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Importance of Early Gluten Sensitivity Diagnosis

Celiac.com 02/08/2012 - Having finally being diagnosed with celiac disease myself, I enjoy writing about this autoimmune disease in my gluten-free advocacy work with my mom, Tina Turbin. However, there is a whole other segment of the population who, rather than having celiac disease, have a food sensitivity to gluten. In fact, according to The Food Intolerance Consumer, gluten-sensitive people make up 15% of Americans, whereas celiac disease is currently estimated to exist in 1% of the population. Clearly, in view of its prevalence in the U.S., gluten sensitivity needs to be addressed, but as it turns out, research is showing that an early diagnosis of gluten sensitivity is particularly crucial in preventing celiac disease and other serious health conditions from developing among the gluten-sensitive population.

Photo: CC - milos milosevicAccording to the website of the ALCAT Food and Chemical Sensitivity/Intolerance Test, food sensitivity "induces chronic activation of the innate immune system and gives rise to inflammatory process," and this inflammation "has been linked to countless chronic conditions, including: digestive disorders, migraines, obesity, chronic fatigue, ADD, aching joints, skin disorders, arthritis and many more.' Perhaps you're wondering how a food sensitivity is different from a food allergy. According to ALCAT, food allergies encompass reactions to food that activate the immune system to produce large amounts of histamine, which leads anaphylaxis, a condition that can be deadly, causing swelling in the throat and esophagus so that one can't access air from the lungs or other reactions such as hives and rashes.

According to Kenneth Fine, MD, in a transcript of a talk he gave to the Greater Louisville Celiac Sprue Support Group, as published by Celiac.com, the immune system reaction that gluten sensitivity causes starts in the intestine because this is where gluten is found after being digested in foods. When this reaction causes damage to the absorptive finger-like projections that line the small intestine called villi, known as villous atrophy, celiac disease is said to exist. However, says Dr. Fine, "Although the small intestine is always the portal of the immune response to dietary gluten, it is not always affected in a way that results in villous atrophy." In fact, he says that most gluten-sensitive people don't have this symptom of celiac disease and are therefore not celiac.

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Despite this fact, the testing that has been commonly administered in order to diagnose gluten sensitivity have yielded positive results only when damage to the villi was noted, a fact which can have devastating health consequences for gluten-sensitive people without such damage, who are likely to continue ingesting gluten. According to Dr. Fine, "This can result in significant immune and nutritional consequences, many of which are irreversible even after treatment with a gluten-free diet." The list of disorders and health conditions that can manifest is long, including, Dr. Fine says, "loss of hormone secretion by glands (hypothyroidism, diabetes, pancreatic insufficiency, etc), osteoporosis, short stature, cognitive impairment, and other inflammatory bowel, liver, and skin diseases, among others." That's why he stresses early diagnosis for gluten sensitivity.

Dr. Fine seeks to change current testing methods and clear up misconceptions that prevent early diagnosis from being made. One of the misconceptions he discusses is the reliability of specific blood testing for not only antigliadin antibodies but also autoimmune antiendomysial or anti-tissue transglutaminase antibody. He says that "a negative test does not mean you do not have the problem. This is the biggest pitfall of all because the only thing a very specific test, like blood testing for celiac disease, can do is 'rule in' the disease; it cannot 'rule it out.'" This means that people with advanced or long-term celiac disease will show positive results. In fact, when the villi were only partly damaged, only 30% of celiac individuals being tested had positive results.

Detecting gluten sensitivity early in individuals can have major health benefits, preventing not only the development of celiac disease (that is, villous atrophy, according to Dr. Fine), but a wide array of autoimmune diseases and conditions such as osteoporosis, malnutrition, infertility, certain mental disorders, and even some forms of cancer. I myself was diagnosed in my early 20's after being in and out of hospitals and incorrect diagnoses. Additionally, the treatment for gluten-sensitive individuals diagnosed early would be simple-a gluten-free diet-which should result in improvement in symptoms. With the medical community enlightened by Dr. Fine's research, we can look forward to better testing and earlier diagnosis of the gluten-sensitivity community and their resultant health benefits.

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6 Responses:

 
Jeeva
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated
said this on
08 Feb 2012 12:22:28 AM PDT
Same here...got diagnosed 2 years back. That is my late 20's, GF diet is working on me.

 
Dorothy Glendenning
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said this on
13 Feb 2012 4:12:48 PM PDT
I was impressed to find any information on intolerance.

 
Mary
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said this on
13 Feb 2012 5:40:36 PM PDT
The article supports diagnosing gluten sensitivity early, but does not tell us how... It states that blood tests are unreliable anyway... So how do we go about it?

I am non-celiac gluten sensitive, and all my blood tests are negative. I am looking for a way to know if my kids are gluten-sensitive - their blood tests unsurprisingly negative as well... Their symptoms if any are mild and well within the normal human variations (just like mine were as a child - but definitely I was gluten sensitive back then too). They can't tell me if they "feel better" on a GF diet, and it is nearly impossible to keep them off gluten while they eat at school, birthday parties, etc...

 
Ron Corn
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said this on
14 Feb 2012 4:58:10 AM PDT
Have there been efforts to ban gluten from our food supply. Fifteen % of the population is a big number. Why do suffers and our elected officials allow this product to be used? Have there been lobbying efforts to purge gluten's use? I was just diagnosed two weeks ago and I am shocked that this product is allowed to be distributed.

 
Sharon
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said this on
16 Feb 2012 8:17:51 PM PDT
Helpful to be reminded that blood tests do not always show accurately. I had two different blood tests at the same time. So glad I paid for both, the cheaper test was negative. But the second test showed a strong positive and I felt better in days.

 
VPeach
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said this on
16 Apr 2012 5:57:12 PM PDT
As someone who has a strong gluten intolerance, I have serious concerns about the 100's of products on the market labeled "Gluten Free" that have some form of corn replacing the wheat. Corn is as bad or worse for me, and it is very nearly impossible to find any kind of food product that does not have some form of wheat or corn.

Bought a Rice-A-Roni style rice product recently and it had 4 types of wheat products and 2 types of corn products ... in a box of rice!!! What are food producers thinking for goodness sake.




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I would stick to a very basic gluten-free diet as recommended by Dr. Fasano and other celiac experts. It would not hurt for a short amount of time and might get him through his exams. This is the study about dealing with Trace Amounts of Hidden Gluten (not saying your son has non-responsi...

Yes do follow up with testing, once confirmed we can help you along the road. Other intolerance and allergies are very common with this disease. Lactose is broken down by enzymes produced by the tips of your villi in your intestines, they are normally the most damaged and in some cases just gone....

Please follow the advice of celiac experts and get your daughter tested before going gluten free, Your doctor, like many, is woefully misinformed. You should be tested too (all first degree relatives), even if symptom free, and especially since your mother was recently diagnosed. Learn more a...

We in the UK he takes a pack lunch and have asked for a health plan so wait and see. Not easy when he taking his gcse and he wants to do well. Thanks for the advice

My daughter, who does not have celiac disease, is also in the 11th grade. Since you said exams instead of finals, I assume you are not in the US where a 504 plan can accommodate anyone with a disability (celiac disease counts). This includes tudors, more time to complete tests, etc. Do you hav...