Blood Test Results - 2 Weeks In To Gluten Challenge

[charlie76]

Hi all,

 

As I mentioned in a thread a few weeks ago, I've recently started a gluten challenge after 3 years of very strict gluten free eating. 

 

I've got a biopsy in 2 weeks time (after which I will have been eating gluten for 5 weeks and 2 days in total - I've been eating around 6 slices of bread per day or equivalent).

 

2 weeks into the gluten challenge I had blood tests done.

 

Deamidated Gliadin IgA        * 99  U/mL    ( <15 )

Deamidated Gliadin IgG          <1  U/mL    ( <15 )

Tissue Transglutaminase IgA     <1  U/mL    ( <15 )

Tissue Transglutaminase IgG     <1  U/mL    ( <15 )

 

My results from 2010 are as follows (following many years of low gluten, but not gluten free eating):

 

Gliadin IgA Abs               * 47  U/mL    ( 0 - 20 )

tTG IgA/IgG                   * 52  U/mL    ( 0 - 20 )

 

When I had a biopsy in 2010, there wasn't any sign of Villous atrophy.

 

I was wondering after my latest blood test if I might be going for a biopsy too soon?

 

I understand that the 99 U/mL result for Gliadin IgA suggests that there's something going on, but am I understanding correctly that the other results (the IgG and the tissue results) suggest that there's no sign of damage being done?

 

Again, whatever the result I will be going back to strict gluten free eating. I'm definitely intolerant to the stuff. 

 

Thanks...!

[Mum in Norway]

I think thats a very short challange for a biopsi? Sins you have been glutenfree for some time, it will take a while to get your gutts nice and damaged... If you want to be sure the test result is as accurat as posible, you should probably put the biopsi of for a bit.

 

Me, I'v been eating very little gluten for many years, but not been glutenfree. I did a blodtest (that wasen't planed), came back with DGP IgG of 9, when <7 is normal and >10 is positive. After two weeks of not very heavy challange, about 3 slices of bread a day, it came back 10. So doctor orderd biopsy, and I was told to eat 'normaly' (3 bread based meals a day and some pasta etc several times a week) for AT LEAST two months prior to the biopsy. And I have not been glutenfree, just glutenfree lightat best.

[nvsmom]

I can't remember why you are doing a biopsy...You had a positive AGA IgA, which means a gliadin/gluten intolerance; and a positive tTG IgA, which means your body is making autoantibodies against the mucosal lining of your small intestine - so damage was being attempted; and you had a very positive result to the gluten-free diet. Did some other health issues come up so that you need to revisit the fact that you most likely are a celiac (of whom doctors missed the damage)?

 

Now you also have a positive DGP IgA  after only 2 weeks of gluten - pretty impressive by the way because many people need two months in order make enough DGP antibodies to register on tests. Your other tests were negative at 2 weeks, but that is quite the norm.  Not many people have so many positive celiac tests; most only have one or two.  The only one you are missing is the EMA IgA but that only shows up after advanced damage has happened and will definitely need more than 2 weeks to raise it.... Not that you'd want to. 

 

Anyway, back to your question... Many doctors only require a two week gluten challeng for a biopsy so 4 weeks will probably be enough. If you want to be sure, you could delay it for another month and that should be enough time to do plenty of damage to yourself (these tests are quite barbaric). If the challenge is getting too difficult, then do it after the four weeks. you don't want to make yourself too sick. There are a few board members around here who did gluten challenges but they set themselves back many many months and more than one member apparently ("coincidentally") set off a permenent health problem. It's good to have a diagnosis but not if you are going to make yourself have longterm problems.  KWIM?

 

Good luck with that biopsy. 

[charlie76]

Thanks Nicole.

 

I didn't specifically get any more health issues come up, but I went back to speak to my doctor as I still get "IBS" symptoms when I deviate from my diet (my normal diet is somewhere between gluten free with some gluten-free grains and paleo. I avoid dairy most of the time and try to avoid all grains where possible). 

 

I often have issues when I eat out at restaurants (even when being careful that what I'm eating is gluten free). I can get gas, having to make a dash for the bathroom and even fatigue and a headache thrown in for good measure the next day! I am assuming that there is either cross contamination occurring, leaky gut, intolerance to soy, preservatives, processed oils etc. or something else happening.

 

When I spoke to the doctor about these continuing "IBS" symptoms, he explained that it would be an idea to re-check for celiac disease because the biopsy is the gold standard. I also understood from the consultation that if I have a definite celiac diagnosis then my health might be monitored more closely in the future for any related conditions. 

 

Anyway, now that I have done more research (and this forum has been really helpful) I might have decided again the gluten challenge if I was making the decision again right now. But I'm so close to the biopsy now that I'll carry on. I don't think I'll delay it ... I want to get back to feeling well again

 

I'm considering doing an elimination diet like Whole30 and/or seeing a dietician once I'm done with the challenge. 

 

Thanks again.

[nvsmom]

Understandable. After putting in so much time on the gluten challenge, I would probably continue through with it too.

 

Dairy is a good first food to eliminate for celiacs. Because the intestinal area attacked is where lactase is made, many celiacs are lactose intolerant for 6 months until they heal, sometimes much longer.

 

A food journal is helpful when trying to figure out sensistivities, as is posting your diet here. The people around here helped me figure out that apples and pears cause me some gas issues and bloating - I never would have figured that one out on my own.

 

Good luck.  Let us know how it goes.

[charlie76]

It's been quite a while since my last update. I did in fact finish my gluten challenge and had a biopsy in September 2013. 

 

The outcome of my "gluten challenge" last year was a negative biopsy. The gastroenterologist who I was referred to came to the conclusion (despite the blood tests and symptoms) that I don't have coeliac disease and that it's okay for me to continue to eat gluten.

 

In a way it was disappointing as I (and others) think that I do have celiac disease and I believe other doctors would give me a positive diagnosis on the blood work and symptoms. 

 

Obviously I returned to a gluten free diet (I think this is especially important as there are other autoimmune issues in my immediate family).

 

And on to my family... unfortunately my brother who has terrible "gastrointestinal symptoms" at times (to put it politely) still refuses to get tested for coeliac. My elderly mother has quite advanced MS and other issues so even if she were tested and it were a positive result, I doubt she would be able to change her diet. 

 

My only concern for myself in the future is that Open Original Shared Link which might be developed will only be available to those who have been diagnosed with a biopsy. Also my doctor mentioned that they wouldn't be as concerned with screening for other associated conditions in the future without the positive biopsy / diagnosis. 

 

Whatever happens, the gluten-free diet is for life for me. 

 

Anyway, that's the end of my very late update - thanks for listening and the advice :-)

[nvsmom]

I'm glad you are doing so well!