Please Help! What Does This Mean?

[Jocelyn357]

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value

Fecal Antigliadin IgA 222 (Normal Range <10 Units)

Fecal Antitissue Transglutaminase IgA 28 Units (Normal Range <10 Units)

Quantitative Microscopic Fecal Fat Score 663 Units (Normal Range <300 Units)

Fecal anti-casein (cow's milk) IgA antibody 17 Units (Normal Range <10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0201

HLA-DQB1 Molecular analysis, Allele 2 0602

Serologic equivalent: HLA-DQ 2,1 (Subtype 2,6)

Please explain further what this means...I'm sort of freaking out!

[Ursa Major]

Well, from what I can see your values are extremely high, if you don't have celiac disease I'll eat my hat .

It also looks like you're intolerant to casein, so shouldn't have any dairy products.

I guess you need to be gluten and casein free for sure!

Other people here are a lot more knowledgable than me, and will be able to explain things better.

[Jocelyn357]

Well, from what I can see your values are extremely high, if you don't have celiac disease I'll eat my hat .

It also looks like you're intolerant to casein, so shouldn't have any dairy products.

I guess you need to be gluten and casein free for sure!

Other people here are a lot more knowledgable than me, and will be able to explain things better.

Thanks Ursula! I totally felt like those numbers are really high, but then again, I'm not sure what "high" is! Hopefully someone can explain! Thanks!

[Jocelyn357]

Is there anyone with Enterolab knowledge that can help me better understand these results? Does this mean I actually have Celiac or just an intolerance? And Casein? Holy crap, what the heck am I gonna eat??? Please explain the fecal fat, and the genes, because I can't tell what the heck those genes are. Sorry if I'm being impatient, I'm just having some anxiety over this. Any help you can give is GREATLY appreciated!

[CMCM]

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value

Fecal Antigliadin IgA 222 (Normal Range <10 Units)

Fecal Antitissue Transglutaminase IgA 28 Units (Normal Range <10 Units)

Quantitative Microscopic Fecal Fat Score 663 Units (Normal Range <300 Units)

Fecal anti-casein (cow's milk) IgA antibody 17 Units (Normal Range <10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0201

HLA-DQB1 Molecular analysis, Allele 2 0602

Serologic equivalent: HLA-DQ 2,1 (Subtype 2,6)

Please explain further what this means...I'm sort of freaking out!

First of all, remember that Enterolab cannot diagnose celiac, only a predisposition to it and evidence of reaction to gluten. The ONLY thing that will currently diagnose "officially" celiac disease is a biopsy, which doctors are starting to suggest might not always be necessary. So you can never get an "official" diagnosis of celiac without a biopsy, although other things can strongly suggest you have it.

GENES: You have a celiac gene (the 0201 gene) and a gluten sensitivity gene (the 0602). These two genes mean you are PREDISPOSED to celiac disease and/or gluten sensitivity. A person can have these genes predisosing to celiac but not actually have it actively occurring. But read further...

Your Antigliadin IgA was 220 where less than 10 is normal. Here's general info about this, from Enterolab:

"Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet."

Your score of 220 seems high, but it isn't necessarily so. Read this from Enterolab:

"The numeric value of an antibody is not a measure of clinical severity. Values of 10 Units can be associated with the same reactions as the maximum values we measure (200-300). Most positive reactions are between 20 and 80 Units. An analogy would be trying to use the level of antibodies to penicillin in a person who has had an allergic reaction to penicillin to determine if it would be safe for them to take penicillin again. This obviously is not done because those with demonstrated penicillin allergy could not take penicillin without the risk of suffering severe health consequences. Although gluten sensitivity is not a true allergy like penicillin allergy, the concept is the same."

Your Transglutaminase test was 28 where normal is less than 10. Again, number doesn't equate with severity. Here's what Enterolab says:

"Values greater than or equal to 10 Units indicate that the immune reaction to gliadin has resulted in an autoimmune reaction to the human enzyme tissue transglutaminase. It is this autoantibody that may be responsible for the many autoimmune diseases associated with gluten sensitivity."

Finally, your fecal fat score was measuring evidence of malabsorption. Your score was moderately high at 663, where normal is less than 300. Enterolab comments:

"A fecal fat score greater than 300 Units indicates there is an increased amount of dietary fat in the stool which usually is due to gluten-induced small intestinal malabsorption/damage when associated with gluten sensitivity. Values between 300-600 Units are mild elevations, 600-1000 Units moderate elevations, and values greater than 1000 Units are severe. Any elevated fecal fat value should be rechecked in one year to ensure that it does not persist because chronic fat malabsorption is associated with osteoporosis among other nutritional deficiency syndromes."

This score could definitely indicate celiac, or at the very least, gluten sensiivity, although there do exist other possibilities:

Possible causes of elevated fecal fat scores besides gluten-induced damage to the intestine include:

* Another inflammatory bowel disease (such as Crohn's disease which is associated with gluten sensitivity)

* Deficiency in the production or secretion of pancreatic enzymes or bile salts

* Overgrowth of bacteria in the small intestine

* Diarrhea itself causing the fat to rush through the intestine unabsorbed

* Consuming very large amounts of dietary fat, eating unabsorbable synthetic dietary fat substitutes or taking "fat blockers"

* Resection of the small intestine causing "short bowel syndrome"

Your casein test was above 10, so it could cause the same problems as gluten sensitivity.

You really should take gluten AND casein entirely out of your diet.

There looks to be a very high probability that you have celiac disease, but of course, you can't really know without a biopsy.

The best thing is to do a gluten-casein free diet and see how you feel. That's the real test.

[slpinsd]

Jocelyn,

given your test results, it is highly likely you have Celiac, although yes, Enterolab does not diagnose Celiac. I would take your test results and review them w/your doctor, preferrably a good GI, and get a biopsy done before you go Gluten Free, if you are looking for a solid diagnosis. If you are gluten-free during the biopsy, the damage that may be present will not show:) good luck and hang in there!