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Confusing blood tests results


Olfy75

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Olfy75 Apprentice

Hi Trent, 

thank you.

these were the tests:

TTG IgA 0.2 ELI U/ml  -reference

< 7.0 normal

7-10 equivocal 

> 10 positive

S-IgA (g/L) 1.16 g/L -Reference 0.41-3.49


ANTI GLIADIN IgA Ab 86.0 U/ml - reference < 7.0

Only the anti gliadin was positive both times I got tested one month apart.

 I’m also not sure about the lymphocytes findings, for which they did not give any specifics? I thought they should give numbers and ranges!


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RMJ Mentor

How much gluten were you eating prior to the endoscopy?  You said you gravitate towards a gluten free diet.  If you’re fairly gluten free that could affect your endoscopy results.

Olfy75 Apprentice

Hi RMJ,

thanks for the answer, I made sure I was eating gluten for the 6 weeks prior to the procedure, that should be enough, I think? 

 

9 hours ago, RMJ said:

How much gluten were you eating prior to the endoscopy?  You said you gravitate towards a gluten free diet.  If you’re fairly gluten free that could affect your endoscopy results.

Hi RMJ,

thanks for the answer, I made sure I was eating gluten for the 6 weeks prior to the procedure, that should be enough, I think? 

Olfy75 Apprentice
11 hours ago, trents said:

I would not be too quick to accept the doctor's conclusion that you don't have celiac disease. You are by no means the first participant on this forum to report this phenomenon. Several things can cause positive antibodies but negative biopsy, including patchy damage to the villi combined with a lack of being thorough in sampling by the one doing the scoping. Anemia and vitamin D deficiency also could point to celiac disease.

Can you share the specifics of what antibody tests were run to check for celiac disease along with their scores and the ranges used for each to define negative vs. positive?

Hi Trent, 

thank you.

Of course, these were the test results :

TTG IgA 0.2 ELI U/ml  -reference

< 7.0 normal

7-10 equivocal 

> 10 positive

S-IgA (g/L) 1.16 g/L -Reference 0.41-3.49


ANTI GLIADIN IgA Ab 86.0 U/ml - reference < 7.0

Only the anti gliadin was positive (both times I got tested one month apart).

I’m also not sure about the lymphocytes findings, for which they did not give any specifics? I thought they should give numbers and ranges!

RMJ Mentor
4 hours ago, Olfy75 said:

 

Hi RMJ,

thanks for the answer, I made sure I was eating gluten for the 6 weeks prior to the procedure, that should be enough, I think? 

Yes, 6 weeks should be enough.

DebJ14 Enthusiast
On 3/16/2023 at 12:19 PM, trents said:

 

Ataxia can be reversed but not always. Depends on how much nervous system damage was done and how long it was subjected to the toxic effects of gluten on the nervous system.

I was diagnosed with Ataxia.  We jokingly call it "My Tilt."  I could not walk down a sidewalk without falling off the curb into the gutter. Someone always goes with me to walk on the outside, so I do not fall over.   I would never in a million years pass a roadside sobriety test because I cannot walk a straight line and my balance is horrible.  I did improve after going gluten-free, but only up to a point.  My ataxia is still with me 16 years after going gluten-free.  But, I was not diagnosed until I was 54, so there was lots of time for the damage to occur.

Olfy75 Apprentice
11 hours ago, DebJ14 said:

I was diagnosed with Ataxia.  We jokingly call it "My Tilt."  I could not walk down a sidewalk without falling off the curb into the gutter. Someone always goes with me to walk on the outside, so I do not fall over.   I would never in a million years pass a roadside sobriety test because I cannot walk a straight line and my balance is horrible.  I did improve after going gluten-free, but only up to a point.  My ataxia is still with me 16 years after going gluten-free.  But, I was not diagnosed until I was 54, so there was lots of time for the damage to occur.

Hi Deb, I am glad you are better, although not completely “cured”. 
I think the most frustrating part is knowing that “it could have been avoided”. 
Best of luck!

 


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DebJ14 Enthusiast
4 hours ago, Olfy75 said:

Hi Deb, I am glad you are better, although not completely “cured”. 
I think the most frustrating part is knowing that “it could have been avoided”. 
Best of luck!

 

It is especially frustrating after finding a letter from the dermatologist in my parent's papers after their death, that stated my biopsy was positive for Dermatitis Herpetiformis.  The biopsy was done on my arm when I was a teenager.  I had a blistering, weepy, itchy rash on my arms, so even in the hot summers I kept them covered.  The letter had a reference to the prescription for steriod cream that was enclosed, but no mention was made of celiac disease nor the need for a gluten free diet.  Just steroid cream.  I had that rash,  until I went gluten-free at age 54.  It was gone within a week and does not return unless I get glutened.  

trents Grand Master
18 minutes ago, DebJ14 said:

It is especially frustrating after finding a letter from the dermatologist in my parent's papers after their death, that stated my biopsy was positive for Dermatitis Herpetiformis.  The biopsy was done on my arm when I was a teenager.  I had a blistering, weepy, itchy rash on my arms, so even in the hot summers I kept them covered.  The letter had a reference to the prescription for steriod cream that was enclosed, but no mention was made of celiac disease nor the need for a gluten free diet.  Just steroid cream.  I had that rash,  until I went gluten-free at age 54.  It was gone within a week and does not return unless I get glutened.  

I'm supposing the dermatologist dropped the ball there since celiac disease is the only known cause for DH? He probably didn't know that. Was that derm pathology report a part of your medical record that your GP would have access to at that time?

knitty kitty Grand Master
On 7/17/2023 at 4:27 PM, DebJ14 said:

I was diagnosed with Ataxia.  We jokingly call it "My Tilt."  I could not walk down a sidewalk without falling off the curb into the gutter. Someone always goes with me to walk on the outside, so I do not fall over.   I would never in a million years pass a roadside sobriety test because I cannot walk a straight line and my balance is horrible.  I did improve after going gluten-free, but only up to a point.  My ataxia is still with me 16 years after going gluten-free.  But, I was not diagnosed until I was 54, so there was lots of time for the damage to occur.

I had Ataxia like you describe.  Yes, gluten will cause some ataxia, but my ataxia only improved after I supplemented with a B Complex and high doses of Thiamine Vitamin B 1.  

Thiamine and the other Essential B vitamins are water soluble and nontoxic.  Our bodies cannot make these vitamins, so we must get them from our diet every day.  This can be difficult because the small intestine gets damaged in Celiac Disease.  

Thiamine deficiency affects the cerebellum, that part of your brain that deals with balance.  Vitamin D deficiency can also affect the inner ear and cause balance issues.  

I took high doses of Thiamine, (500-2000 mg) of Benfotiamine as Dr. Derrick Lonsdale and Dr. Chandler Marrs have shown to be effective.  Benfotiamine has been shown to promote intestinal healing and reduce inflammation. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451766/

DebJ14 Enthusiast
1 hour ago, knitty kitty said:

I had Ataxia like you describe.  Yes, gluten will cause some ataxia, but my ataxia only improved after I supplemented with a B Complex and high doses of Thiamine Vitamin B 1.  

Thiamine and the other Essential B vitamins are water soluble and nontoxic.  Our bodies cannot make these vitamins, so we must get them from our diet every day.  This can be difficult because the small intestine gets damaged in Celiac Disease.  

Thiamine deficiency affects the cerebellum, that part of your brain that deals with balance.  Vitamin D deficiency can also affect the inner ear and cause balance issues.  

I took high doses of Thiamine, (500-2000 mg) of Benfotiamine as Dr. Derrick Lonsdale and Dr. Chandler Marrs have shown to be effective.  Benfotiamine has been shown to promote intestinal healing and reduce inflammation. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451766/

I have been having testing for nutritional deficiencies done for 16 years.  Everything is good except for D, B12 and my antioxidant function.  When they did not resolve to the doctor's satisfaction, he ordered genetic testing.  I have mutations that impact those levels.  I am on a wide range of vitamins and minerals and take Bentofiamine and B12 as well as the rest of the B's.  I am improving in the antioxidant dept.  Bowel Tolerance of C is down from 30 grams to 12 grams.  I take 10,000 IU of D3 +`100 mcg.  Doses are adjusted based on test results.  Sadly, the doctor says all the vitamins in the world will not repair the damage done by the gluten.  But, at least all my inflammation markers are good.

Wheatwacked Veteran
1 hour ago, DebJ14 said:

Sadly, the doctor says all the vitamins in the world will not repair the damage done by the gluten. 

Doctors have been wrong before.

Carotene and Retinol Efficacy Trial (CARET) The trial was ended prematurely after a mean of 4 years, partly because the supplements were unexpectedly found to have increased lung cancer risk by 28% and death from lung cancer by 46%;  see the link below

Yet these are still being used in multivitamins.  And we are told they are good for us.

I would be interested in which markers.  Are you supplementing choline, Taurine?  Getting enough iodine?  Vitamin A, E and folic acid supplenents cause increased cancer.

How long on the D? D2 or D3? 10,000 IU + 100 mcg = 14000 IU or 350 mcg.  I have been taking 250 mcg of D3 since spring of 2015.  By Sept 2019 I was only at 47 ng/ml.  By 2121 I was finally at 86 ng/ml and it remains steady at ~80.

What is your vitamin D plasma and homocysteine levels?

Western Medicine in general seems to work by shutting down systems ranther than fixing the cause. 

Acid indigestion is responded to by turning off the proton pumps which we need the HCl to sterilize our food and chemically break down the nutrients.  Instead of adding choline to help gall bladder caused poor fat digestion they cut out the gall bladder.  

Quote

Only very high doses (>30 mg/day), mainly as iodide (I−), generate hypothyroidism and goiter, which rapidly revert to normal... On the other hand, considerable evidence indicates that iodine per se can ameliorate physiopathologies of several organs that take up iodine, primarily the thyroid, mammary, and prostate glands and potentially the pancreas, gastric, and nervous systems, and it may act as an antioxidant in the whole organism 

This is the opposite conclusion of the Wolff - Chaikoff effect,  which effectively ended the medical use of iodine except in nuclear medicine.

Iodine kills off defective cells allowing new ones to take their place.  Without it sick cells linger on and we have poor healing.

Taurine is an essential amino acid amino acid that acts as an anti ROS antioxident.  ROS is an oxidant.  Avoid too much UV  because you might get skin cancer and don't take iodine because we need it stockpiled incase of nuclear disaster.  But sufficent iodine can kill cancer.  There are one million in the US with skin cancer, 51 million with autoimmune diseases. The common factors are low D and low Iodine.

Metformin for example works to lower glucose by disabling B5 action on glucose in the Krebs Cycle by only allowing it to make one ATP instead of the three it normally does.  This reduces the ROS created in the process but makes the mitochondria process three times as much glucose for the same energy. Turned me into a zombi.  While trying out various glucose lowering drugs the vision in my right eye went dark. My retinas are pristene.  Adding lots of vitamin A and betacarotine from carrots, red leaf lettuce etc. it began to recover.  Night vision improved.  Adding Taurine has accelerated the healing and I finally added kelp and my right vision is improving and a non healing sebaceous cyst I've been using as a bellweather since 2014 has begun to heal.

Quote

Vitamin A

The Carotene and Retinol Efficacy Trial (CARET) included 18,314 male and female current and former smokers (with at least a 20 pack-year history [equivalent to smoking 1 pack per day for 20 years or 2 packs per day for 10 years, for example] of cigarette smoking), as well as some men occupationally exposed to asbestos (who also have a higher risk of lung cancer), all aged 45–74 years. The study randomized participants to take supplements containing 30 mg beta-carotene plus 25,000 IU (7,500 mcg RAE) retinyl palmitate or a placebo daily for about 6 years to evaluate the potential effects on lung cancer risk [63]. The trial was ended prematurely after a mean of 4 years, partly because the supplements were unexpectedly found to have increased lung cancer risk by 28% and death from lung cancer by 46%; the supplements also increased the risk of all-cause mortality by 17%.

Among nonsmokers, beta-carotene and vitamin A supplements do not appear to affect the risk of cancer.

 very high doses (typically more than 100 times the RDA

The FNB has not established ULs for beta-carotene and other provitamin A carotenoids [3]. However, the FNB advises against the use of beta-carotene supplements for the general population, except as a provitamin A source to prevent vitamin A deficiency.

https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/

 

 

Olfy75 Apprentice
17 hours ago, DebJ14 said:

It is especially frustrating after finding a letter from the dermatologist in my parent's papers after their death, that stated my biopsy was positive for Dermatitis Herpetiformis.  The biopsy was done on my arm when I was a teenager.  I had a blistering, weepy, itchy rash on my arms, so even in the hot summers I kept them covered.  The letter had a reference to the prescription for steriod cream that was enclosed, but no mention was made of celiac disease nor the need for a gluten free diet.  Just steroid cream.  I had that rash,  until I went gluten-free at age 54.  It was gone within a week and does not return unless I get glutened.  

I can imagine. I hope this won’t happen anymore, now, when knowledge is (a bit) better on gluten and celiac disease.

Beverage Rising Star
On 3/16/2023 at 10:10 AM, Wheatwacked said:

Colonoscopy goes in the bottom. Endoscopy goes in through the top. 😇

Here is a list of essential vitamins and minerals that could be deficient due to malabsorption.  The mininum RDA is set at a level that keeps most healthy people healthy. Sick people need more than the minimum to recover.

image.png.12759412ee3900398c65b1ed0256361c.png
 

VANADIUM1.8 mgND

@Wheatwacked why does it say avoid on B9 FOLIC ACID???

knitty kitty Grand Master

@Beverage,

Folic acid is the synthetic form of Folate Vitamin B9.  Our bodies don't utilize Folic acid well. 

Folic acid is "shelf stable" (allowing for a food product to stay on the grocery shelf longer).  

Folate, like the other B vitamins, are denatured (broken down easily and made ineffective) by heat and light and time.  

Folic acid has been linked to prostrate problems (cancer) in men. 

Folic acid and Thiamine mononitrate are shelf stable forms of vitamins used by food manufacturers because they are cheap and can keep a product on the grocery shelf longer. 

These forms of vitamins are not bioavailable.  Our bodies cannot use them easily.  Folate and Thiamine Hydrochloride are better choices.

Wheatwacked Veteran

It the US Folic Acid and Folate are interchangeable on the nutrition labels.  Folate B9 has no Tolerable Safe Upper Limit.  Folic Acid B9 is 1000 mg.  I thought my prostate hypertrophy diagnosed when I was 21, got better because of the gluten free, but when I went gluten free I was also Folic Acid Free.  In any case, I think that folic acid and gluten also plays a role in endometriosis.  Prostate and endometrium come from the same embryonic cells.  No studies have been done that I am aware of.

Quote

      Among the 643 men who were randomly assigned to placebo or supplementation with folic acid, the estimated probability of being diagnosed with prostate cancer over a 10-year period was 9.7% in the folic acid group and 3.3%in the placebo group. In contrast, baseline dietary folate intake and plasma folate in nonmultivitamin users were inversely associated with risk of prostate cancer, These findings highlight the potential complex role of folate in prostate cancer and the possibly different effects of folic acid–containing supplements vs natural sources of folate.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657096/#:~:text=Folic acid supplementation was associated,associated with prostate cancer risk.

 

Beverage Rising Star
On 7/20/2023 at 9:02 AM, Beverage said:

@Wheatwacked why does it say avoid on B9 FOLIC ACID???

 

On 7/20/2023 at 9:27 AM, knitty kitty said:

@Beverage,

Folic acid is the synthetic form of Folate Vitamin B9.  Our bodies don't utilize Folic acid well. 

Folic acid is "shelf stable" (allowing for a food product to stay on the grocery shelf longer).  

Folate, like the other B vitamins, are denatured (broken down easily and made ineffective) by heat and light and time.  

Folic acid has been linked to prostrate problems (cancer) in men. 

Folic acid and Thiamine mononitrate are shelf stable forms of vitamins used by food manufacturers because they are cheap and can keep a product on the grocery shelf longer. 

These forms of vitamins are not bioavailable.  Our bodies cannot use them easily.  Folate and Thiamine Hydrochloride are better choices.

Thanks. Recently I was pushed by a naturopath I hadn't gone to before to start taking Folic Acid.  I questioned it at the time, but I went ahead and took it. 

OMG I felt horrible.  My BP systolic went from 110's-120's up to 140's and diastolic from 60's-70's up to 80's. I felt awful, felt heavy heart pounding, exhausted, irritable, not my sweetie pie self. 

The worst part was severe insomnia, could not fall asleep until about 4:30am on the worst night.

Luckily I had not taken it for more than a week, suspected the Folic Acid, but stopped taking every supplement just in case.  BP went back to normal range a few days. I'm gradually adding back my supplements, and so far it's good.  I won't be adding back the Folic Acid.

I have never been tested for MTHFR, but I have always gotten amped up with caffeine or many B vitamins.  All my B complex and Multi contain methyl forms.  I am now suspecting I have MTHFR.

Definitely not going back to that naturopath.  

Thank you, appreciate the information, B.

 

 

knitty kitty Grand Master

Good point, @Beverage!

Lots of us here have that MTHFR mutation and methylated forms of vitamins do work better for us! 

Thanks!

  • 2 weeks later...
Wheatwacked Veteran

Folate and Choline share many of the same funcitions.  Increasing one can compensate for the other.  Neural Tube Defects, Methylation of homocysteine and Non Alcoholic Fatty Liver Disease are three.  I find it easier to supplement choline and get my folate from food.  The reason I think testing for high homocysteine.

Though I haven't found any studies on folic acid and endometrial cancer, they both come from the same embryonic cells.  I think it just hasn't been studied.

        Folic Acid and Risk of Prostate Cancer: Results From a Randomized Clinical Trial  "the estimated probability of being diagnosed with prostate cancer over a 10-year period was 9.7% in the folic acid group and 3.3% in the placebo group In contrast, baseline dietary folate intake and plasma folate in nonmultivitamin users were inversely associated with risk of prostate cancer. These findings highlight the potential complex role of folate in prostate cancer and the possibly different effects of folic acid–containing supplements vs natural sources of folate."

        Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions   It has been hypothesized that unmetabolized folic acid is related to cognitive impairment among seniors [89], although the findings might have been confounded by patients with pernicious anemia. Currently, there are no definitive studies that have found health effects from exposure to unmetabolized folic acid."

Dietary Choline Reverses Some, but Not All, Effects of Folate Deficiency on Neurogenesis and Apoptosis in Fetal Mouse Brain

Prenatal Folate and Choline Levels and Brain and Cognitive Development in Children

Folate and Choline Inte Folate and Choline Interplay Investigatedrplay Investigated

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I’m working a temporary job right now that involves: • Powder coating • Sandblasting • Wet spray painting • Anodizing There’s also a laboratory. I don’t need this job, and my OCD makes me believe that dust or air particles there might contain gluten somehow. Should I quit?   Doctors Haven’t Helped My family doctor told me: “Asymptomatic celiac isn’t serious, if you have no symptoms, your intestines won’t get damaged, so you don’t need a gluten-free diet.” I knew that was wrong, but he wasn’t open to listening. I just nodded and didn‘t argue. My gastroenterologist (who’s also a dietitian) said: „If your antibodies are negative, there’s no damage. It might even be okay to try small amounts of gluten later if antibodies stay negative.“ Also said, pepper that says “may contain gluten” is fine if it only contains pepper. She was more informed than my family doctor but didn’t seem to fully understand celiac either.   Questions I Need Help With 1. Is it realistically safe to eat food my mom cooks, if we get separate pans/ and boards even if gluten is still used in the same kitchen? There will always be low risk of cc chances like that she will still touch stuff that was touched by her and my siblings after they ate gluten. And as there are gluten eaters in the house and she also prepares and eats gluten. So would opening the fridge then getting the food and touching the food be okay? So basically what i am doing, washing my hands multiple times while preparing food, she would only wash it once before, then touch anything else (for example water tap or handles) that were touched with gluteny hands, then also touch the food. I dont know if I ever could feel safe, I could try telling her how important cc really is. And I trust her so she wouldnt lie to me then be careless about cc, but idk how safe it really can be if she and everyone else keeps eating gluten and touching stuff in the house after eating. 2. Do I need to worry about touching doorknobs, fridge handles, light switches, etc. that family members touched after eating gluten? What about public places like bus handles or school desks? Or like if i went to the gym, I would be touching stuff all the time, so there will be small amounts of gluten and those would get transferred on my phone if I touch my phone while in the gym. But I want to knos if it would be enough to do damage. 3. Is an endoscopy (without biopsy) enough to tell if my intestines are healed? I’d pay privately if it could help and if i dont get a refferal. Or do i need a biopsy? 4. Could my job (powder coating, sandblasting, etc.) expose me to gluten or damage my intestines through air/dust? 5. Do I need certified gluten-free toothpaste, hand soap, shampoo, or moisturizer? (For example: Vaseline and Colgate don’t contain gluten ingredients but say they can’t guarantee it’s gluten-free.) 6. Is spices like pepper with “may contain traces of gluten” safe if no gluten ingredients are listed? Or does everything need to be labeled gluten-free?  7. Is continuing to only eat my own food the better choice, or could I eventually go back to eating what my mom cooks if she’s careful? 8. is cutlery from dishwasher safe if there are stains? Stuff like knives is used for cutting gluten bread or fork for noodles etc. I often see stains which i dont know if its gluten or something else but our dish washer doesnt seem to make it completely clean. 9. I wash my hands multiple times while preparing food. Do i need to do the same when touching my phone. Like if i touch the fridge handle, I wash my hands then touch the phone. I dont eat while using my phone but i leave it on my bed and pillow and my face could come in contact with where it was.  10. Do i need to clean my phone or laptop if theyve been used by people who eat gluten? Even if no crumbs fall onto my keybaord, i mean because of invisible gluten on their fingers. 11. Does medication/supplements have to be strictly glutenfree? One company said they couldn‘t guarantee if their probiotics don’t contain traces of gluten.  12. I had bought supplements in the past, some of them say glutenfree and some of them dont(like the brand „NOW“ from iherb). I bought them and used them when i wasnt washing my hands so often, are they still safe? As I touched and opened them after touching door knobs, water taps etc. It was like a year ago when i bought those and even though i was eating gluten-free, I never worried about what i touch etc. I know this post is long. I’m just extremely overwhelmed. I’m trying to protect myself from long-term health damage, but the OCD is destroying my quality of life, and I honestly don’t know what’s a reasonable level of caution anymore. Thanks for reading.
    • lmemsm
      I've been making a lot of black bean brownies lately because it's one of the few gluten free dessert recipes that actually tastes palatable.  I've also seen chocolate cake recipes with black beans.  Someone mentioned a cookie recipe using lentils in place of flour.  Just wondering if anyone's run across any tried and true recipes using beans, lentils or peas for desserts?  I've seen a lot of recipes for garbanzo flour but I'm allergic to garbanzo beans/chickpeas.  Was wondering if adzuki or pinto beans might be useful in replacing some or all of the flour in baking.  Since gluten free flours can be crumbly was hoping the beans might help produce a better, less crumbly consistency.  Any recommendations for recipes?  Thanks.
    • lmemsm
      I've seen a lot of recipes for chia pudding, so I decided to make some with chia, water, cocoa and honey.  Didn't like the taste, so I added ground sunflower and ground pumpkin seed to it.  It tasted okay, but came out more like frosting that pudding.  I used to make pudding with tapioca starch, milk powder, water and sugar.  It came out very good but I haven't figured out what to use to replace the milk powder to make it dairy free.  Most starches will work in place of tapioca starch but quantity varies depending on the type of starch.  If I didn't add enough starch to get a pudding consistency, I'd add gelatin as well to fix it.  Avocado and cocoa makes a good dessert with a pudding like consistency.  Unfortunately, I have a bad reaction to avocados.
    • lmemsm
      Seems like when I find a gluten free product I like, the producer stops manufacturing it and then I have trouble finding a new gluten free source for it.  What's worse, I've been contacting companies to ask if their products are gluten free and they don't even bother to respond.  So, it's making it very hard to find safe replacements.  I was buying teff flour at nuts.com and they no longer carry it.  I noticed Naturevibe has teff and soy flour.  However, I can't get a response as to whether their flours are safe for someone with celiac.  Can't get a response from Aldi if their peas are safe for someone with celiac either.  I know Bob's Red Mill has teff flour but was hoping to get a large quantity.  I've been using up the 20 ounce Bob's Red Mill teff flour too quickly.  Does anyone know of a good source for teff or soy flour?  Any recommendations where to get gluten free beans, peas or lentils?  I found some packages of gluten free beans at Sprouts but not much variety.  I've also been looking for lentil elbow macaroni and it seems like no one is making that now that Tolerant was bought out.  Any suggestions for safe sources for these types of ingredients.  Thanks.
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