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How Important Is An Official Diagnosis?


NotMollyRingwald

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NotMollyRingwald Apprentice

Hi all.  I don't have a firm diagnosis, just a "likely celiac" label.  Seeing a GI in a couple weeks, whom I assume will want to scope/biopsy.  By the time the scope comes, I'll be at least 3 mo gluten-free (I've been very strict, but I'm sure there has been some CC here and there).  I can't decide if it's worth it.  I know that gluten bothers me.  I know that my GDA number was above the normal range, but that the tTg number was normal when I was tested 6 weeks gluten-free.  I know that to get accurate results, I should be consuming gluten for a while before the scope/biopsy...  What I don't know, and can't decide, is how important is an actual diagnosis?  I just can't think far enough ahead in time to imagine when/where it will help or where having a lack of a diagnose will hurt.  I would appreciate your opinion/experience with this... I'm still struggling to believe all this...kinda down and confused I guess...just don't feel normal right now and don't know how best to advocate for myself.  Anyway, thanks in advance for the input.

 

-Amy


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kareng Grand Master

This was just on the University of Chicago Facebook page.  You might find it interesting:

 

"It is not. Five reasons exist as to why someone might feel better on a gluten-free diet. It’s crucial to understand which of the five is the cause in order to implement a safe dietary program.

1. Celiac disease
2. Non-celiac gluten sensitivity
3. Wheat allergy
4. Sensitivity to foods rich in FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols); wheat grains are rich in FODMAPs and those sensitive to them have reported marked improvement
5. Placebo effect (this is quite common in adults)

It’s unwise to maintain a gluten-free diet without diagnosing a specific health concern, as the above conditions differ profoundly in mechanisms, severity of damage, and complications. If already eating gluten free there’s no way to establish a diagnosis other than re-exposure to gluten. Plus, autoimmune diseases tend to cluster together in one individual and celiac disease is an inherited disease, so we believe it wise to understand the health risks for your other family members.

The duration of the challenge (12 weeks of ½ slice of bread or a cracker per day prior to a blood panel) is required for antibodies to appear in the blood, but it can be shortened from the 12 weeks because intestinal damage can occur within a week of re-exposure.

Open Original Shared Link · Open Original Shared Link · Open Original Shared Link"
kareng Grand Master

Some other reasons to consider in getting an "official" diagnosis:

 

- Some people won't take the gluten-free diet seriously with no diagnosis

- Doctors, hospitals, nursing homes, etc do not have to give you gluten-free food

- It is genetic.  Having a first degree relative with it means you need to be tested.  For example - your kids

- Some Schools & colleges will need an official diagnosis before feeding you special food or letting you out of a food contract

- There are other illness that may go with a Celiac diagnosis

- rreason for an insurance company to pay for a name brand med that is gluten-free when the generic isn't

 

I'm sure you can think of more reasons for and against. Fortunately, you don't need a doctor to agree to prescribe meds or do procedures to treat Celiac. 

NotMollyRingwald Apprentice

 

This was just on the University of Chicago Facebook page.  You might find it interesting:

 

"It is not. Five reasons exist as to why someone might feel better on a gluten-free diet. It’s crucial to understand which of the five is the cause in order to implement a safe dietary program.

1. Celiac disease

2. Non-celiac gluten sensitivity

3. Wheat allergy

4. Sensitivity to foods rich in FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols); wheat grains are rich in FODMAPs and those sensitive to them have reported marked improvement

5. Placebo effect (this is quite common in adults)

It’s unwise to maintain a gluten-free diet without diagnosing a specific health concern, as the above conditions differ profoundly in mechanisms, severity of damage, and complications. If already eating gluten free there’s no way to establish a diagnosis other than re-exposure to gluten. Plus, autoimmune diseases tend to cluster together in one individual and celiac disease is an inherited disease, so we believe it wise to understand the health risks for your other family members.

The duration of the challenge (12 weeks of ½ slice of bread or a cracker per day prior to a blood panel) is required for antibodies to appear in the blood, but it can be shortened from the 12 weeks because intestinal damage can occur within a week of re-exposure.

Open Original Shared Link · Open Original Shared Link · Open Original Shared Link"

 

Thank you for this!  

NotMollyRingwald Apprentice

Some other reasons to consider in getting an "official" diagnosis:

 

- Some people won't take the gluten-free diet seriously with no diagnosis

- Doctors, hospitals, nursing homes, etc do not have to give you gluten-free food

- It is genetic.  Having a first degree relative with it means you need to be tested.  For example - your kids

- Some Schools & colleges will need an official diagnosis before feeding you special food or letting you out of a food contract

- There are other illness that may go with a Celiac diagnosis

- rreason for an insurance company to pay for a name brand med that is gluten-free when the generic isn't

 

I'm sure you can think of more reasons for and against. Fortunately, you don't need a doctor to agree to prescribe meds or do procedures to treat Celiac. 

Again, these are great points...I have been wondering about my son.  He has had "intolerance issues" since birth and seems to be constipated a lot. I suppose my having a "real" celiac disease diagnosis would be more convincing to his Ped if I were to request he is tested...    And the gluten free Rx is something I had not thought of at all...I better go check labels/call the pharmacy.  Thank you!

kareng Grand Master

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    • Samanthaeileen1
      thank you RMJ! That is very helpful advice. Good to know we aren’t crazy if we don’t do the endoscopy. We are going to try the gluten free and see how symptoms and levels improve.    thank you Wheatwacked (love the username lol) that is also reassuring. Thankfully she has an amazing and experienced pediatrician. And yesss I forgot to mention the poop! She has the weirdest poop issues.    How long did it take y'all to start seeing improvement in symptoms? 
    • Wheatwacked
      My son was diagnosed when he was weaned in 1976 after several endoscopies.  Given your two year old's symptoms and your family history and your pediatrition advocating for the dx, I would agree.  Whether an endoscopy is positive or negative is irrelevant.   That may happen even with endoscopy.  Pick your doctors with that in mind. In the end you save the potential trauma of the endoscopy for your baby.   Mine also had really nasty poop.  His doctor started him on Nutramigen Infant because at the time it was the only product that was hypo allergenic and had complete nutrition. The improvement was immediate.
    • RMJ
      So her tissue transglutaminase antibody is almost 4x the upper end of the normal range - likely a real result. The other things you can do besides an endoscopy would be: 1.  Genetic testing.  Unfortunately a large proportion of the population has genes permissive for celiac disease, but only a small proportion of those with the genes have it. With family history it is likely she has the genes. 2.  Try a gluten free diet and see if the symptoms go away AND the antibody levels return to normal. (This is what I would do). Endoscopies aren’t always accurate in patients as young as your daughter. Unfortunately, without an endoscopy, some doctor later in her life may question whether she really has celiac disease or not, and you’ll need to be a fierce mama bear to defend the diagnosis! Be sure you have a good written record of her current pediatrician’s diagnosis. Doing a gluten challenge for an endoscopy later in life could cause a very uncomfortable level of symptoms.   Having yourself, your husband and your son tested would be a great idea.  
    • Samanthaeileen1
      here are the lab ranges.  Normal ranges for tissue transglutaminase are: <15.0 Antibody not detected > or = 15.0 Antibody detected normal for endomysial antibody is < 1.5. So she is barely positive but still positive. 
    • JoJo0611
      I have been diagnosed with coeliacs disease today after endoscopy, bloods and CT scan. I have also been diagnosed with Mesenteric Panniculitis today. Both of which I believe are autoimmune diseases. I have been told I will need a dexa scan and a repeat CT scan in 6 months. I had not even heard of Mesenteric Panniculitis till today. I don’t know much about it? Has anyone else got both of these. 
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