Do I Have Celiac Disease

[Justsherry]

Hello. In April bloodwork showed I was anemic. My hemoglobin was 7.6 and further testing revealed low iron level of 17, and vitamin B12 and folate deficiency. I received five iron infusions, and my levels greatly improved. Currently my hemoglbin is 12, but iron is dropping again. Nothing too abnormal in other testing, came back with a weak positive of 32 on an ANA test for Sjogrens SSB, and I tested positive for parietal cell antibody antibody, which can affect vitamin B12 absorption. I've done research, and I'm wondering if I could have Celiac Disease. I have had stomach/bowel issues for most of my life, but my doctor said it's most likely IBS and it was never really addressed again until these findings. My doctor is referring me to a gastroenterologist and I will see him in August. Looking at the symptoms, I think it could be a real possibility. I'm looking on advice on what to request, and what to expect. Thank you.

[trents]

Welcome to the forum, Justsherry!

Parietal cell antibody positive and low B12 would indicate pernicious anemia. In this condition, your parietal cells are not producing enough "intrinsic factor" which is necessary for the absorption of B12 which, in turn, prevents the proper absorption of iron from the diet. This condition is offset by B12 injections but sometimes can be addressed by massive sublingual doses of B12. The low iron itself can be directly addressed by iron infusions. But B12 is important for other reasons in the the metabolic processes of the body so it shouldn't be overlooked.

Since you also describe having stomach/bowel issues for many years it certainly is possible you have celiac disease as the damage it causes to the villi that line the small bowel can also cause poor absorption of vitamins and minerals. When you go to the GI doc, ask for a "full celiac panel":

1. Total serum IGA

2. tTG-IGA

3. EMA

4. DGP (IgA and IgG)

These are antibody tests specifically designed to detect celiac disease. If you throw positives in any of them the GI doc may want to do an endoscopy with biopsy of the small bowel lining to check for damage. Do not experiment with a gluten free diet until all testing for celiac disease is complete.

[Justsherry]

Thank you for your response. I will request these tests.  I am taking sublingual doses of B12 daily and monthly B12 shots, as well as folic acid as prescribed by doc. I saw a link between iron deficient anemia and b12 deficiency with celiac, so I started looking in this direction.

[trents]

Besides celiac disease, there is another gluten-related disorder known as NCGS (Non Celiac Gluten Sensitivity). The two share many of the same symptoms but NCGS does not damage the villi that line the small bowel. NCGS is 10x more common than celiac disease but there is no test for it yet. Celiac disease must first be ruled out. If you test negative for celiac disease then you might experiment with a gluten free diet after all the celiac testing is done.

[Wheatwacked]

Quote

"What causes gastric parietal cell antibodies? Anti-gastric parietal cell antibodies (in the presence or absence of anaemia) are frequently associated with other autoimmune diseases such as autoimmune thyroiditis, insulin dependent diabetes or Addisons disease. Antibodies to intrinsic factor can also be detected in the same diseases."

"It’s not completely clear what causes irritable bowel syndrome."

"Autoimmune gastritis is a chronic inflammatory disease with destruction of parietal cells of the corpus and fundus of the stomach. The known consequence is vitamin B12 deficiency and, consequently, pernicious anemia."

Hi Justsherry. 

1. Are you vegan or some other restrictive diet?  There is not much vitamin B12 in a vegan diet.  
2. Celiac, IBS, Sjrogens and autoimmune gastritis are autoimmune diseases and they are all have low vitamin D in common.  Vitamin D and the Immune System

The only one in this bunch that has a definate cause is Celiac Disease.  The others are "we know the symptoms and we have drugs to treat, but we don't know why." Since you've had stomach issues most of your life it is likely to be Celiac Disease which the tests outlined by Trents should indicate, if the gastroenterologist chooses them.  It is not reasonable while suffering and I suspect getting worse while you wait for the gastroenterologist until August to maybe or maybe not test you for Celiac.  Doctors like to test for things they have drugs to treat you with.

Your primary is already prepping you for IBS. 10 to 15% US Adults have IBS and 11% have Gluten Sensitivity. 1% Celiac Disease and 10% Non Celiac Gluten Sensitivity. Why would IBS be the more likely? There are drugs for IBS and the only treatment for Gluten Sensitivity is abstenance from Gluten and replenishment of the vitamin and mineral deficiencies caused malabsorbtion.

While waiting for your appointment with the gastroenterolist I suggest a trial gluten free diet.  If it is GS. Celiac Disease or Non Celiac Gluten Sensitivity, you can expect improvement almost immediately and  it will help the gastroenterologist to differentiate between IBS and gluten.  The caveat is that you need to be consuming at least two slices of bread a day for six weeks before the appointment to build enough antibodies to show up in the blood tests and for a least two weeks before an endoscopy/Celiac biopsy to ensure villi damage will be found.

You might ask for a blood test for homocysteine.  It can indicate a deficiency of Folate, B12, Choline or Taurine.  It can also indicate too much Folic Acid in your diet.

Quote

"An elevated homocysteine level is one of the more common findings I see in people with chronic healthcare problems.... Elevated homocysteine has been shown to be a contributing factor in vessel damage, high blood pressure, cardiovascular disease, stroke, migraines, Alzheimer’s disease, dementia, macular degeneration, and cancer.There are a number of factors that can affect the amount of folate getting to MTHFR for conversion to 5MTHF: a low folate diet, high intake of folic acid from supplements and processed foods, medications that block folate absorption" https://www.linkedin.com/pulse/part-2-four-pathways-homocysteine-one-more-your-dr-eric-balcavage

 

Quote

 

Top 6 Foods That Are High in Vitamin B12:

• Liver & kidney
• Beef
• Lamb
• Fish (Sardines, Tuna & Salmon)
• Milk and dairy products
• Eggs

[Justsherry]

I am not vegan or vegetarian. My diet should be sufficient to meet my dietary needs. This is why I'm looking in the direction of autoimmune diseases that may be causing iron deficiency anemia, vitamin b12 and folate deficiency. Or possibly just iron deficiency anemia, if B12 is solely due to parietal cell antibody. I honestly feel like it is an absorption issue, and I'm trying to be prepared with my thoughts when I visit the gastroenterologist. Initially my GP sent me to a hematologist/oncologist. I had weekly blood draws when I was receiving iron infusions, and he feels the risk of cancer is low. There is nothing pointing to that possibility at this time other than anemia. This is why I'm looking for alternatives, of what could be the cause. I have always had bowel issues of some sort, I feel that it was never really investigated due to age when I was younger. I just accepted it was probably IBS, but IBS doesn't cause anemia that I know of. Maybe celiac disease isn't the culprit, I really don't know, but I want to explore any possible reasons. 

[Wheatwacked]

8 hours ago, Justsherry said:

I honestly feel like it is an absorption issue, and I'm trying to be prepared with my thoughts when I visit the gastroenterologist.

Celiac Disease is a disease of malabsorbtion. 

https://www.celiac.com/celiac-disease/nutrient-deficiencies-and-celiac-disease-understanding-the-connection-r6192/page/2/?tab=comments#comment-24119