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Enterolab Test Results


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#1 kkline

 
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Posted 16 June 2010 - 02:04 PM

So, below are my results and I can happily say that I finally have an answer... Well, sort of. From the interpretation, it appears that I am producing anti-bodies so I should go on a strict gluten free diet. Also, my body has not received any damage from gluten and is still absorbing nutrients. Am I correct? Now I am curious if I should even bother going to my MD with these results and ask for additional tests for Celiac Disease. Should I even bother?

Additional notes: I have a suspected autoimmune condition called Vitiligo and I suffer from chronic constipation. I'm wondering if maybe I have a Fungal overgrowth and/or bacterial overgrowth of some type that may be causing an anti-body reaction (Candida, H.Pylori, etc...). Any type of digestive stress and/or dysfunction would logically cause me to have problems digesting a protein such as gluten. Anyone that would like to comment should because I would appreciate many perspectives :). Thanks!

Kenneth D. Fine, M.D.
Medical Director
10875 Plano Rd., Suite 123 Dallas, Texas 75238

Final Laboratory Report

Date: 6/16/2010

Name: Kline, Kameron

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value
Fecal Anti-gliadin IgA 19 Units (Normal Range is less than 10 Units)

Fecal Anti-tissue Transglutaminase IgA 7 Units (Normal Range is less than 10 Units)

Quantitative Microscopic Fecal Fat Score Less than 300 Units (Normal Range is less than 300 Units)

Fecal Anti-casein (cow’s milk) IgA 8 Units (Normal Range is less than 10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0303

HLA-DQB1 Molecular analysis, Allele 2 0604

Serologic equivalent: HLA-DQ 3,1 (Subtype 9,6)

Interpretation of Fecal Anti-gliadin IgA: 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: The level of intestinal IgA antibodies to the human enzyme tissue transglutaminase was below the upper limit of normal, and hence, there is no evidence of a gluten-induced autoimmune reaction.

Interpretation of Quantitative Microscopic Fecal Fat Score: Provided that dietary fat is being ingested, a fecal fat score less than 300 indicates there is no malabsorbed dietary fat in stool indicating that digestion and absorption of nutrients is currently normal.

Interpretation of Fecal Anti-casein (cow’s milk) IgA: 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
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#2 burdee

 
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Posted 16 June 2010 - 03:32 PM

Correct. Your Elab results indicate nonceliac (intestinal damage) gluten sensitivity. So you need to abstain from gluten to prevent further damage somewhere in your body. Gluten sensitivity reactions could cause your constipation. You also might have other undiagnosed allergies which cause constipation. Not everyone gets diarrhea from allergy reactions. My usual reaction is constipation.

Also consider getting a stool test for bacterial dysbiosis. You may have deficient good bacteria or even an overgrowth (infection) of bad (even pathogenic) bacteria, parasites or candida (fungus). Candida classically causes constipation. However, I initially reacted to 5 different bacteria and 2 different parasites (as well as candida) with constipation.

SUE
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Gluten, dairy, soy, egg, cane sugar, vanilla and nutmeg free. Enterolab diagnosed gluten/casein intolerant 7/04; soy intolerant 8/07. ELISA test diagnosed egg/cane sugar IgG allergies 8/06; vanilla/nutmeg 8/06. 2006-10 diagnosed by DNA Microbial stool tests and successfully treated: Klebsiella, Enterobacter Cloaecae, Cryptosporidia, Candida, C-diff, Achromobacter, H. Pylori and Dientamoeba Fragilis. 6/10 Heidelberg capsule test diagnosed hypochloridia. Vitamin D deficiency, hypothyroiditis, hypochloridia and low white blood cells caused vulnerability to infections. I now take Betaine HCl, probiotics, Vitamin D and T3 thyroid supplement to maintain immunity.


#3 Skylark

 
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Posted 16 June 2010 - 10:14 PM

Yes, you should ask for standard celiac bloodwork from your doctor if your insurance covers it before going off gluten. Enterolab is not a substitute for a proper celiac panel. You need to be sure you don't have anti-endomysial antibodies, or anti-tTG antibodies in your blood, which would indicate a clear need to go off gluten permanently.

Your serotype is DQ6 and DQ9. As your test results note, neither of those are really associated with celiac disease. That's actually really good news. Having only anti-gliadin IgA is not necessarily a clear-cut result either. Enterolab is the only place that recommends a permanent gluten-free diet based only on fecal anti-gliadin IgA, and it seems to be a very extreme stance that is not supported in the scientific literature. It would be more compelling if you had a celiac allele, because then the anti-gliadin IgA might be an early sign of autoimmune gluten reactivity in your intestine.

Here is a study showing that the anti-gliadin IgA by itself doesn't mean much.
http://www.ncbi.nlm....pubmed/16607144

By the way, you might find it interesting that your DQB1*0303 allele is linked to the gene for vitiligo in people of Chinese ancestry.
http://en.wikipedia.org/wiki/HLA-DQ9

Once you have a celiac panel done, the positive anti-gliadin IgA is a decent reason to at least try a gluten-free diet and see if it helps. Tests are not nearly as good as listening to your body.
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#4 Jestgar

 
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Posted 17 June 2010 - 03:40 AM

I would say, don't bother. You wouldn't ask your doctor before going vegetarian, so why do it to go gluten-free?
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#5 ravenwoodglass

 
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Posted 17 June 2010 - 04:36 AM

Your serotype is DQ6 and DQ9. As your test results note, neither of those are really associated with celiac disease. That's actually really good news.


As someone who is a double DQ9 I can say from personal experience that it can have devestating effects on the body and brain when combined with gluten. That gene is not to be taken lightly IMHO. If you read my signature the reason I say that is obvious.
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Courage does not always roar, sometimes courage is the quiet voice at the end of the day saying
"I will try again tommorrow" (Mary Anne Radmacher)


celiac 49 years - Misdiagnosed for 45
Blood tested and repeatedly negative
Diagnosed by Allergist with elimination diet and diagnosis confirmed by GI in 2002
Misdiagnoses for 15 years were IBS-D, ataxia, migraines, anxiety, depression, fibromyalgia, parathesias, arthritis, livedo reticularis, hairloss, premature menopause, osteoporosis, kidney damage, diverticulosis, prediabetes and ulcers, dermatitis herpeformis
All bold resoved or went into remission with proper diagnosis of Celiac November 2002
Some residual nerve damage remains as of 2006- this has continued to resolve after eliminating soy in 2007

Mother died of celiac related cancer at 56
Twin brother died as a result of autoimmune liver destruction at age 15

Children 2 with Ulcers, GERD, Depression, , 1 with DH, 1 with severe growth stunting (male adult 5 feet)both finally diagnosed Celiac through blood testing and 1 with endo 6 months after Mom


Positive to Soy and Casien also Aug 2007

Gluten Sensitivity Gene Test Aug 2007
HLA-DQB1 Molecular analysis, Allele 1 0303

HLA-DQB1 Molecular analysis, Allele 2 0303

Serologic equivalent: HLA-DQ 3,3 (Subtype 9,9)

#6 Skylark

 
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Posted 17 June 2010 - 08:22 AM

As someone who is a double DQ9 I can say from personal experience that it can have devestating effects on the body and brain when combined with gluten. That gene is not to be taken lightly IMHO. If you read my signature the reason I say that is obvious.

I forgot about your DQ9! I wonder what the mechanism of DQ9 celiac is. The structural biology studies that are so compelling are on DQ2, and DQ8 is structurally similar enough that the pathway to celiac is fairly clear.

Hmmm... There is some real science I could possibly do there... You've just inspired me to do a little research.
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#7 ravenwoodglass

 
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Posted 17 June 2010 - 08:46 AM

I forgot about your DQ9! I wonder what the mechanism of DQ9 celiac is. The structural biology studies that are so compelling are on DQ2, and DQ8 is structurally similar enough that the pathway to celiac is fairly clear.

Hmmm... There is some real science I could possibly do there... You've just inspired me to do a little research.


Finding that our lead me to a lot of research also. It was how I found out it is linked to RA which was no surprise to me since my arthritis has been in remission now for many years. Since many RA patients are also diagnosed with IBS it makes me wonder how many are suffering needlessly and taking toxic meds like I was prescribed that they wouldn't need gluten free.
It also made me very angry because since my DD does not carry DQ2 or DQ8 she was told she could never be celiac and she is now back on gluten. She had been diagnosed by both positive blood test and biopsy but since she is an RN and my child I of course can't tell her anything. LOL I hope someday she realizes her need for the diet before as our GI told her after her diagnosis 'she ends up just like me' on the gluten diet.
I should note that most of the research I found was done in Europe, the Middle East and Asia since it is an uncommon gene, or thought to be, in the US caucasian population and found in rather technical medical journals. I unfortunately had a computer crash and lost all my saved links but hopefully you will be able to find some info.
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Courage does not always roar, sometimes courage is the quiet voice at the end of the day saying
"I will try again tommorrow" (Mary Anne Radmacher)


celiac 49 years - Misdiagnosed for 45
Blood tested and repeatedly negative
Diagnosed by Allergist with elimination diet and diagnosis confirmed by GI in 2002
Misdiagnoses for 15 years were IBS-D, ataxia, migraines, anxiety, depression, fibromyalgia, parathesias, arthritis, livedo reticularis, hairloss, premature menopause, osteoporosis, kidney damage, diverticulosis, prediabetes and ulcers, dermatitis herpeformis
All bold resoved or went into remission with proper diagnosis of Celiac November 2002
Some residual nerve damage remains as of 2006- this has continued to resolve after eliminating soy in 2007

Mother died of celiac related cancer at 56
Twin brother died as a result of autoimmune liver destruction at age 15

Children 2 with Ulcers, GERD, Depression, , 1 with DH, 1 with severe growth stunting (male adult 5 feet)both finally diagnosed Celiac through blood testing and 1 with endo 6 months after Mom


Positive to Soy and Casien also Aug 2007

Gluten Sensitivity Gene Test Aug 2007
HLA-DQB1 Molecular analysis, Allele 1 0303

HLA-DQB1 Molecular analysis, Allele 2 0303

Serologic equivalent: HLA-DQ 3,3 (Subtype 9,9)

#8 Skylark

 
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Posted 17 June 2010 - 03:00 PM

Bummer about the computer crash. I'm sure I can find what I need if I know there is some info out there. I mostly read biological and medical journals for information so "technical" is not a problem. (To me they are not technical. Scary, huh? :lol: )
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#9 Skylark

 
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Posted 17 June 2010 - 04:09 PM

Mighty convenient when the study I was thinking of has been done. This is modeling basically showing that DQ9 can probalby present gliadin peptides to T-cells, although not as efficiently as DQ8.
http://intimm.oxford...tract/12/8/1157
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#10 Jestgar

 
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Posted 17 June 2010 - 06:39 PM

Just pointing out that this was done in silico, which doesn't mean it's wrong, it just hasn't been tested biologically.
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"But then, in all honesty, if scientists don't play god, who will?"
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My sources are unreliable, but their information is fascinating.
- Ashleigh Brilliant

Leap, and the net will appear.

#11 Skylark

 
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Posted 17 June 2010 - 11:27 PM

Just pointing out that this was done in silico, which doesn't mean it's wrong, it just hasn't been tested biologically.

Pointing out to whom? It says so in the abstract. *looks confused*
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#12 Jestgar

 
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Posted 18 June 2010 - 03:17 AM

To people just reading the thread that don't look at the link.
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"But then, in all honesty, if scientists don't play god, who will?"
- James Watson

My sources are unreliable, but their information is fascinating.
- Ashleigh Brilliant

Leap, and the net will appear.

#13 nora_n

 
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Posted 18 June 2010 - 08:54 AM

DQ9 is common in Japan, and DQ2 uncommon.
Now DQ9 differs from DQ8 by just one base I think and therefore can present gliadin kinda like DQ2 or DQ8 can.
Even DQ7 is a celiac gene in Sicily, and there is research on that too, and how it does it structure-wise.

About gliadin, this is very important re. neuro issues with gluten, just google hadjivassiliou and you get explanation about the significance of antigliadin antibodies, AND DQ1 (DQ6 and DQ5 are DQ1, and DQ1 was the old name before they could discriminate between them)

Another thing to google regarding the significance of antigliadin, is Ford Gluten, you get to Dr. Fords website where he explains the significance of the antigliadin test.

You know gluten intolerance is NOT a gut issue, it is an immune issue, and has got a lot to do with the brain.
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gluten-free since may 06 after neg. biopsy symptoms went away and DH symptoms which I had since 03 got gradually better.
daughter officially diagnosed celiac and casein intolerant.
non-DQ2 or DQ8. Maybe DQ1? Updated: Yes, double DQ5
Hypothyroid since 2000, thyroxine first started to work well 06 on a low-carb and gluten-free diet
Lost 20 kg after going gluten-free and weighing 53 kg now. neg. biopsy for DH. Found out afterwards from this forum that it should have been taken during an outbreak but it was taken two weeks after. vitaminD was 57 nmol/l in may08)

#14 Skylark

 
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Posted 18 June 2010 - 11:14 AM

To people just reading the thread that don't look at the link.

Gotcha! B) I'll put a wee bit more detail in the thread next time. I was excited to find something that fast on DQ9. I haven't had time to chase down whether DQ9 got put into an in vivo system to validate those computational models. I don't think it's been crystallized like DQ2 and gliadin.
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#15 nora_n

 
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Posted 18 June 2010 - 11:58 AM

Here is one article that says DQ7 (beta 0301 and 0304) and DQ5 (beta 0501) have been found in celiacs:
http://www.clinchem..../full/44/8/1755 note the conclusion is different from what we read out of the article......researchers probably are not allowed to publish they found other genes in celiacs.

http://www.celiac.co...enetic-results/ another thread about non-typical genes and celiac

yes, I found the link to THE article about DQ9 in the above thread:
http://intimm.oxford.../full/12/8/1157
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gluten-free since may 06 after neg. biopsy symptoms went away and DH symptoms which I had since 03 got gradually better.
daughter officially diagnosed celiac and casein intolerant.
non-DQ2 or DQ8. Maybe DQ1? Updated: Yes, double DQ5
Hypothyroid since 2000, thyroxine first started to work well 06 on a low-carb and gluten-free diet
Lost 20 kg after going gluten-free and weighing 53 kg now. neg. biopsy for DH. Found out afterwards from this forum that it should have been taken during an outbreak but it was taken two weeks after. vitaminD was 57 nmol/l in may08)




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