Osteoporosis & Celiac

[trents]

My guess would be you are still getting gluten from somewhere. Had to look up "pescetarian". That was a new one one for me. Do you have any concerns about heavy metal toxicity from eating fish as your main source of protein, besides dairy that is? By the way, dairy can cause villi blunting just like gluten for some people. But I don't think it would cause elevated tTG-IGA.

[RMJ]

4 hours ago, PME said:

Sorry...another question...blood work from last week shows my Celiac number actually went UP.  Previously, it was 19. Now it's 21.4. Does this mean I am inadvertently ingesting gluten? Many thanks in advance.

Celiac antibody results are not reported in absolute units, so cannot be compared from lab to lab.  (If you want me to explain more about units I can - just ask.  I used to develop tests similar to these and don’t know how much of a nerd to be on a forum).

For your earlier results, your result was 19, and positive was greater than 10. Your result was almost twice the positive limit.

Current results, yours is 21.4, but positive is greater than or equal to 15.  You are not anywhere near twice the positive limit.  So it’s impossible to tell for sure, not knowing the slope of the lab’s standard curve, but your antibodies MIGHT actually be going down!

 

[PME]

4 hours ago, trents said:

My guess would be you are still getting gluten from somewhere. Had to look up "pescetarian". That was a new one one for me. Do you have any concerns about heavy metal toxicity from eating fish as your main source of protein, besides dairy that is? By the way, dairy can cause villi blunting just like gluten for some people. But I don't think it would cause elevated tTG-IGA.

Actually, I eat relatively little dairy. Just Fage plain, fat-free yogurt - about 8 oz a day. And maybe a slice of cheese. I don't eat that much fish either, unfortunately. Maybe once a week. Usually seafood - farm raised clams. Hard to get decent fresh fish where we are now. I do eat poultry. Ground turkey once a week. Chicken breast once a week. Otherwise, my protein comes from vegetarian refried beans, buckwheat groats or tofu. I'm wondering whether the herbs or spices in my cabinet could be problematic... We did go to a restaurant a few days before blood test. I had a salad with blackened chickpeas and balsamic vinaigraite   dressing... I'm just stumped, really.

[PME]

21 minutes ago, RMJ said:

Celiac antibody results are not reported in absolute units, so cannot be compared from lab to lab.  (If you want me to explain more about units I can - just ask.  I used to develop tests similar to these and don’t know how much of a nerd to be on a forum).

For your earlier results, your result was 19, and positive was greater than 10. Your result was almost twice the positive limit.

Current results, yours is 21.4, but positive is greater than or equal to 15.  You are not anywhere near twice the positive limit.  So it’s impossible to tell for sure, not knowing the slope of the lab’s standard curve, but your antibodies MIGHT actually be going down!

 

Thanks, RMJ! It didn't occur to me that different labs had different scales to measure.  I didn't even notice the difference in range between the two labs! And it sure would be great to think my antibodies were actually declining if it meant I was doing something right! I would love to understand this better if you have a standard explanation and wouldn't have to spend a lot of time writing it!   So is the recommendation to try to repeat the test at the same lab at intervals?

 

 

23 minutes ago, RMJ said:

Celiac antibody results are not reported in absolute units, so cannot be compared from lab to lab.  (If you want me to explain more about units I can - just ask.  I used to develop tests similar to these and don’t know how much of a nerd to be on a forum).

For your earlier results, your result was 19, and positive was greater than 10. Your result was almost twice the positive limit.

Current results, yours is 21.4, but positive is greater than or equal to 15.  You are not anywhere near twice the positive limit.  So it’s impossible to tell for sure, not knowing the slope of the lab’s standard curve, but your antibodies MIGHT actually be going down!

 

 

[trents]

38 minutes ago, PME said:

Thanks, RMJ! It didn't occur to me that different labs had different scales to measure.  I didn't even notice the difference in range between the two labs! And it sure would be great to think my antibodies were actually declining if it meant I was doing something right! I would love to understand this better if you have a standard explanation and wouldn't have to spend a lot of time writing it!   So is the recommendation to try to repeat the test at the same lab at intervals?

 

 

 

Herbs and spices can be sources of gluten cross-contamination ("CC") and it's not impossible that wheat could be used as a texturing agent in some spice products. Getting "glutened" a few days before a test would not likely generate enough antibodies to be detectable I don't think.

[RMJ]

Many lab results for blood tests are reported with units of a weight divided by a volume, for example milligrams per milliliter (mg/mL).  To report this way, individual results must be compared to results obtained with standards with known amounts of material.  Take total IgA antibody for example.  IgA can be highly purified from blood and measured to create a primary standard.  Then other secondary standards are made and compared in tests to the primary.  That way one doesn’t have to make the highly purified IgA repeatedly.

For celiac specific antibodies, no one has bothered to purify the tiny portion of IgA that reacts with Tissue Transglutaminase (TTG) to make standards. Instead of knowing how many milligrams or micrograms of TTG IgA antibody are in the standard, they just assign some number of arbitrary units.  The results are reported as units per milliliter (U/mL)  or in the case of your first test, EliA U/mL.  I would guess that EliA stands for ELISA - the abbreviation for the test technology (Enzyme Linked ImmunoAssay). 

Manufacturers of the tests still have primary and secondary standards, so within a lab/manufacturer the results can be compared from test to test, but one cannot compare between manufacturers, since each may assign their own units.

Therefore, as you stated, the recommendation is definitely to have followup results performed at intervals at the same lab.

[PME]

9 hours ago, RMJ said:

Many lab results for blood tests are reported with units of a weight divided by a volume, for example milligrams per milliliter (mg/mL).  To report this way, individual results must be compared to results obtained with standards with known amounts of material.  Take total IgA antibody for example.  IgA can be highly purified from blood and measured to create a primary standard.  Then other secondary standards are made and compared in tests to the primary.  That way one doesn’t have to make the highly purified IgA repeatedly.

For celiac specific antibodies, no one has bothered to purify the tiny portion of IgA that reacts with Tissue Transglutaminase (TTG) to make standards. Instead of knowing how many milligrams or micrograms of TTG IgA antibody are in the standard, they just assign some number of arbitrary units.  The results are reported as units per milliliter (U/mL)  or in the case of your first test, EliA U/mL.  I would guess that EliA stands for ELISA - the abbreviation for the test technology (Enzyme Linked ImmunoAssay). 

Manufacturers of the tests still have primary and secondary standards, so within a lab/manufacturer the results can be compared from test to test, but one cannot compare between manufacturers, since each may assign their own units.

Therefore, as you stated, the recommendation is definitely to have followup results performed at intervals at the same lab.

Thank you so much for this explanation!  Based on my very cautious behavior leading up to this latest test (and my careless Thanksgiving dinner consumption prior to the previous one!), my celiac number "should" have dropped, unless I'm unconsciously sabotaging my diet with, say, herbs/spices containing wheat products or cross contamination in my kitchen.  I'm wondering if my doctor will recommend that if I want to re-test, I do so in six months at the same lab??? Is that the standard interval?

[PME]

9 hours ago, trents said:

Herbs and spices can be sources of gluten cross-contamination ("CC") and it's not impossible that wheat could be used as a texturing agent in some spice products. Getting "glutened" a few days before a test would not likely generate enough antibodies to be detectable I don't think.

Thanks for this, Trents. I guess it's time to throw out all my herbs/spices and start over!

[RMJ]

38 minutes ago, PME said:

Thank you so much for this explanation!  Based on my very cautious behavior leading up to this latest test (and my careless Thanksgiving dinner consumption prior to the previous one!), my celiac number "should" have dropped, unless I'm unconsciously sabotaging my diet with, say, herbs/spices containing wheat products or cross contamination in my kitchen.  I'm wondering if my doctor will recommend that if I want to re-test, I do so in six months at the same lab??? Is that the standard interval?

I don’t think there is a standard interval  but 6 months should be good.