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Enterolab Results
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4 posts in this topic

Hi Everyone,

After my daughter's diagnosis with celiac about two years ago, I began to read and research like crazy. This was a real eye-opener for me and many years of symptoms (since childhood) which I never knew could be related to one another and to gluten; I just knew that I was gluten sensitive as are many others in my and my husband's families. But, both my husband and myself were screened by blood tests and were both NEGATIVE.

With the birth of our most recent child being seemingly sensitive to gluten and dairy through breasmilk, I have been gluten and dairy free for about seven months. The baby is doing VERY WELL and is thriving at 9 months. During this time we also turned our home gluten free, which has helped us immensely in regards to avoiding cc for our daughter. Even though I expected a great turn around in myself with the diet too, I have not been feeling well at all (you could even say absolutely terrible), so I decided to do the enterolab testing. I am posting the results below.

Despite testing positive for gluten, dairy, egg, yeast, and soy sensitivities, in addition to a malabsorption level very near the severe range, I somehow, in a strange way, feel validated and now somewhat optimistic that by eliminating additional foods, I may someday have some energy and feel good like a normal person. I was very impressed with the thorough explanation of the findings, but have a couple questions that were not addressed that I thought all you experts may be able to help me with:

1. SO, do I consider myself officially diagnosed as celiac?

2. Will these other food intolerances likely/sometimes/hopefully go away once I can fully heal and once my malabsorption number is within normal range?

3. Anyone else ever re-test their malabsorption number and have it come back normal after being on the diet? If so, how long after did you wait?

4. Since I was positive for everything I was tested for, what is the likelihood that I may also be sensitive to other things like corn, rice, nightshades etc? (this is what scares me)...and how long after eliminating the soy, egg, and yeast should I expect to feel better before suspecting something else? I HOPE this will do it, but I'm just wondering/worrying.

I was considering calling or emailing enterolab with these questions but thought I'd post it here in the meantime. Anyone else ever have luck getting ahold of or talking to Dr. Fine personally? Thanks for your help.

Results below:

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value

Fecal Anti-gliadin IgA: 159 Units

Fecal Anti-tissue Transglutaminase IgA: 102 Units

Quantitative Microscopic Fecal Fat Score: 994 Units

Fecal Anti-casein (cow's milk) IgA: 25 Units

HLA-DQB1 Molecular analysis, Allele 1: 0501

HLA-DQB1 Molecular analysis, Allele 2: 0501

Serologic equivalent: HLA-DQ 1,1 (Subtype 5,5)

C) Egg, Yeast, and Soy Food Sensitivity Stool Panel

Fecal Anti-ovalbumin (chicken egg) IgA: 12 Units

Fecal Anti-saccharomyces cerevisiae (dietary yeast) IgA: 15 Units

Fecal Anti-soy IgA: 36 Units

Interpretation of Fecal Anti-gliadin IgA (Normal Range is less than 10 Units): Intestinal antigliadin IgA antibody was elevated, indicating that you have active dietary gluten sensitivity. For optimal health, resolution of symptoms (if you have them), and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.

Interpretation of Fecal Anti-tissue Transglutaminase IgA (Normal Range is less than 10 Units): You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.

Interpretation of Quantitative Microscopic Fecal Fat Score (Normal Range is less than 300 Units): A fecal fat score greater than or equal to 300 Units indicates there is an increased amount of dietary fat in the stool which usually is due to gluten-induced small intestinal malabsorption/damage when associated with gluten sensitivity. Values between 300-600 Units are mild elevations, 600-1000 Units moderate elevations, and values greater than 1000 Units are severe elevations. Any elevated fecal fat value should be rechecked in one year after treatment to ensure that it does not persist because chronic fat malabsorption is associated with osteoporosis among other nutritional deficiency syndromes.

Interpretation of Fecal Anti-casein (cow's milk) IgA (Normal Range is less than 10 Units): Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation Of HLA-DQ Testing: Although you do not possess the main HLA-DQB1 genes predisposing to celiac sprue (HLA-DQB1*0201 or HLA-DQB1*0302), HLA gene analysis reveals that you have two copies of a gene that predisposes to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having two copies of a gluten sensitive gene means that each of your parents and all of your children (if you have them) will possess at least one copy of the gene. Two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity may be more severe.

Interpretation of Fecal Anti-ovalbumin (chicken egg) IgA (Normal Range is less than 10 Units): Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation of Fecal Anti-saccharomyces cerevisiae (dietary yeast) IgA (Normal Range is less than 10 Units): Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation of Fecal Anti-soy IgA (Normal Range is less than 10 Units): Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

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hi :)

1. you are definitely reacting to transglutaminase, so that is a big marker for celiac as i understand it. however the "gold standard" in the medical world for diagnosing celiac is a small intestine biopsy. i think that's crap and never got it done, i just went by my enterolab results and the million other clues that i was celiac. so yes i say i officially have celiac, and that is because i know i do, not because some biopsy confirmed it or not. :)

2. some people's food intolerances do go away and some dont. i dont know the real statistics, but it seems like things like corn and soy dont go away AS OFTEN (my personal theory is because they're GMO, terrible for certain people's metabolisms, and soy contains mycotoxins that are only rendered harmless with proper soaking and preparation/fermenting - which the soy industry in this country definitely doesn't do! but i've heard of people being able to introduce limited amounts of egg back in after months without it. be careful though. some people go on a rotation diet to keep the immune system from freaking out. personally, i think you should read about leaky gut and the candida connection. bee's Healing Naturally website has a lot to say about candida... there's gotta be a reason our bodies started reacting to foods!

3. no i could just tell i was absorbing better after 3-4 months, but it takes time. try to eat healthy and rest. drink a lot of fluids like home-made electrolyte drinks, broths, pure water...

4. it helped me to keep a food diary and do a food rotation, also taking my pulse before and after eating "suspect" foods. i would maybe give it a few months on a healthy, antigen-free diet and then if you have a gut feeling there's something else, remove and challenge it after that... but yeah take it easy on the nightshades as some people say the nightshade intolerance is common in people who had them in abundance.

5. i'm on a list serve for the Pecan Bread site and a lot of the people who write in know a ton about food intolerances. it's taught me a lot. they're all on a special diet but i bet you could just go sign up to be on their mailing list if you wanted...

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1. SO, do I consider myself officially diagnosed as celiac?

No.

If you want to know if you have celiac, and you have had a complete panel of celiac blood tests, including total IGA, the only thing you can do next is an endoscopy.

With the postive dietary response, you can consider your self diagnosed as gluten intolerant. You may want to challenge the other foods later. From what I have read, the casein and egg intolerances are likely to be permanent.

3. Anyone else ever re-test their malabsorption number and have it come back normal after being on the diet? If so, how long after did you wait?

My spouse returned to normal at one year. All his blood work and biopsy were negative.

He is DQ5/DQ8 and is avoiding gluten, dairy, eggs and soy. He is not specifically avoiding yeast (positive enterolab test) but he is eating basically grain free and very low carb so his yeast exposure is pretty minimal. He does not have any sysmptoms that suggest yeast is an issue.

4. Since I was positive for everything I was tested for, what is the likelihood that I may also be sensitive to other things like corn, rice, nightshades etc? (this is what scares me)...and how long after eliminating the soy, egg, and yeast should I expect to feel better before suspecting something else? I HOPE this will do it, but I'm just wondering/worrying.

My spouse felt better almost immediately after gluten-free and continued to improve over about 6 months, Every time he gave up another food, he saw a burst of improvement around the 6 week mark. This varies widely from one person to the next. I have also read that a rule of thumb is one year per decade. He's in his late 40's so I am optimistic that he may continue to have small improvements for the next couple of years.

I am wondering if you are noticing any symptoms besides physical ones? He notices problems with food that are related to mood and motivation. particularly with eggs.

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1. SO, do I consider myself officially diagnosed as celiac?

I am afraid you are not "officially" diagnosed through Enterolabs. Enterolabs does not diagnose for Celiac Disease. But you can be self diagnosed, as many here have been. Often times, it's the many pieces of the puzzle that leads people to remove gluten from their daily lives. :)

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    • Thank you! I will call and ask for a full panel and see where it leads!!
    • I think the idea of grinding your own at home stems from the thought that flavored coffees might be ground on the same machines.  The grinders in the grocery are not cleaned between uses.  However, I have not found a flavored coffee bean that had gluten, so it's probably not a real concern.  For coffee that comes from a factory ground, I wouldn't worry at all.   Machines would be cleaned between flavors and nothing but coffee could be made on the machines or even in the same building ( everything made would taste/ smell like coffee). if you still have doubts - I went to the International Celiac Disease Symposium a few years back.  This is held every few years in different countries for medical professionals that study and treat Celiac.  They present research, etc.  All food served was gluten-free.  We drank a lot of plain, already ground, coffee!  A lot!   Coffee is not on any lists as a gluten containing food.  Talking legitimate organizations - not some blogger or pseudo- science website.   After all this, if you still doubt that coffee is gluten free...... Then don't drink it!  It leaves more for me!    
    • To answer some of your questions.... Non celiac gluten sensitivity does not cause any damage to the small intestine so that is not the source of the "little holes or bumps".  You need to get her records including the report of the endoscopy to see exactly what it says as well as the pathology report of the biopsies. You should always get medical records anyway & keep a copy for yourself. How many biopsies did he take? There should be a minimum of 4, ideally 6. The small intestine is very vast even in a small child. An adults is the size of a tennis court! That's a whole lot of territory so biopsies can miss damage especially when enough of them are not taken! She has 2 positives on the serum panel. This crap about "weak" positives should be thrown out of the nomenclature! A positive is a positive, weak or not! Her DgP IGG is way over the range and extremely telling. As far as my knowledge goes, there is nothing else that causes a positive DgP IGG other than celiac disease. False positives are really rare and to have 2 false positives would be astronomically rare! You are right & smart that she really does need an official diagnosis! IMHO, keep her on gluten for right now. Get a second opinion pronto & I believe you'll be able to get her a dx based on the 4 out of 5 rule if nothing else. I wouldn't think it's going to take more than a month to get to see another doc for a second opinion. Then you can take her off gluten. Kids heal up really fast, way faster than us old geezers! I'm sure as others  wake up & get on their computers they will be along to voice their knowledge. I am in the eastern time zone & rise before the birds so I was on here early. Hang in there mom! You're doing the right thing!
    • Now that my initial rage has calmed a tad.... your daughter has to fulfill 4 out of 5 of the diagnostic criteria. Second opinion can do a gene test. If positive, then she will have4 out of 5 of the dx criteria to dx without a positive biopsy. See: http://www.gastro.org/news_items/a-biopsy-should-not-be-required-to-make-the-diagnosis which says in part: The presence of signs and symptoms compatible with celiac disease. Positive serology screening (high serum levels of anti-TTG and/or EMA). Presence of the predisposing genes HLA-DQ2 and/or –DQ8. Histological evidence of auto-insult of jejunal mucosa typical of celiac disease. Resolution of the symptoms and normalization of serology test following the implementation of a gluten-free diet.   Also see: http://www.tenderfoodie.com/blog/2014/5/1/dr-fasano-on-new-gut-autoimmune-research-autism-clearing-up.html She can get a dx after her symptoms resolve on a gluten-free diet!
    • OMG!!!! The doc wants her to get sicker & sicker & do further damage so he can diagnose her? Don't do me any favors doc!!! I'm so spitting med right now I can't even speak! Find a new doc, take the records & get a second opinion. Maybe the next doc will have a freaking brain & dx your daughter. She should be dx'd! This is absurd in the extreme. The very least that should happen is the doc give her a dx now & then in a year or 2 have her do a gluten challenge & do a biopsy all over again but seriously, that would be just as cruel as what he's doing now. He's an ASS!
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