Does anyone know the correct way to prepare for Celiac blood test?

[rmcozart22]

So I’ve been back on gluten foods for about a week. Currently, feeling sharp pains on my left back area that start from the front of my stomach, nauseated and super tired but no throwing up, or diarrhea. I was doing so good not eating gluten for about 3 months. I’m so scared I literally pass out everytime I get sick 🤢. I’ve been eating gluten free minus cross contamination here and there.. Does anyone have any tips or know how long you should eat gluten and how much to eat daily my doctor told me a week but I’ve read to eat gluten daily for at least 3 months before testing for celiac disease. I've had an endo(which I naturally before the endo test stopped eating gluten by accident doctors said it was okay to eat how I was eating ironically only rice and eggs) and colonoscopy had test done to check my gallbladder and everything was good. Pretty much all of my symptoms matched and at the time I had developed a rash on my elbow as well from I’m assuming getting gluten. However told me in so many words that people of color usually don't have Celiac. Sadly I feel like he's kind of gave up helping, reluctant to test me and told me he'd see me in a year. Really new to this but maybe someone could suggest how to prepare for a celiac blood test as he told me to just look on Google but some say eat two slices a bread and go till you get sick, wait 2 weeks eat all the gluten or 3 months to be on the safe side. Sorry for the essay and thanks in advance ❤️.

[trents]

Welcome to the forum, rmcozart22!

The Mayo Clinic guidelines are the daily consumption of two slices of wheat bread (or the gluten equivalent) for 6-8 weeks leading up to the day of the blood draw for celiac antibody testing. Different medical entities have different guidelines so if you research this you will find different recommendations and some of them will be less protracted than those of the Mayo. But, I think the Mayo can be trusted. You don't want to short change the gluten challenge and waste the effort for nothing because you didn't stay on gluten long enough for the build up of enough antibodies to make for valid testing.

Edited November 9, 2023 by trents

[rmcozart22]

Thank you, very helpful! 

[knitty kitty]

Welcome to the forum!

You could ask your doctor for a genetic test to see if you have any of the common genes for Celiac Disease.  Having the genes simply means you have the potential to develop Celiac Disease.  Not all Celiac genes have been identified though.  Yes, Celiac does happen in people of color.  

Also get your rash biopsied by a dermatologist who understands how to biopsy for Dermatitis Herpetiformis, the rash of Celiac Disease.  The rash appears after ingesting gluten.

According to recent research, updates to the gluten challenge are being implemented.

Recommended intake of gluten should be increased to 10 grams of gluten per day for at least two weeks. Or longer.

While three grams of gluten will begin the immune response, ten grams of gluten is needed to get antibody levels up to where they can be measured in antibody tests and changes can be seen in the small intestine.  

Keep in mind that there are different amounts of gluten in different kinds of bread and gluten containing foods.  Pizza crust and breads that are thick and chewy contain more gluten than things like cake and cookies.  

References:

https://www.beyondceliac.org/celiac-disease/the-gluten-challenge/

And...

Evaluating Responses to Gluten Challenge: A Randomized, Double-Blind, 2-Dose Gluten Challenge Trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878429/?report=reader

 "In our study, limited changes in Vh:celiac disease (villi height vs crypt depth - aka damage to the small intestine)  following 14-day challenge with 3 g of gluten were observed, in accordance with Sarna et al.  While the 3 g dose was sufficient to initiate an immune response, as detected by several biomarkers such as IL-2, the 10 g dose was required for enteropathy within the study time frame. Based on our data, we would suggest that gluten challenge should be conducted over longer durations and/or using doses of gluten of ≥ 3 g/day to ensure sufficient histological change can be induced."

Hope this helps!  Keep us posted on your results! 

[rmcozart22]

Woah so helpful thank you! 

[trents]

If you want to ensure that you are getting 10 gm. of gluten daily, you can buy pure powdered gluten at natural food stores and then you can weigh it on a scale. Before I was diagnosed with celiac disease my wife used to buy gluten and add it to the homemade bread she made in order to make it stick together better. We now joke how she was poisoning me.

[Scott Adams]

Quote

"...in order to properly diagnose celiac disease based on serology and duodenal histology, doctors need patients to be on gluten-containing diets, even if they are causing symptoms, and this is called a "gluten challenge."

• Eat gluten prior to celiac disease blood tests: The amount and length of time can vary, but is somewhere between 2 slices of wheat bread daily for 6-8 weeks and 1/2 slice of wheat bread or 1 wheat cracker for 12 weeks 12 weeks;
• Eat gluten prior to the endoscopic biopsy procedure: 2 slices of wheat bread daily for at least 2 weeks;

and this recent study recommends 4-6 slices of wheat bread per day: