse occurring...but the *cause* of that immune response is actually candida....and gluten intolerance is the result.

If Candida can trigger the same chemical and immunological reactions as wheat gluten do we can imagine a number of interesting implications.

First, in people with celiac disease, symptoms usually get better rapidly when they eliminate gluten from their diet. This isn't always the case. Even without gluten some people continue to have symptoms. They may have intestinal Candidiasis. The Candida in their gut may be acting like gluten and continues triggering symptoms.

Second, an acute Candida infection may trigger the onset of celiac disease. Even if the Candida is treated and eliminated, the person could be left with a permanent sensitivity to wheat gluten. Candida infections occur frequently with antibiotic usage. In people genetically susceptible to celiac, extra caution should be exercised when using antibiotics to prevent Candida overgrowth.

Third, if wheat can cause neurological damage as in gluten ataxia, it is reasonable to assume that Candida could also do so by the same process. Reports of Candida infections causing neurological symptoms are not uncommon; now we have a possible explanation.

Fourth, if only a small portion of the people with gluten ataxia have gastrointestinal symptoms despite their severe damage elsewhere in their bodies, it is reasonable to assume that Candida could stimulate significant problems while producing slight or no digestive symptoms.

If the research is true...this would seem a more reasonable explanation as to why so many people test positive through Enterolab....this could explain why there is elevated tTG in the stool and no Celiac genes. It would also explain why many people do not get a complete resolution of symptoms while on the diet.

Candida overgrowth is also the leading cause of leaky gut.

Open Original Shared Link

https://www.celiac.com/st_prod.html?p_prodid=859

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hathor Contributor

Also check out Clan Thompson newsletter #79. This has a summary of a talk Dr. Fine gave at a conference and it summarizes what study he did. Not as good as a peer-reviewed article, but the best I've been able to find.

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GeoffCJ Enthusiast

I've been dealing a lot with patents lately, for a start-up I'm working on. I wonder if Dr. Fine's reluctance to publish or lack of published work is due to patents and difficulties. Follow me here.

It's hard to get a process patented, and without a patent, if he publishes enabling material, others could start offering the same test.

Patents and the like are important, without them scientists and companies can't get money to develop new products, since investors will never recoup their expenses. Without a patent, his publishing might be "enabling". This impacts the ability to get a patent, especially internationally.

At the university I'm at, the tech transfer people are always complaining about professors that go to a conference, present a paper on something, and then two months later talk to the tech transfer people and want to patent it.

I'm just speculating. But it could be a very valid reason Dr. Fine would choose to wait.

Several people seem to base their doubts on the high percentage of people who test positive. I think this board is a very biased sample. I would have never found this board if I hadn't been having issues that led my Dr and I to suspect Celiac. I then heard about Dr. Fine here. I never would have spend the $300+ if I didn't have strong suspicions. All those factors lend to a situation where it would seem that a very high percentage of people on a _Celiac_ website probably DO have issues with gluten. And people who don't have issues with gluten would not likely be here in the 1st place, and less likely to spend the $.

Geoff

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Judyin Philly Enthusiast
Also check out Clan Thompson newsletter #79. This has a summary of a talk Dr. Fine gave at a conference and it summarizes what study he did. Not as good as a peer-reviewed article, but the best I've been able to find.

I hate to ask you this but i went back over my saves Clan Thompson file any only started saving at #96.

Is there any way you could print it here if you've saved it???

I saw your numbers and they are so much higher than mine..but i've been gluten-free for 20 months and dairy and casein for 4 weeks since my EnteroLab results.

I'm going to look at Scott's lists on here and maybe it's here.

I'd so appreciate it as i have NEW GI apt March 8th this Thursday.

thanks for any help you can give I'd like to take something to apt.

Judy in Philly

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confused Community Regular

[

Several people seem to base their doubts on the high percentage of people who test positive. I think this board is a very biased sample. I would have never found this board if I hadn't been having issues that led my Dr and I to suspect Celiac. I then heard about Dr. Fine here. I never would have spend the $300+ if I didn't have strong suspicions. All those factors lend to a situation where it would seem that a very high percentage of people on a _Celiac_ website probably DO have issues with gluten. And people who don't have issues with gluten would not likely be here in the 1st place, and less likely to spend the $.

Geoff

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hathor Contributor
I hate to ask you this but i went back over my saves Clan Thompson file any only started saving at #96.

Is there any way you could print it here if you've saved it???

All the newsletters from #50 on are archived on the web site.

Open Original Shared Link

Here is #79-- Open Original Shared Link

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Judyin Philly Enthusiast
All the newsletters from #50 on are archived on the web site.

Open Original Shared Link

Here is #79-- Open Original Shared Link

YOUR THE BEST...THANKS SO VERY MUCH

I NOW HAVE THIS AND REALLY DO SOME RESEARCH.

I DID GO TO THE SITE BUT WASN'T ABLE TO FIND THIS.

DID YOU PAY FOR THIS?

I KNOW THERE ARE THINGS FROM HIM YOU CAN PURCHASE BUT MY LISTS NEVER COME LIKE THIS.

YOU HAVE BEEN SUCH A HELP TO ME.. I AM SO GREATFUL

JUDY IN PHILLY

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hathor Contributor

No, the newsletters are free, as is access to the ones that are archived. You have the link now. But if you don't hold on to it, all you have to do is go to the Clan Thompson celiac site, click on newsletters, and then click on the active link in the middle of the page to see the archives. Clicking on where it says "archive" on the left panel doesn't work!

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Judyin Philly Enthusiast

thanks ...that was the problem

It's now in my favoirites and also bookmarked..

judy

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Judyin Philly Enthusiast

thanks all....so agree...

i was gl for 20 months now and suspected dairy and casein...and the test confirmed it for me.

i didn't need them to tell me SOY...my body tells me soy.

now with the dairy and casein out of diet (as she sobs quietly---loved my cheese and ice cream) i'm doing so much better!

judy in philly

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Rachel--24 Collaborator
If we didnt have issues then i bet we would all test negative for the entrolab test.

I dont think this is true. Many people who have had family members (who are not symtpomatic) tested have found the results to be positive.

It is not only those who are sick who test positive with Enterolab. The fact is that most people test positive....whether or not they have symptoms.

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e&j0304 Enthusiast
It is not only those who are sick who test positive with Enterolab. The fact is that most people test positive....whether or not they have symptoms.

And then there's my son who does have symptoms who tested negative in all areas through enterolab. Go figure. I really don't trust that they accurately diagnose people with gluten sensitivity. I also have a friend who's child tested neg. for tTG through enterolab and tested positive months later in his blood after being gluten-free!! So there goes their theory that the diagnose people in the early stages.

I urge people to just save their money and try the diet if that's what they're going to do anyway.

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      Fermentation breaks down some of the gluten in wheat. Nowhere enough for a wheat dough to become gluten free, but the gluten may be significantly reduced. I think some pizzerias make the dough the day before and leave it overnight. The longer the microbes are acting on the flour, the better.
    • LimpToeTheTimeless
      I am M 21 and I diagnosed myself after a week of fasting and slowly reintroducing stuff in my diet except gluten, I had terrible eczema scars ,dandruff and brain fog, now I am free after 6 years of just pain, I am 6'2, will I grow taller? And since I am a gymnast will my muscles grow like quicker, cause before no matter how effort I put in I just couldn't. 
    • trents
      And the fact is, no two celiacs will necessarily respond the same to gluten exposure. Some are "silent" celiacs and don't experience obvious symptoms. But that doesn't mean no harm is being done to their gut. It just means it is subclinical. 
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