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Negative Fecal Fat But Underweight

ADevoto

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ADevoto Explorer
ADevoto
Posted

My 12 year old son has the following results from Enterolab -

Antigliadin IgA of 128 units (normal is <10

Antitissue Transglutaminase of 70 (normal is <10

Fecal Fat score of <300 (normal is <300)

They recommend that he go on a gluten free diet which I agree. But I am confused. He is very underweight (5%) but it shows no malabsorb issues. Is that conflicting? I would think that he isn't absorbing nutrients if he is under weight and has those high value results. Any thoughts???

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natalie Apprentice
natalie
Posted

When did he start losing weight? Maybe he has some of his intestines working properly, therefore absorbing the fat. Maybe severe damage hasn't occured yet. I would start the gluten-free diet because his numbers are high.

Natalie

debmidge Rising Star
debmidge
Posted

For all the 27 years my husband went mis-diagnosed his fecal fat count was in normal range however, his weight plummeted from about 180 to 127 over the course of 2.5 years from first symptoms. Those specific blood tests were not invented or his doctors did not utilize them for the first 15 years or so of his illness. It got to the point where even new GI's viewed him as being "mentally ill" and "obsessed" over foods that gave him stomach trouble. Because using their testing methods THEY couldn't find anything wrong with him.

He lost all his body fat and became so malnourished that his body -- for lack of a better word -- ate his muscles - in the same way it would happen to an anexoric.

The doctors brushed this off and he is at point today where the muscles are not re-building; BUT as for a 12 year old he's still growing and as long as you get to the bottom of his problems (i.e., if he is celiac then go gluten-free) it shouldn't turn out this way.

My husband was 27 when he got first symptoms of celiac disease.

confused Community Regular
confused
Posted

My step-son was negative on fecal fat also, but his numbers were kinda high on everything else. He is also underweight, but now when he does stick to the plan he is starting to grow and gain weight. He is 13, going on 14.

paula

dally099 Contributor
dally099
Posted

when you have D all the time you tend to not absorb nutrients and calories very well, im the same thing lost 10lbs in a month but my fecal fat score was normal. also if your sysem is working over time you can be burning more calories, i bet he gains weight when he goes on the diet. i did, good luck

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      By Scott Adams · Posted

      Based on those results alone, it’s not possible to say you have celiac disease. The test that is usually most specific for celiac, tTG-IgA, is negative in your results, and the endomysial antibody (EMA) is also negative, which generally argues against active celiac disease. However, your deamidated gliadin IgA is elevated, and your total IgA level is also high, which can sometimes affect how the other antibody tests behave. Another important factor is that you were reducing gluten before the test, which can lower antibody levels and make the results less reliable. Because of that, many doctors recommend a gluten challenge (eating gluten regularly for several weeks) before repeating blood tests or considering an endoscopy if symptoms and labs raise concern. It would be best to review these results with a gastroenterologist, who can interpret them in context and decide whether further testing is needed.
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      Test interpretations

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      Since you compromised the validity of the antibody testing by experimenting with gluten withdrawal ahead of the testing, you are faced with two options: 1. Reintroduce significant amounts of gluten into your diet for a period of weeks, i.e., undertake a "gluten challenge". The most recent guidelines are the daily consumption of at least 10g of gluten (about the amount found in 4-6 slices of wheat-based bread) for at least two weeks leading up to the day of testing. Note: I would certainly give it more than two weeks to be sure. 2. Be willing to live with the ambiguity of not knowing whether gluten causes you problems because you have celiac disease or NCGS (Non Celiac Gluten Sensitivity). There is no test for NCGS. Celiac disease must first be ruled out and we have tests for it. Celiac disease has an autoimmune base. NCGS does not. GI symptoms overlap. In the early stages of celiac disease, other body systems may not be showing stress or damage so, symptomatically, it would be difficult to distinguish between celiac disease and NCGS. Both conditions require elimination of gluten from the diet for symptom relief. Some experts feel that NCGS can be a precursor to celiac disease.
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      I had been eating reduced gluten until about 3 days before the test. I did realize that wasn’t ideal, but it was experimental to see if gluten was actually bothering me. One slip up with soy sauce and it was quite clear to me that it was, lol. 
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