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Kberry1

Gluten Sensitivity-Severe Hives

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I am new to this forum - I also belong to the Microscopic  Colitis Forum, which is an amazing wealth of information. My story, I am a 56 yr old female.  In 2016 I had papillary thyroid cancer so my thyroid has been removed and I am on 137 mcg of levothyroxine.  Ive been on anti depressant medications for probably 20 years.  In 2016, because of extreme depression and anxiety I switched medications and was given the highest dose using Effexor at 300mg a day. In 2015 I had a colonoscopy and was told that I have lymphocytic colitis.  My symptoms are chronic constipation not the usual text book diarrhea.  Anyway, additional symptoms, which was debilitating for me was whenever I ate gluten, drank alcohol, etc my stomach would be distended so bad that I would look 4 months pregnant.  It got so bad recently that I decided to have a lab test done to find out which foods I was sensitive to.  Below is my lab report....not pretty.  I've been on a strict or though I thought gluten free, dairy free, nut free diet by combining the Paleo and gluten free diets.  I have also been suffering from swollen glands in my neck, head, face and ears, with hives.  It has gotten so bad that I've been searching the internet for forums like yours.  I am taking Benedryl at night and claritin in the morning, but sometimes I feel like these aren't working because I wake up and still have th hives and itching.  I've also incorporated the Autoimmune Anti-inflammatory Diet, I'm still reacting.  I am at my wits end.  The only thing I've been eating since this lab report which has been 2 months is ground turkey and well cooked vegetables using olive oil or coconut oil, salt pepper and dried basil.  Someone on the MC forum said that pre-packaged ground turkey organic is most likely injected with rosemary extract which is soy based, and of course I'm not supposed to have anything soy.  I have A LOT to learn, but boy this is hard and frustrating. Any advice out there would be greatly appreciated.  Thank you in advance:)

 

EnteroLab www.enterolab.com

Specialized Laboratory Analysis for Optimum Intestinal and Overall Health
Kenneth D. Fine, M.D.
Medical Director
13661 Jupiter Road, Suite 307 Dallas, Texas 75238
Laboratory Report
 



Quantitative Microscopic Fecal Fat Score      930 Units   (Normal Range is less than 300 Units)

Fecal Anti-gliadin IgA      171 Units   (Normal Range is less than 10 Units)

Fecal Anti-casein (cow’s milk) IgA      27 Units   (Normal Range is less than 10 Units)

Fecal Anti-ovalbumin (chicken egg) IgA      15 Units   (Normal Range is less than 10 Units)

Fecal Anti-soy IgA      27 Units   (Normal Range is less than 10 Units)

Mean Value # Antigenic Foods      19 Units   (Normal Range is less than 10 Units)

Mean Value 11 Antigenic Foods      19 Units   (Normal Range is less than 10 Units)

While all of the foods tested can be immune-stimulating, the hierarchy of reactions detected were as follows:

Food to which there was no significant immunological reactivity: Food to which there was some immunological reactivity (1+): Food to which there was moderate immunological reactivity (2+): Food to which there was significant and/or the most immunological reactivity (3+):
None Corn
Rice
Chicken
Pork
Beef
Almond
Cashew
Walnut
White potato
Oat
Tuna
None


Within each class of foods to which you displayed multiple reactions, the hierarchy of those reactions detected were as follows:

Grains:
Grain toward which you displayed the most immunologic reactivity: Oat
Grain toward which you displayed intermediate immunologic reactivity: Corn
Grain toward which you displayed the least immunologic reactivity: Rice

Meats:
Meat toward which you displayed the most immunologic reactivity: Tuna
Meat toward which you were next most immunologically reactive: Chicken
Meat toward which you displayed intermediate immunologic reactivity: Pork
Meat toward which you displayed the least immunologic reactivity: Beef

Nuts:
Nut toward which you displayed the most immunologic reactivity: Almond
Nut toward which you displayed intermediate immunologic reactivity: Cashew
Nut toward which you displayed the least immunologic reactivity: Walnut

Nightshades:
You displayed immunologic reactivity to white potato, the member of the nightshade family usually consumed most often and in greatest quantities. While this does not necessarily mean you would react to all other nightshade foods (tomatoes, peppers, eggplant), it is possible. In the realm of elimination diets for immunologic disorders, nightshades are usually eliminated as the entire food class (i.e., all four previously mentioned foods in this class). This is especially important to the clinical setting of arthritis.

 

TEST INTERPRETATION(S)


Interpretation of Quantitative Microscopic Fecal Fat Score:  A fecal fat score greater than or equal to 300 Units indicates that an abnormally high amount of dietary fat has passed undigested and/or unabsorbed into the stool. Malabsorption of dietary fat almost always is associated with malabsorption of all other nutrients as well (protein, carbohydrates, vitamins, etc.). When associated with gluten sensitivity, elevated fecal fat usually is due to gluten-induced small intestinal functional damage and subsequent malabsorption; this does not require there be villous atrophy present. However, deficient production of enzymes by the pancreas can also be associated with celiac disease or non-celiac gluten sensitivity with autoimmune attack on the pancreas, causing maldigestion and malabsorption of dietary fat and other nutrients. Some other causes of exocrine pancreatic insufficiency include chronic pancreatitis from any cause (alcoholism being the most common), pancreatic resection, pancreatic cancer, or common bile duct obstruction. Pancreatic insufficiency as the primary cause of fat malabsorption usually causes significant elevations of fecal fat values, usually into the moderate (600-1000 Units) or severe (>1000 Units) ranges.

To distinguish between small intestinal malabsorption and pancreatic maldigestion, a fecal pancreatic elastase test is necessary, which is now available from our laboratory.

Other possible causes of elevated fecal fat (steatorrhea) include - another inflammatory bowel disease (such as Crohn’s disease which can be associated with gluten sensitivity); deficiency in the production or secretion of bile salts; overgrowth of bacteria in the small intestine; diarrhea from any cause which can, in turn, cause dietary fat to rush through the intestine unabsorbed; consuming very large amounts of dietary fat; eating unabsorbable synthetic dietary fat substitutes; or taking “fat blockers;” and resection of the small intestine causing “short bowel syndrome” (if you have had an intestinal resection).

Any elevated fecal fat value should be rechecked in one year after treatment to ensure that it does not persist, because chronic fat malabsorption is associated with osteoporosis and other nutritional deficiency syndromes.

Interpretation of Fecal Anti-gliadin IgA:  The level of intestinal anti-gliadin IgA antibody was elevated, indicative of active dietary gluten sensitivity. For optimal health; resolution or improvement of gluten-induced syndromes (mainly falling into six categories abbreviated as NAAAGS – neuropsychiatric, autoimmune, asthma, abdominal, glandular deficiencies/hyperactivity or skin diseases); resolution of symptoms known to be associated with gluten sensitivity (such as abdominal symptoms - pain, cramping, bloating, gas, diarrhea and/or constipation, chronic headaches, chronic sinus congestion, depression, arthritis, chronic skin problems/rashes, fibromyalgia, and/or chronic fatigue); and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.

For additional information on result interpretation, as well as educational information on the subject of gluten sensitivity, please see the "FAQ Result Interpretation," "FAQ Gluten/Food Sensitivity," and "Research & Education" links on our EnteroLab.com website.

Interpretation of Fecal Anti-casein (cow’s milk) IgA:  Levels of fecal IgA antibody to food antigens greater than or equal to 10 Units are indicative of an immune reaction, and hence immunologic “sensitivity” to that food. It is recommended that for any elevated fecal antibody level to a highly antigenic food such as milk, that it be removed from your diet.

Interpretation of Fecal Anti-ovalbumin (chicken egg) IgA:  Levels of fecal IgA antibody to food antigens greater than or equal to 10 Units are indicative of an immune reaction, and hence immunologic “sensitivity” to that food. It is recommended that for any elevated fecal antibody level to a highly antigenic food such as egg, that it be removed from your diet.

Interpretation of Fecal Anti-soy IgA:  Levels of fecal IgA antibody to food antigens greater than or equal to 10 Units are indicative of an immune reaction, and hence immunologic “sensitivity” to that food. It is recommended that for any elevated fecal antibody level to a highly antigenic food such as soy, that it be removed from your diet.

Interpretation of Mean Value # Antigenic Foods:  Not yet categorized

Interpretation of Mean Value 11 Antigenic Foods:  With respect to the mean value of the 11 foods tested, overall, there was only a modest amount of immunological reactivity detected to these antigenic foods in terms of fecal IgA production.

Many foods besides gluten, milk, egg, and soy are antigenic in their own right; the main classes of which include other grains, meats, nuts, and nightshades (potatoes being the primary food eaten from this latter class). Minimizing exposure to antigenic foods is an important component of an anti-inflammatory lifestyle to optimize immune system health. This is especially important for those with chronic abdominal symptoms and/or chronic immune/autoimmune syndromes, or for those who want to prevent them.

For immunologic food sensitivity testing, the actual numeric value (in Units) for any given food or for the overall average of a group of foods is important mainly for determining: 1) if the immune reaction is present or absent, and 2) the immune reaction in relative terms to different foods tested in a given individual at a given point in time. It is not a score, per se, to be interpreted as a measure of clinical or immunological severity for that individual or between individuals. This is because the amount of IgA antibody made by a given person is particular for the immune function of that person. Furthermore, sometimes a person can display what can be viewed as immunological and nutritional “exhaustion,” whereby a more significant and symptomatic immunologic food sensitivity is accompanied by a lower positive measured anti-food antibody value (rather than a higher positive). In such an instance, following clinical improvement and improved nutritional status (while the suspect antigenic foods are withdrawn), values can actually be higher for a time before finally falling into the negative range after several years.

Thus, the overall average food sensitivity antibody value for this panel is an assessment of your overall humoral immunologic food reactivity, which can help determine if dietary elimination trials may help you. If the mean value is less than 10 Units, the humoral immune reactions can be considered clinically insignificant (negative); if greater than or equal to 10 Units, they can be considered clinically significant (positive). Rather than reporting the absolute value of a positive result for each individual food, since it cannot be considered as an assessment of severity, the results are reported in semi-quantitative terms between the foods tested (1+, 2+, or 3+). This provides you with the knowledge of which foods are stimulating the most immune response which, in turn, is indeed the most practically applied information to dietary elimination trials.

Dietary Recommendation Based on Test Results to Individual Foods: 

This test panel was designed to guide your choices when building a new more healthful, less antigenic dietary plan. The results are delivered in such a way that you are not left with “nothing to eat,” but instead they should guide you in avoiding the foods to which the highest or most immunologic reaction was detected (and hence, are most stimulating to your immune system). We discourage dietary changes that involve removing too many foods at once. This can lead you to feel too hungry too often, especially if adequate healthful replacement foods are not readily available. Dietary elimination (beyond gluten-free, dairy-free, and soy-free) is best approached over a period of weeks to months and sometimes years, removing one or two additional foods at a time, rather than removing many foods at once.

If you reacted to more than one of the grains, meats, or nuts, we recommend that you first eliminate from your diet the one food from that class you reacted to most strongly, while keeping in your diet the ones you reacted to less strongly. When you want to try and eliminate additional foods, do so in the order of the strength of reaction from highest, intermediate, to least. In the case of potato, you may want to eliminate it if you reacted positively to it.

If you have an autoimmune or chronic inflammatory syndrome, or just want to pursue an optimally healthy diet and lifestyle, avoiding all grains, meats, and nightshades can optimize an anti-inflammatory diet (despite a negative result on food testing). As nuts and seeds are a very healthful source of vegetarian protein and heart-protective oils and minerals, rather than avoiding all nuts and seeds, you can render nuts and seeds less antigenic, more digestible, and more easily tolerated by choosing the few that you seem to best tolerate overall, soaking a one-day supply in a glass jar filled with clean water for 4-8 hours (or for ease, overnight), and pouring off the water and rinsing before eating. The resultant soaked nuts or seeds can be eaten as is (alone or with fresh or dried fruit), blended into nut butters (by adding some water), or added to “smoothies.”

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If you live in the US legally soy has to be labeled on the ingredients list. It should say contains soy or soy based ingredients. The ground turkey could contain other problematic ingredients, but they should be listed on the ingredients.  I am avoiding chicken as it says it contains a vegetable based broth. I don't know for sure but this may mean that it has corn in it. Corn does not have to be listed on food labels. 

Pepper (also alchohol) helps with the absorption of some other spices. This probably means that it can contribute to "leaky gut syndrome" or make the intestines more permeable. This can be problematic for some people. 

Have you had a blood test for vitamin deficiencies? Vitamin deficiencies are very common with Celiac disease. 


Wheat sensitive. Probably Celiac disease but it could be an allergic response. I get very strong anxiety and then autistic symptoms whenever I eat wheat. It is probably a form of encephalitis (swelling in the brain due to wheat) but I am not sure.  Things that I avoid: All grain, alcohol, eggs, dairy, processed food.

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I guess you can't get tested by a doctor for Celiac because you have been gluten-free for so long.  Maybe you are on the wrong tract with blaming gluten for your problems?  I am wondering if you shouldn't be dealing with that lyphocytic colitis.  I would suggest you consult a GI doctor and see how you should be treating that or if it has progressed.  


 

 

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Kberry1,

Kareng is right with you having removed gluten from your diet before testing . . .. your tests would be inclusive at best.

Though having said that I did some research to answer your question about their association?

And they are diseases that are concomitant in the same person often.

see this link entitled "Celiac disease is highly prevalent in lymphocytic colitis" that asks this very question.

https://www.ncbi.nlm.nih.gov/pubmed/11246349

also this link entitled "The association of coeliac disease and microscopic colitis: a large population-based study."

https://www.ncbi.nlm.nih.gov/pubmed/21517923

where they conclude quoting

"There exists a strong association between microscopic colitis and celiac disease with disease concomitance being approximately 50-times that expected in the general population"

but having removed gluten already from your diet you might never now unless you add back gluten into your diet and see if your symptom's get worse.

and I wouldn't personally recommend that with all the other problems you see seem to be having currently.

I hope this is helpful but the medical research on this topic/your question about concomitance seems to indicate a high rate concurrence with/in other celiac's who have been tested/studied for this connection.

Again this is not medical advise --- but I hope it is helpful.

2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included.

Posterboy by the grace of God,

 

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