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Reffinej

Gluten Challenge -Is 3 Weeks Enough?

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As of Friday I am officially doing a gluten challenge. Doc said 2 slices of bread, or equivalent, daily for 3 weeks then do the blood test.
I don't want to get a false negative, if I do have celiac disease, but don't want to have gluten in my diet longer than necessary. Conflicting info out there!

http://celiacdisease.about.com/od/diagnosingceliacdisease/f/Gluten-Challenge.htm

http://www.celiaccentral.org/research-news/researchers-now-say-gluten-challenge-can-be-modified-8149/

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If you have been eating a normal diet up until now, then you probably do not even need to do that.  Most people eat the equivalent of 1-2 slices of bread (in the form of noodles, muffins, crackers, gravy, breaded meats, baked desserts) per day.

 

If you have been gluten-free, it is better to eat gluten for 8-12 weeks, with 12 weeks being better.  Some tests, like the tTG IgA, tTG IgG, and EMA IgA will be slower to increase, and to decrease.  After going gluten-free, it can take some celiacs a good year for their tTG tests to get back to normal.  The DGP tests (deaminated gliadin peptides) will change a bit faster, but possibly not within 3 weeks... probably not.

 

If you were having the endoscopic biopsy done, 3 weeks would be about right.

 

Good luck!


Nicole 

"Acceptance is the key to happiness."

ITP - 1993

Celiac - June, 2012

Hypothyroid - August, 2012

CANADIAN

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Ok,thanks. So I've been as gluten free as I thought I needed to be for health (thyroid antibodies) for 18 months, but without being strict about cross contamination. I had bloods done a few months back and had a high DGP-IgA result hence this journey. 
 

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You are most likely a celiac then.  The DGP IgA is pretty specific to celiac disease; around 95% of people with a positive test have celiac disease.  The fact that you were eating gluten-light and made a positive result - that's pretty meaningful.   :(

 

I would try to drag your gluten challenge out to at LEAST 6 weeks if possible.  If you make it too short you run the risk of getting false negative results, and then the doctors might discount that positive test (a mistake 99% of the time).

 

This report has some good info on the tests: http://www.worldgastroenterology.org/assets/export/userfiles/2012_Celiac%20Disease_long_FINAL.pdf

 

Enjoy a guiness and a donut for me... not together though.  ;)


Nicole 

"Acceptance is the key to happiness."

ITP - 1993

Celiac - June, 2012

Hypothyroid - August, 2012

CANADIAN

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I agree that you need to be consuming gluten longer to get accurate test results since you have been gluten free.   Four weeks is enough for just the endoscopy.  8 to 12 weeks for another blood panel (University of Chicago celiac website).  

 

My GI doc ran the complete panel.  I tested positive on just the DPG-iga test.  The others were negative.  Yet, my intestinal biopsies showed moderate to severe damage (Marsh Stage IIIB).  My result was weird per my doctors.  But I am glad the entire panel was ran!  

 

Seems like you have celiac disease!  Plus, you have Hashi's like me!  

 

Welcome to the club!  


Non-functioning Gall bladder Removal Surgery 2005

Diagnosed via Blood Test and Endoscopy: March 2013

Hashimoto's Thyroiditis -- Stable 2014

Anemia -- Resolved

Fractures (vertebrae): June 2013

Osteopenia/osteoporosis -- June 2013

Allergies and Food Intolerances

Diabetes -- January 2014

Celiac.com - Celiac Disease Board Moderator

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Haha. not sure it's a club I want to be in! Oh well. 
I thought the DGP-IgA was pretty specific, my GP thought not (I like him so was disappointed we didn't seem to agree)....anyway, I guess I can just eat it for longer and do the test when I'm ready. But I am already feeling a bit dodgy from all the gluten. Although, I have to admit that I've enjoyed a couple of croissants- they're pretty much the one thing I miss. (Well, marmite on real bread is nice too)

 

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Figure 2 in this paper shows the time course for antibody level increases during a gluten challenge. They didn't test at 3 weeks, but the values went up nicely sometime between 3 and 4 weeks. This was a small study, only about 20 patients, but this is a paper that people refer to for determining the length of a gluten challenge.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525791/#!po=33.8235

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After my DPG-iga came back positive, I knew in my heart that I had celiac disease.  I had seven weeks in between my blood test results and endoscopy (work contraints), so I loaded up on even more gluten (I was eating gluten prior to my blood tests).  I ate a loaf of sourdough a day, I kid you not!  Plus, I ate every cookie, cupcake, dessert, I could get.  Not the whole package (I shared), but enough to get that last taste!  

 

By the time my endoscopy came, I developed intestinal symptoms.  I do not recommend over eating gluten on a challenge!  Well.....maybe!


Non-functioning Gall bladder Removal Surgery 2005

Diagnosed via Blood Test and Endoscopy: March 2013

Hashimoto's Thyroiditis -- Stable 2014

Anemia -- Resolved

Fractures (vertebrae): June 2013

Osteopenia/osteoporosis -- June 2013

Allergies and Food Intolerances

Diabetes -- January 2014

Celiac.com - Celiac Disease Board Moderator

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Yeah, I'm not feeling great already. I did indulge a wee bit over the weekend (we were away from home, too) but quickly learnt that a) gluten challenge does not equate to an eat-all-rubbish-you-usually-avoid challenge, and gluten, I think, really doesn't agree with me...and I'm starting to look back at much of the sickness I experienced in years gone by and wonder  if gluten played a bigger part that I realised.

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