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still on this confusing journey


kitty4751

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kitty4751 Rookie

Hi all. Thanks in advance to anyone who reads this long post. I'm a 23 yo female. 

I have had quite the year in terms of health issues. here's a recap, which actually starts senior year in high school:

may 2012 - had horrible bouts of constipation that came out of no where. something I had never experienced before. tested positive tTg IgA = 38.3 where >20 was positive. I also had Gliadin antibodies and EMA tested which were both negative. Important to note: I did not see these test results until this past November! my pediatrician never told me or my mom, I just discovered them in my online portal. 

 october 2015 - still dealing with random periods of horrible constipation. they seemed to correlate with stress. always seemed to have terrible canker sores. History of real bad migraines. Had another tTG IGA test which was now negative. 

March 2016 - had barium follow through xray to see why I am always constipated and irregular. nothing abnormal with this test. 

April 2016 - got seriously injured from running. shin splints that made it impossible for me to even walk to class. was prescribed ridiculous amounts of ibruprofen and naproxen (800mg twice a day) probably the cause of my gastritis

June-August 2016 - shin splits are not healing. doctors run slew of tests to see if I have a malabsorption issue or blood clotting issues, I had positive anti ccp antibodies (this is a rheumatoid arthritis blood marker) and iron deficiency (though not anemic). Another celiac panel was ran and DGP was negative and tTg was BARELY positive: 4 where >=4 was weak positive and >10 strong positive. This time I had an endoscopy which found intestinal metaplasia of the stomach, gastritis and duodenitis. no villi blunting so I was told no celiac. 

September 2016- was prescribed prilosec for the metaplasia. I thought screw it, I'll try eating gluten free for 8 weeks. I felt GREAT. first time in forever that my stools were normal and regular and my stomach was emptying it self in a normal timely manner. Not sure if this was from the diet or the prilosec.

october 2016: had a little ER trip after a night of drinking due to brown colored urine - had high billirubin in urine, was not told what this meant, I'm assuming alcohol poisoning 

November 2016 - Weaned off prilosec. found those strong positive tTG IGA blood lab from high school, freaked out, and demanded I be re tested. Did gluten challenge for 12 weeks until February 2017 and re tested, tTG IGA was negative, B12 was borderline very low, still have iron deficiency and low vitamin D. EMA was never tested. 

summary of symptoms I've had: constipation, stomach takes forever to digest, canker sores, iron deficiency, borderline low B12, low vitamin D, gastritis, migraines, anxiety, tingling numbness and bone pain in lower legs--> possibly due to shin splint injury not healing properly. keratosis pilarsis(chicken skin) on my upper arms which I've had for as long as I can remember. Moodiness --> I can be a real grouch when my insides are bothering me. 

Currently: I feel like crap. My shins aren't healed after a whole year.  I've been prescribed pepcid because my primary suspects the metaplasia/inflammation/ulcers are not healed. I often have pain on my right side abdomen below the rib cage, is something wrong with my liver? am I a hypochondriac at this point? Lately I've been having very fatty oily stools that stick to the toilet bowl. I know this is a sign of malabsorption, heck I lost 3 pounds in 10 days this month, obviously not on purpose! I'm 110 pounds, I'm going to evaporate! My primary told me this week to try  the pepcid along with gluten free and dairy free diet, I am to report back in a month. I'm seeing a rheumatologist next week to sort out the positive anti ccp test, I'm not sure if I should ask to get celiac retested( i know i have to eat gluten for this) and ensure the EMA and DGP are done. I've only had one completely complete panel (in high school) and since then 2 negative ttg iga's and 1 barely positive. What the heck? I just want one day where I'm not worried about how much my stomach is going to hurt. I'm only 23, this has been consuming my life for the past 5 years. 

 


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jasmine24 Rookie

I was just diagnosed a little over a month ago, so I'm not sure if I'm the best person to reply, but if I were you I would get the panel redrawn and make sure they include EMA and DGP. 

 
I am a 24 year old female and had a similar (although not nearly as drawn out) situation about a year before my diagnosis. I had been having symptoms for several years with no answer, and went to another primary care doc who wanted to test me. I'm not sure if she ordered the wrong thing by mistake, or didn't know enough about it, but she ordered 1 test-- just the TTG IgG (instead of IgA) and it was positive. I was referred to a GI who said that test wasn't the best one, but he would do a biopsy anyway. It was negative so he said I didn't have celiac. I wish I had asked him to redo the whole panel back then, but I hadn't done enough research at that time. This past December I went to another doctor for the same problems, still trying to find an answer, and my blood work showed anemia and other vitamin deficiencies, so I asked her to run the full celiac panel and I was positive on everything. I went to a different GI to have the biopsy done it was positive (he said he would be very thorough so nothing was missed and took 11 biopsies). 
 
Anyway, long story, but if I had pushed to have all the tests done and found the right doctor, I would have had my diagnosis a year earlier. Keep fighting until you get all the answers you need (and before you give up gluten for good). I've read some posts on this board of people who are only positive on the DGP. Its interesting that you had a high positive before and now its been low or negative, but I would think that has to mean something. 
cyclinglady Grand Master

Are you serious?  You found a sympathetic GI (12/16) who was shocked that you were not handled properly, asked you to do a gluten challenge,  and then did NOT order a complete celiac panel?   

Looks like your options are to:

1.  With your GP or GI's full support, do another challenge and ask in writing for a complete celiac panel.  Why would you go back to a gluten free diet, if your new GI told you you did not have celiac disease?  Do you look at your lab orders?   Maybe you are losing weight and your stomach is hurting due to ulcers or something else?   It can be hard for doctors to diagnose properly when the patient is changing the variables (remember your 5th grade science project?)  

2.  Get another GI consult, from a GI who treats and diagnoses celiac disease. 

3.  If you have been gluten-free for a month, then give up a diagnosis for now.  Follow your GP's advice and go gluten free for a month.   See if you are feeling better, but honestly, it can take a year or longer to recover from some symptoms.  Anemia or iron-Deficieny, with supplements, should resolve within months.  What exactly is your ferritin level?  Those can drop with every monthly cycle.  If you felt great on a gluten free diet, then stay gluten free.  Why is a diagnosis so important to you?  

4.  Follow-up with the Reumatologist as you might not have celiac disease at all, but another AI issue.  A strong TTG could be possibly related to any AI issue.  

I am sorry for all the mis-haps.  I hope you figure it out.  

For those out there struggling for a firm diagnosis -- DO NOT GIVE UP GLUTEN UNTIL ALL TESTING IS COMPLETE!  Keep and maintain your medical records!!!!  Document all requests in writing to your doctors!  

 

 

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    • knitty kitty
      @Hmart, The reason why your intestinal damage was so severe, yet your tTg IgA was so minimal can be due to cutting back on gluten (and food in general) due to worsening symptoms.  The tTg IgA antibodies are made in the intestines.  While three grams of gluten per day for several weeks are enough to cause gastrointestinal symptoms, ten grams of gluten per day for for several weeks are required to provoke sufficient antibody production so that the antibodies move out of the intestines and into the blood stream where they can be measured in blood tests.  Since you reduced your gluten consumption before testing, the antibody production went down and did not leave the intestines, hence lower than expected tTg IgA.   Still having abdominal pain and other symptoms this far out is indicative of nutritional deficiencies.  With such a severely damaged small intestine, you are not absorbing sufficient nutrients, especially Thiamine Vitamin B 1, so your body us burning stored fat and even breaking down muscle to fuel your body.   Yes, it is a very good idea to supplement with vitamins and minerals during healing.  The eight essential B vitamins are water soluble and easily lost with diarrhea.  The B vitamins all work together interconnectedly, and should be supplemented together.  Taking vitamin supplements provides your body with greater opportunity to absorb them.  Thiamine and the other B vitamins cannot be stored for long, so they must be replenished every day.  Thiamine tends to become depleted first which leads to Gastrointestinal Beriberi, a condition that doctors frequently fail to recognize.  Symptoms of Gastrointestinal Beriberi are abdominal pain and nausea, but neuropathy can also occur, as well as body and joint pain, headaches and more.  Heart rhythm disruptions including tachycardia are classic symptoms of thiamine deficiency.  Heart attack patients are routinely administered thiamine now.   Blood tests for vitamins are notoriously inaccurate.  You can have "normal" blood levels, while tissues and organs are depleted.  Such is the case with Gastrointestinal Beriberi, a thiamine deficiency in the digestive tract.  Eating a diet high in carbohydrates, like rice, starches, and sugar, can further deplete thiamine.  The more carbohydrates one eats, the more thiamine is required per calorie to turn carbs into energy.  Burning stored fats require less thiamine, so in times of thiamine shortage, the body burns fat and muscles instead.  Muscle wasting is a classic symptoms of thiamine deficiency.  A high carbohydrate diet may also promote SIBO and/or Candida infection which can also add to symptoms.  Thiamine is required to keep SIBO and Candida in check.   Thiamine works with Pyridoxine B 6, so if Thiamine is low and can't interact with Pyridoxine, the unused B 6 accumulates and shows up as high.   Look into the Autoimmune Protocol diet.  Dr. Sarah Ballantyne is a Celiac herself.  Her book "The Paleo Approach" has been most helpful to me.  Following the AIP diet made a huge improvement in my symptoms.  Between the AIP diet and correcting nutritional deficiencies, I felt much better after a long struggle with not feeling well.   Do talk to your doctor about Gastrointestinal Beriberi.  Share the article linked below. Thiamine, gastrointestinal beriberi and acetylcholine signaling https://pmc.ncbi.nlm.nih.gov/articles/PMC12014454/ Keep us posted on your progress!
    • Trish G
      Thanks, that's a great addition that I hadn't thought of. 
    • trents
      Other diseases, medical conditions, medications and even (for some people) some non-gluten foods can cause villous atrophy. There is also something called refractory celiac disease but it is pretty uncommon.
    • trents
      knitty kitty asks a very relevant question. So many people make the mistake of experimenting with the gluten free diet or even a reduced gluten diet soon before getting formally tested.
    • trents
      Another great fiber option is dried apricots. Four of them give you 3g of fiber and I find they don't produce all the gas that some other high fiber options do. They taste good too. Costco sells a large bag of them that are labeled gluten-free so you don't have to worry about cross contamination issues like you might in bulk grocery settings.
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