Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Where Your Contribution Counts!
    eNewsletter
    Support Us!
  • Record is Archived

    This article is now archived and is closed to further replies.

    Dr. Vikki Petersen D.C, C.C.N
    Dr. Vikki Petersen D.C, C.C.N

    New Laboratory Tests for those with Gluten Intolerance

    Reviewed and edited by a celiac disease expert.

    Journal of Gluten Sensitivity Autumn 2011 Issue

    New Laboratory Tests for those with Gluten Intolerance - CC--jepoirrier
    Caption: CC--jepoirrier

    Celiac.com 11/26/2012 -  I speak to many people from across the country, and internationally, who contact me requesting help. The issues they face are summarized into three categories:

    1. individuals with celiac disease who do not have their disease under good control;
    2. those with gluten sensitivity who remain less than healthy despite their gluten-free diet;
    3. individuals, and this is a big one, who are convinced that they have a gluten problem, due to self experimentation, but who are unable to get any corroboration or support from their doctors.

    Having been immersed in this field for almost twenty years, it is frustrating not having a laboratory test that will reliably state whether someone has celiac disease or if gluten sensitivity has been ever present.

    Celiac.com Sponsor (A12):
    The good news is that this situation has improved. It’s not perfect, but it’s better than it has been, and I wanted to share this data with you and those you care about.

    These newly available tests can have a big impact on those who need a diagnosis, as well as those who are already gluten-free but want to know why they are not enjoying the good health they desire.

    I have no affiliation with either of the labs I mention so there is no conflict of interest in my recommendations.

    The first lab, Cyrex Laboratories, is the newest lab specializing in gluten intolerance in the US. It currently offers four different profiles. There is a fifth one coming, hopefully very soon, that is also very exciting and a description of it follows.

    I will provide the data that the lab lists in their brochure for each test along with my personal opinion as to its benefit and use. Here at HealthNOW Medical Center we have been utilizing these tests for almost five months—the lab just opened in January after three years of research and passing governmental licensing requirements.

    Array 1: Gluten Sensitivity

    “This is a saliva test which is recommended for patients who:

    • Are suspected of having mucosal abnormality
    • Have relatives with celiac disease
    • Have type 1 diabetes
    • Have autoimmune thyroid disorder
    • Have relatives with autoimmune disorders, especially, multiple sclerosis, diabetes and arthritis.”

    This is an easy screening test for those who wonder if they have gluten sensitivity or celiac disease based on their own symptoms or symptoms in their family.  As a saliva test it’s very easy to perform (no blood draw is needed) and it’s the least expensive of all the tests offered.

    When utilizing saliva, a test is only as accurate as the strength of the salivary immune system. Due to this limitation, the lab also measures this as part of the panel. In the past, labs would not include this measurement, sometimes resulting in false negative results—something we all wish to avoid.

    Array 2: Intestinal Barrier Integrity Screen

    “Intestinal barrier integrity plays a vital role in the overall health and well-being of patients.  This blood test is recommended for patients who:

    • Have gut dysbiosis, which appears to be resistant to standard therapy
    • Are suspected of having intestinal mucosal damage
    • Complain of food allergy and intolerance
    • Present multiple symptom complaints (including chronic fatigue syndrome)
    • Suffer from abnormal immune cell count and function (including autoimmune diseases)
    • May suffer from depression or neuroautoimmunity [including such conditions as: thyroid disease, arthritis, myocarditis, dermatitis, endocrinopathy, osteoarthritis and pernicious anemia] ”

    Healing a leaky gut is a very big part of regaining one’s health after a diagnosis of gluten intolerance. Gluten has caused damage to the lining of the small intestine and the presence of this damage is thought to be an initiator of the many “non-digestive” symptoms and diseases that are associated with gluten, including autoimmune disease.

    Prior to this test two substances have been traditionally used to measure a leaky gut: lactulose and mannitol. The disappointment of the test lay within the sensitivity, or I should say lack of sensitivity, to adequately diagnose subtle leakiness vs. gross leakiness such as that found in advanced celiac disease and complete villous atrophy.

    Much as an intestinal biopsy can miss the early and more subtle damage to the villi of the small intestine [its lining], so too does the lactulose/mannitol test seem to miss the more subtle changes in a leaky gut.

    This test will detect increased permeability through the cells that line the small intestine, as well as increased permeability between the cells.

    Clinically we use this test as a gauge of how we are progressing clinically rather than as a first tier diagnostic tool. There is no sense in measuring a leaky gut when it’s obviously there. But to prove that a clinical program is producing results or to perhaps show a less than compliant patient that their indiscretions are creating problem, this is an excellent test.

    Array 3: Comprehensive Gluten Sensitivity & Autoimmunity

    “To broaden the view of celiac disease and gluten sensitivity, our doctors can better diagnose the disorder by assessing antibody production against an array of protein, enzyme and peptide antigens.  This blood test is recommended for patients who:

    • Have gut dysbiosis—poor probiotic balance
    • Are suspected of having intestinal mucosal damage—this means damage to the lining of the small intestine
    • Complain of food allergies
    • Complain of chemical hypersensitivity
    • Present multiple symptom complaints (including chronic fatigue syndrome and  Fibromyalgia)
    • Suffer from abnormal immune cell count and function
    • May suffer from depression or neuroautoimmunity [see below]
    • Neuroautoimmune patients to consider: thyroid, arthritis, myocarditis, dermatitis, endocrinopathy,  polyendocrinopathy, osteoarthritis and pernicious anemia”

    This panel is the broadly inclusive blood test designed to measure both celiac disease and gluten sensitivity. Because this test measures several aspects of the protein structure (rather than just the single protein fragment heretofore analyzed), we believe it will take many of the false negatives out of the picture—certainly a welcome change.

    Despite feeling better when removing gluten from their diets, patients like to confirm their own experience with a third party lab test. In the past, lab tests were so riddled with false negatives that we had to encourage patients not to discount their personal experience with a gluten-free diet, despite the absence of correlation with the lab test.

    This approach was not always successful and at times patients returned to gluten simply because they had no lab test to verify the truth. Inevitably they would return to us many months later, feeling worse than ever and ready to, once again, look at a gluten-free diet.

    This panel is more sensitive and specific than any we have had in the past, thereby reducing false negatives greatly. A patient does have to be consuming gluten for this profile to be accurate.

    Array 4: Gluten-Associated Cross-Reactive Foods

    Complete normalization of gut lesions is very rare in adult patients with celiac disease (8%), despite compliance with the gluten-free diet.  This may be due to cross-reactions with an array of foods.  This blood test is recommended for patients who:

    • Have gluten sensitivity or celiac disease.
    • Are non-responsive on a gluten-free diet—in other words don’t feel better.
    • Have gut dysbiosis [not enough healthy bacteria and too many unhealthy ones], which appears to be resistant to standard therapy.
    • Have an autoimmune disorder.

    This panel is very exciting and we are already seeing a dramatic impact on our patients. When one has eliminated gluten (and often dairy) from one’s diet, it obviously takes a big commitment. The last thing such a person might want to hear is that there are other foods they may also need to eliminate.

    Consider this: What if a temporary dietary change of eliminating foods that are confirmed as problematic on a laboratory test resulted in the difference between continued ill health and good health? Now, perhaps, it sounds like a good idea.

    That is exactly what we found in patients who were being extremely vigilant about their diet but still felt “glutenated” or just ill and the cause was not being found.

    Cross-reactive foods are foods with a protein structure similar to gluten’s that, upon ingestion, confuse one’s immune system into thinking that it has ingested gluten. The proteins are confused, one for another, and the reaction is as negative as if one has consumed gluten. This panel looks at twenty five possible foods (mostly in the grain and dairy families) to which one could be experiencing a cross-reactivity reaction.

    While it definitely takes a further commitment to confront more dietary change, our current patients consider it well worth it based on their health improvement.

    Finally, Array 5 that is not yet released, will focus on possible autoimmune reactions occurring from gluten. Autoimmune diseases can be “in the works” so to speak for well over a decade before the body experiences its first symptom. As the third leading cause of death in this country and with no known cure, any forewarning of autoimmune activity would be an excellent tool.

    This test provides another much needed tool for those patients who, although know they are gluten intolerant, cheat on their diet with seeming impunity—meaning they don’t feel any ill effects from having done so.

    Array 5 will be able to reveal what is occurring on a deeper level of the body such that the patient can see where gluten may be beginning to create autoimmune tendencies in certain organs or systems that he or she cannot feel.

    The second laboratory I want to mention is Enterolab. Although Enterolab is not new, they are unique. A few things make them different from all other labs I know about:

    1. You don’t have to work with a doctor to receive a lab test. Enterolab works directly with the patient on-line. They will send you a test kit after you have paid them and test results are emailed to the customer.
    2. Enterolab uses stool testing for their celiac and gluten sensitivity panels. They have a unique technology that allows them to test for these conditions even if the patient has not been eating gluten.
    3. They offer genetic testing as well as testing for other food intolerances. Once again, no doctor referral is required.

    I believe these tests offer benefit not only for those who need a diagnosis but also for those with a diagnosis who are not yet enjoying ideal health.

    I hope you found this informative. Please do feel free to contact me regarding any further questions that you may have. Our clinic, HealthNOW is a destination clinic and we treat patients from across the country as well as internationally. We are here to help.

    To your good health!



    User Feedback

    Recommended Comments

    Guest Attila Csutak

    Posted

    Excellent article, thank you!

    Link to comment
    Share on other sites
    Guest graciela woodbury

    Posted

    Important information that all doctors should know.

    Link to comment
    Share on other sites
    Guest Duane Benton

    Posted

    Good summary. Makes me think I may need more tests done. It took me 5 years to get diagnosed with lots of false negatives.

    Link to comment
    Share on other sites
    Guest Charlotte

    Posted

    Thank you for the added insight into symptoms of and testing for celiac disease. Regarding Array 4: Gluten Associated Cross-reactive Foods, can you please provide additional information on which grains tend to fall into this category? My son has multiple severe food allergies. However, he doesn't test positive (skin or blood tests) for allergies to corn, soy or oat. Yet he still has adverse reactions to those grains. The information in your article leads me to speculate that he has celiac disease in addition to food allergies.

    Link to comment
    Share on other sites
    Guest Carina Wagner

    Posted

    Great article and summary of these two labs. As a practitioner, I have been recommending Entero Lab and like that it is so easy for people to sign up for tests themselves. I have a question for you.

    Do you think that you can get the same information about IgA from the mucosal lining of the mouth vs the IgA in the stool? It seems to me that the stool would be a more accurate evaluation since the food passes through the intestines and starts reacting right there. I appreciate your insight.

     

    Link to comment
    Share on other sites
    Guest Nancy

    Posted

    Excellent article.

    Link to comment
    Share on other sites
    Guest Bruce Steigner

    Posted

    Good info; now know where to look.

    Link to comment
    Share on other sites


    Guest
    This is now closed for further comments

  • Get Celiac.com Updates:
    Help Celiac.com:
    Donate
  • About Me

    Dr. Vikki Petersen D.C, C.C.N

    Dr. Vikki Petersen, a Chiropractor and Certified Clinical Nutritionist is co-founder and co-director, of the renowned HealthNow Medical Center in Sunnyvale, California. Acclaimed author of a new book, "The Gluten Effect" - celebrated by leading experts as an epic leap forward in gluten sensitivity diagnosis and treatment. Dr. Vikki is acknowledged as a pioneer in advances to identify and treat gluten sensitivity. The HealthNOW Medical Center uses a multi-disciplined approach to addressing complex health problems. It combines the best of internal medicine, clinical nutrition, chiropractic and physical therapy to identify the root cause of a patient's health condition and provide patient-specific wellness solutions. Her Web site is:
    www.healthnowmedical.com


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Related Articles

    Scott Adams
    The following was received on March 5, 1998 from Kathryn K. Harden, Ph.D., Open Original Shared Link, Assistant Editor, The Journal of Nutrition, University of Illinois, Urbana-Champaign.
    The latest issue of the American Journal of Clinical Nutrition contains two articles concerning celiac disease. It is encouraging to see research papers concerning celiac disease in important basic research and clinical journals. The citations are:
    Reversal of low bone density with a gluten-free diet in children and adolescents with celiac disease. S. Mora, G. Barera, A. Ricotti, G. Weber, C. Bianchi and G. Chiumello. AJCN 67: 477-481, 1998. The authors conclude that in children and adolescents with low bone mineral density (BMD) due to celiac disease, a gluten free diet promotes a...


    Scott Adams
    Gene Ther 2003 May;10(10):835-43
    Londei M, Quaratino S, Maiuri L.
    Institute of Child Health, University College London, London, UK.
    Celiac.com 05/29/2003 - This highly technical and hopeful article covers the possibility of using gene therapy to one day cure celiac disease. Here are the introduction and final words:
    "Gene therapy (GT) is still at the experimental stage and some recent setbacks have cooled the potential use of this therapeutic tool even in life-threatening conditions. However, this therapeutic approach has a potential, which is not limited to disease for which we have not other option. There are increasing evidence that GT will be soon used in diseases that are not life threatening. One group of diseases that can benefit from GT is the autoimmune...


    Jefferson Adams
    Celiac.com 04/23/2010 - HLA-DQ2+ patients already following a gluten free diet, but with no clinical diagnosis of celiac disease, can present doctors with some challenges in making an official diagnosis of celiac disease. Because many of these patients are reluctant to endure a prolonged gluten challenge, determining whether patients have clinical celiac disease, rather than clinical gluten intolerance, can be difficult.
    Using HLA-DQ2-gliadin tetramers for detection of gluten specific T cells after a short gluten challenge could offer advantages in such cases.
    A team of researchers affiliated with the South-Eastern Norway Regional Health Authority and the University of Oslo is conducting a clinical trial to evaluate the use of HLA-DQ2-gliadin tetramer for diagnosing celiac disease...


    Gryphon Myers
    Celiac.com 02/18/2013 - Currently, there are two main diagnostic tools available to would-be celiacs: biopsy and serological (antibody) tests. For the past few decades, biopsy has been the only relatively reliable (and diagnostically accepted) path to diagnosis. The problem is, biopsies are expensive and highly invasive – antibody tests would be a cheap and painless alternative, but they haven't proven themselves to be accurate enough for conclusive diagnosis. However, a recent analysis shows that antibody tests have improved a great deal in recent years and when used to test for multiple antibodies concurrently, they can be almost as effective as biopsies for diagnosing celiac disease.
    The study's facilitators began their restrospective analysis by collecting serum samples from 26...


  • Recent Activity

    1. - cristiana replied to Larzipan's topic in Related Issues & Disorders
      16

      Has anyone had terrible TMJ/ Jaw Pain from undiagnosed Celiac?

    2. - Julie Riordan replied to Julie Riordan's topic in Traveling with Celiac Disease
      3

      Any ideas for travelling

    3. - Nedast replied to Larzipan's topic in Related Issues & Disorders
      16

      Has anyone had terrible TMJ/ Jaw Pain from undiagnosed Celiac?

    4. - trents replied to SuzanneL's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      1

      Weak Positive Test

    5. - SuzanneL posted a topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      1

      Weak Positive Test


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      120,498
    • Most Online (within 30 mins)
      7,748

    Kim.cervone513
    Newest Member
    Kim.cervone513
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.2k
    • Total Posts
      1m

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Popular Now

    • JustGemi
    • Linedancegal
    • Hannah24
      9
    • jessiemariecar
    • Rhonda H
  • Popular Articles

    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
  • Upcoming Events

×
×
  • Create New...