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Member Since 10 Oct 2006
Offline Last Active Jan 04 2011 08:43 PM

#663081 Enterolab Testing & Validity?

Posted by on 25 December 2010 - 05:15 PM

The fecal AGA is a worse predictor of outcome than simply trying the diet. You gain nothing from buying Enterolab, unless you need a $300 piece of paper to wave at a family member or doctor to get care.

So, by extension, serum AGA is an even worse predictor of outcome? So, if you need a of paper to wave at a family member or doctor to get care, I would think you would be more likely to get it from Enterolab than from, e.g., Labcorp. My point is, your advice to "save your money and try the diet" applies even more to serum AGA labs. That was the advice I took from a Celiac eye doctor in 2002, before either of us had ever heard of Enterolab.

I also think gluten sensitivity is a much broader set of reactions to wheat than just HLA-B mediated autoimmunity. Wheat germ agglutinin and gliadin peptides seem to have some inflammatory effects that are entirely different from the mechanisms of celiac disease. Because of that research, I'm not convinced that all gluten sensitivity is a result of TTG-driven autoimmune attack on the small intestinal mucosa. Wheat is allergenic as well, and the idea in the literature that most childhood wheat allergy resolves in adulthood is probably a little glib. On top of that, there is the issue of fructans in wheat and the millions of people with unrecognized fructose malabsorption. That's what I mean by the research being a bit of a quagmire.

But, that was pretty much the picture in 2004, Dr. Fine saw a number of those points before then. For example, he was “not convinced that all gluten sensitivity is a result of TTG-driven autoimmune attack”:

However, the most widely held and clinically troublesome misconception is that a negative screening blood test, or one only showing antigliadin antibodies (without the autoimmune antiendomysial or anti-tissue transglutaminase antibody) rules out any problem caused by gluten at that time or permanently.

You see a quagmire, 8 year later I see the swamp being drained, but IMO, Dr Fine’s sites needs more updating.
Look, I’m all for encouraging the diet when obvious symptoms are there, but Dr. Fine is explicitly offering the test before there are obvious symptoms.
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#662363 Enterolab Testing & Validity?

Posted by on 22 December 2010 - 07:37 AM

(I know this is an old thread, but forgive me for not being able to hold my tounge, as is were)

The gist I get from both sides of this argument is it’s all about Celiac Disease. I know that this is Celiac.com, not GFD.com, BUT it’s not all about Celiac Disease. My interest in Dr. Fine comes from his interest in broad autoimmune disease, not just celiac disease. When I was in correspondence with him as a customer, the discussion was about autoimmune disease, not just celiac disease.

Neither do I think his goal is the *curing* of Celiac Disease. I think his goal is the *prevention* of autoimmune disease, which includes celiac disease. (Admittedly, the thought of going on the gluten free diet to prevent celiac disease reminds me of the Elephant Gun Joke.)

He restricts his test for gluten sensitivity genes to those that are present in 99% of Celiacs. He does not test for the associated genes that affect how the gluten sensitivity progresses to various autoimmune diseases, e.g., diabetes, epilepsy, ataxia, Graves, lupus, MS, Hashimotos, microscopic colitis, etc, or effects how severe those disease will be. Since the diet to reduce the likelihood and severity of those conditions is the same, he says he can save the customer half the testing price by not looking at those associated genes. (I call then steering genes in the sense that I see them as steering your gluten response towards various organs.)

If you think it is a tough sell to get an Internist or Gastroenterologist to think about gluten sensitivity, try to get a psychologist or Epileptologist to consider it.

There is a subgroup of autistic children who are GREATLY helped by the gluten free diet and are greatly harmed by subsequent gluten challenges. How do you know your child is in that subgroup without the harmfull gluten challenge? Serum tests will not tell you until too late. Do you put him on the diet at birth with no challenge until he is 18 or 21?

Suppose there is a family history of autoimmune disease and/or autism. Do you wait for the condition to appear before you apply the diet or do you start the diet from birth? (or even before conception?) You can test your child for DQ2 or DQ8 at birth, you don’t need Enterolab for that. If you find your child has DQ2 or DQ8, do you do the diet immediately or wait until there are antibodies in the blood? Still, don’t need Enterolab for that.

It seems to me that what Entrolab can do is detect the development of AGA at the earliest possible stage, generally years before AGA appears in the blood.

I got to thinking about this again recently when skimming an article on Diabetes and recognized the genes they were talking about. Wow, look up newer articles on DQ2, DR3-DQ2, and A1-B8-DR3-DQ2 multigene haplotypes! -- I think the strength of gluten/autoimmune hypothesis is increasing even without his publishing.

You Celiacs think it is frustrating he has not published? What about those thinking about gluten's role in autoimmune disease in general? He is studying the ability of stool gluten antibodies to predict the development of autoimmune disease in general and he should be holding ten years of data by now! To prove that early application of GFD prevents or reduces some autoimmune disease, I realize now that he has to have records of patient populations spanning at 10 to 20 years! Most of his records must be under 5 years at this time.

But when he is asked to say why he hasn’t published, he doesn’t say that......
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