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Need Help For Next Step In Diagnosis


scottb2240

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scottb2240 Newbie

Hello everybody!

 

First off, I've been reading on this site quite a bit and decided to join, so this is my first post.  Thanks in advance for any help. 

 

Here's how it goes....

 

I'm a 23 year old male.  I had migraines (1-2/month) in high school but always linked them to lack of sleep as I played sports year round.

 

In college I started getting awful "hangovers".... a few drinks would lead to being stuck in bed and vomiting until 8 pm the next day.  I had blood work done and it came back negative for celiac.

 

After graduating college I've stopped drinking because I hated wasting my weekends feeling miserable.

 

Within the past several months I have started getting those "hangovers" while being completely sober. (Stomach pains, migraines and nausea)

 

 

I have met with several doctors and this is what I've had done:

Bloodwork

Endoscopy (negative for celiac, duodenal hernia, ulcer in small intestine) so I'm on Dexilant now.

Ultrasound (nothing came back on that)

HIDA gallbladder scan (my ejection fraction was 76%)

 

Here are some symptoms:

Fatigue

Stomach pain

Heartburn/indigestion

Dehydration

Geographic tongue (dentist said it was nothing to worry about but i know my body is trying to tell me something)

Keratosis pilaris

 

My mother had rheumatoid arthritis before passing from ovarian cancer 5 years ago. 

 

My sister had her gall bladder taken out about 5 years ago and suffers from similar symptoms (no geo tongue or keratosis though)

 

 

My doctors all seem to think I'm healthy and I have the feeling that I am a hypochondriac. Now that you know all of my symptoms and my background.... any ideas how to go forward with my diagnosis??

 

My gut feeling is telling me I have celiac but i just cant find medical proof.

 

 

 

 


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mommy2krj Explorer

I would say that the next step after having all those tests done and come back with no answers would be to give going gluten free a try. Or some kind of food elimination diet....not quite sure which I would do first though...this is all quite new to me.

scottb2240 Newbie

After I posted last night I was thinking that I should have said that maybe I dont have Celiac but a gluten intolerance.  I was listening to the "gluten-free Diet" by Elizabeth Hasselbeck at work and it got me back in the rythem of researching my symptoms.  Maybe I need to get the gene testing done for the HLA DQ2/8?

kareng Grand Master

Why not get tested for Celiac? Instead of just guessing ? You have some of the symptoms. Have they tested your thyroid? Iron, Vit D, B12, etc? Those deficiencies can cause fatigue and vitamin deficiencies are symptoms of Celiac

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scottb2240 Newbie

I had a blood panel to test for celiac as my gastro doctor initially thought that it was celiac.  He said that all my numbers indicate that I am healthy.

kareng Grand Master

I had a blood panel to test for celiac as my gastro doctor initially thought that it was celiac. He said that all my numbers indicate that I am healthy.

You might want to get a copy and look for yourself. Make sure there are even any Celiac tests on it. Can't tell you how many people come on here and say " the doc said my Celiac panel was negative" but find out they didn't have one or the doc ignored the positive, etc

frieze Community Regular

yup, get ye old med rec, & bring the back here.


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  • 3 weeks later...
scottb2240 Newbie

It has been about two weeks since I've posted on here.  I finally got around to getting my blood work.  I'll post all my numbers from the tests I had done.

 

Total iron saturation: 94 MCG/DL

Unsaturated iron binding capacity: 267 MCG/DL

Total iron binding capacity: 361 MCG/DL

% saturation: 26

Transferrin: 293 MG/DL

 

Tissue transglutaminase AB, IGA: 1 U/mL

 

Gliadin (deamidated) AD (IGA): 4 U

 

Immunoglobin A: 436 MG/DL

 

Ferritin: 54.4 ng/mL

 

Lipase: 19 U/L

 

That is all the information I was sent.  If anything looks odd, I would appreciate any help!

Thank you, Scott

frieze Community Regular

It has been about two weeks since I've posted on here.  I finally got around to getting my blood work.  I'll post all my numbers from the tests I had done.

 

Total iron saturation: 94 MCG/DL

Unsaturated iron binding capacity: 267 MCG/DL

Total iron binding capacity: 361 MCG/DL

% saturation: 26

Transferrin: 293 MG/DL

 

Tissue transglutaminase AB, IGA: 1 U/mL

 

Gliadin (deamidated) AD (IGA): 4 U

 

Immunoglobin A: 436 MG/DL

 

Ferritin: 54.4 ng/mL

 

Lipase: 19 U/L

 

That is all the information I was sent.  If anything looks odd, I would appreciate any help!

Thank you, Scott

we need the ranges....

nvsmom Community Regular

The full celiac disease panel, which hardly anyone seems to get, is:

  • tTG IgA and tTG IgG
  • DGP IgA and DGP IgG
  • EMA IgA
  • total serum IgA
  • AGA IgA and AGA IgG

It appears they did the tTG IgA and DGP IgA celiac tests for you, as well as the total serum IgA. Celiac tests have various ranges like 0-4, or 0-1, or 0-20. I'm guessing that yours are 0-4, but you need your ranges.  the total serum Iga looks like it is fine though.

 

You might want to request some IgG based tests. some people around here are only serologically positive in the IgG tests, their igA tests are negative. That could be you.

 

Non-celiac gluten sensitivity (NCGS) could apply to you too. Those with NCGS have all the same symptoms as celiac disease but don't have the villi damage (and so have negative blood tests).

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    • trents
      I assume that you already know that genetic testing for celiac disease cannot be used to confirm a celiac diagnosis. About 40% of the general population has the genetic potential to develop celiac disease but only about 1% actually develop celiac disease. It can be used to rule out celiac disease with a high degree of confidence, however, in the case where the genetic testing is negative for the genes. Until and unless you are actually diagnosed with celiac disease I would not raise this as an issue with family. However, if you are diagnosed with celiac disease through blood antibody testing and/or endoscopy with positive biopsy I would suggest you encourage first degree relatives to also purse testing because there is a significant chance (somewhere betwee 10% and almost 50%, depending on which studies you reference) that they will also have or will develop active celiac disease. Often, there are symptoms are absent or very minor until damage to the small bowel lining or other body systems becomes significant so be prepared that they may blow you off. We call this "silent celiac disease". 
    • trents
      If you were off gluten for two months that would have been long enough to invalidate the celiac blood antibody testing. Many people make the same mistake. They experiment with the gluten free diet before seeking formal testing. Once you remove gluten from the diet the antibodies stop being produced and those that are already in circulation begin to be removed and often drop below detectable levels. To pursue valid testing for celiac disease you would need to resume gluten consumption equivalent to the amount found in 4-6 slices of wheat bread daily for at least two weeks, preferably longer. These are the most recent guidelines for the "gluten challenge". Without formal testing there is no way to distinguish between celiac disease and gluten sensitivity since their symptoms overlap. However, celiac disease is an autoimmune disorder that damages the small bowel lining, not true of gluten sensitivity. There is no test available for gluten sensitivity so celiac disease must first be ruled out. By the way, elevated liver enzymes was what led to my celiac diagnosis almost 25 years ago.
    • trents
      Then it does not seem to me that a gluten-related disorder is at the heart of your problems, unless that is, you have refractory celiac disease. But you did not answer my question about how long you had been eating gluten free before you had the blood antibody test for celiac disease done.
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      My genetic test results have arrived - I’m homozygous for DQB1*02, meaning I have HLA-DQ2. I’ve read that this is one of the genes most strongly associated with celiac disease, and my symptoms are very clear. I’m relieved that the results finally arrived, as I was getting quite worried since my symptoms have been getting worse. Next step, blood test. What do these results imply? What should I tell my family? I’m concerned that this genetic predisposition might also affect other family members.
    • Roses8721
      Two months. In extreme situations like this where it’s clearly a smoking gun? I’m in LA so went to a very big hospital for pcp and gi and nutritionist 
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