Diagnosis

[Lizbee]

I have the following symptoms of coeliac which are worse after eating:

fatigue, diarrhoea, brain fog, stomach cramps and nausea.

I received my blood test results the other day: IgA 1.72 g/l

Tissue Transglutiminase IgA 0.7 u/ml (previously had a result of 0.5)

 Does this mean that I am not IgA deficent and therefore am not coeliac? Should I just stop eating gluten and see what happens? Is there any more tests the doctor can do?

[Lizbee]

2 hours ago, Lizbee said:

I have the following symptoms of coeliac which are worse after eating:

fatigue, diarrhoea, brain fog, stomach cramps and nausea.

I received my blood test results the other day: IgA 1.72 g/l

Tissue Transglutiminase IgA 0.7 u/ml (previously had a result of 0.5)

 Does this mean that I am not IgA deficent and therefore am not coeliac? Should I just stop eating gluten and see what happens? Is there any more tests the doctor can do?

I also have anxiety, depression and frequent bloating.

[trents]

You do not tell us what the normal range is for your total IGA score or for the tTG-IGA. Different labs use different reference ranges. Your symptoms are classic for either celiac disease or NCGS (Non Celiac Gluten Sensitivity). There are no tests for NCGS so celiac disease first has to be ruled out.

[Lizbee]

3 minutes ago, trents said:

You do not tell us what the normal range is for your total IGA score or for the tTG-IGA. Different labs use different reference ranges. Your symptoms are classic for either celiac disease or NCGS (Non Celiac Gluten Sensitivity). There are no tests for NCGS so celiac disease first has to be ruled out.

The Normal for tTg-Iga was 0-10.9 and for the IgA was 0.8-2.8. Was told by Coeliac UK that the tTg-Iga was low and suggested IgA deficiency but it appears that is also normal.

[trents]

Your total IGA appears to be in normal range. Not sure why you were told otherwise. I would assume you have NCGS and not celiac disease. The next step would be to trial a gluten-free diet and see if your symptoms improve significantly. But if your physician wants a biopsy done you need to stay on gluten until that is complete. The symptoms you describe after eating, are they present only when you consume a meal with gluten in it?

[Lizbee]

2 minutes ago, trents said:

Your total IGA appears to be in normal range. Not sure why you were told otherwise. I would assume you have NCGS and not celiac disease. The next step would be to trial a gluten-free diet and see if your symptoms improve significantly. But if your physician wants a biopsy done you need to stay on gluten until that is complete. The symptoms you describe after eating, are they present only when you consume a meal with gluten in it?

They seem to be there most of the time but are worse after a heavy gluten-containing meal. I have not tried to cut out gluten before so most of my meals contain gluten in some form.

[trents]

It can be a challenge to eliminate gluten from one's diet. There is a real learning curve involved. Most people who claim to be eating gluten free are really eating lower gluten, especially if they are still eating out. Cross-contamination is perhaps the hardest thing to control. If gluten is the issue you should be feeling better within a few weeks.

 

[Lizbee]

1 minute ago, trents said:

It can be a challenge to eliminate gluten from one's diet. There is a real learning curve involved. Most people who claim to be eating gluten free are really eating lower gluten, especially if they are still eating out. Cross-contamination is perhaps the hardest thing to control. If gluten is the issue you should be feeling better within a few weeks.

 

Thank you for your help. If it is NCGS, do I need to be careful of cross-contamination or is that only coeliac disease?

[trents]

If it is NCGS you may still need to be mindful of CC but it really depends on how sensitive you are. That answer would only come with experience. But at the front end of the experiment you would need to be diligent as a control and then explore the CC issue.

[knitty kitty]

@Lizbee 

Do you have or have you been checked for Diabetes?

 

[Lizbee]

12 hours ago, knitty kitty said:

@Lizbee 

Do you have or have you been checked for Diabetes?

 

I was tested along with my coeliac test and it was normal.

[knitty kitty]

Are you anemic? 

Are you on a PPI, antidepressant, or NSaids? 

Have you been checked for SIBO?

Edited February 23, 2022 by knitty kitty
Typo correction

[Lizbee]

15 minutes ago, knitty kitty said:

Are you anemic? 

Are you on a PPI, antidepressant, or NSaids? 

Have you been checked for SIBO?

I’m not anaemic. I’m on antidepressants. I haven’t been checked for SIBO.

[knitty kitty]

40 minutes ago, Lizbee said:

I’m not anaemic. I’m on antidepressants. I haven’t been checked for SIBO.

Sorry about all the questions... Are you ready for more? 🐱

Were you eating at least two slices of gluten containing bread a day, if not more, before the antibodies blood test?  

Celiac antibodies can go down if you stop or reduce the amount of  gluten before the test.  

Lab tests can be skewed if the blood isn't kept at a certain temperature range.

This study found that SSRI's, PPI's and NSAID's cause more damage to the small intestine in Celiac Disease patients.  

"Factors associated with villus atrophy in symptomatic coeliac disease patients on a gluten-free diet"

https://pubmed.ncbi.nlm.nih.gov/28220520/

I wonder if your symptoms are side effects of your antidepressant.

People with Diabetes or anemia can have funky test results.  I had funky test results due to diabetes and anemia.  I finally opted for genetic testing for Celiac genes.  I have two of the most common ones.  Not all genes for Celiac are known, but having a DNA test might give you a clue.  Having genes for Celiac doesn't necessarily mean you have active  Celiac Disease, but having the genes and showing improvement on a gluten free diet can be used as a diagnosis.

If you eat a heavy carbohydrate diet, bacteria can spread out of the large intestine into the small intestine where they are not meant to be.  This Small Intestinal Bacterial Overgrowth (SIBO) can cause symptoms like yours.  

Thiamine deficiency is connected to SIBO.  (Thiamine is Vitamin B1.)  Thiamine helps keep the bacteria in check and in the large intestine. 

We need thiamine to process carbohydrates, fats, and proteins into energy for the body.  If a heavy carbohydrate diet is consumed, more thiamine is needed than may be available in the diet.  Gluten containing products are enriched, but with a synthetic form of thiamine that the body can't really utilize.  Heavy caffeine consumption can deplete Thiamine.  

Thiamine insufficiency can produce the same symptoms you mentioned, fatigue, diarrhoea, brain fog, stomach cramps and nausea. 

Taking Thiamine along with your antidepressant may improve your symptoms.  Adding a thiamine supplement with a B Complex may be beneficial.  Discuss this with your doctor.

"Adjuvant thiamine improved standard treatment in patients with major depressive disorder: results from a randomized, double-blind, and placebo-controlled clinical trial"

https://pubmed.ncbi.nlm.nih.gov/26984349/

Hope this helps!

P.S.  Have you had your thyroid checked?

[Lizbee]

6 minutes ago, knitty kitty said:

Sorry about all the questions... Are you ready for more? 🐱

Were you eating at least two slices of gluten containing bread a day, if not more, before the antibodies blood test?  

Celiac antibodies can go down if you stop or reduce the amount of  gluten before the test.  

Lab tests can be skewed if the blood isn't kept at a certain temperature range.

This study found that SSRI's, PPI's and NSAID's cause more damage to the small intestine in Celiac Disease patients.  

"Factors associated with villus atrophy in symptomatic coeliac disease patients on a gluten-free diet"

https://pubmed.ncbi.nlm.nih.gov/28220520/

I wonder if your symptoms are side effects of your antidepressant.

People with Diabetes or anemia can have funky test results.  I had funky test results due to diabetes and anemia.  I finally opted for genetic testing for Celiac genes.  I have two of the most common ones.  Not all genes for Celiac are known, but having a DNA test might give you a clue.  Having genes for Celiac doesn't necessarily mean you have active  Celiac Disease, but having the genes and showing improvement on a gluten free diet can be used as a diagnosis.

If you eat a heavy carbohydrate diet, bacteria can spread out of the large intestine into the small intestine where they are not meant to be.  This Small Intestinal Bacterial Overgrowth (SIBO) can cause symptoms like yours.  

Thiamine deficiency is connected to SIBO.  (Thiamine is Vitamin B1.)  Thiamine helps keep the bacteria in check and in the large intestine. 

We need thiamine to process carbohydrates, fats, and proteins into energy for the body.  If a heavy carbohydrate diet is consumed, more thiamine is needed than may be available in the diet.  Gluten containing products are enriched, but with a synthetic form of thiamine that the body can't really utilize.  Heavy caffeine consumption can deplete Thiamine.  

Thiamine insufficiency can produce the same symptoms you mentioned, fatigue, diarrhoea, brain fog, stomach cramps and nausea. 

Taking Thiamine along with your antidepressant may improve your symptoms.  Adding a thiamine supplement with a B Complex may be beneficial.  Discuss this with your doctor.

"Adjuvant thiamine improved standard treatment in patients with major depressive disorder: results from a randomized, double-blind, and placebo-controlled clinical trial"

https://pubmed.ncbi.nlm.nih.gov/26984349/

Hope this helps!

P.S.  Have you had your thyroid checked?

Thank you for this. I believe I was eating enough gluten before the test. I had about two slices of bread a day. Also I haven't had my thyroid checked.

[knitty kitty]

Sometimes it's a process of elimination.  

Keep us posted on your progress! 

 

[Lizbee]

Just an update. I’ve seen the doctor this week who has asked me to do a 💩 sample to check for crohns and colitis. I asked about referral for an endoscopy and my doctor seems reluctant. Not sure if I should push further for this or just cut out gluten and assume it’s an intolerance rather than coeliac?

[trents]

11 minutes ago, Lizbee said:

Just an update. I’ve seen the doctor this week who has asked me to do a 💩 sample to check for crohns and colitis. I asked about referral for an endoscopy and my doctor seems reluctant. Not sure if I should push further for this or just cut out gluten and assume it’s an intolerance rather than coeliac?

Well, I would lean toward that with what you know so far. Besides, the antidote is the same for both celiac disease and NCGS, no more gluten.

[Wheatwacked]

Sibo, IBS and colitis could be symptoms of Thiamine deficiency.

Depression and overactive autoimmune response could be not enough vitamin D. Though >30 ng/ml is enough to avoid rickets, the anti-autoimmune and anti-depression effects seem to work better at blood plasma levels around 80 ng/ml.

Make sure you are eating between 150 mcg and 1100 mcg of iodine a day to avoid adding thyroxine to your list of lifelong meds.