Celiac testing with reflex

[Kwallen]

I've been gluten free for several months. My GI dr. Ordered a celiac screening test with reflex. I researched about the testing and it states that you have to be eating gluten for weeks before the test. My dr said to stay as is( no gluten) ..... I'm confused!!! Thx 

[Scott Adams]

If your doctor is screening you for celiac disease then they've given you bad information. You need to be eating gluten, a lot of it, daily for 6-8 weeks before any antibody blood testing can be done.

Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy:

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:

 

 

[Kwallen]

Thank you .... I have started gluten back!

[Kwallen]

how do you treat symptoms that have started? I'm having some itching, not sure if I can take Benadryl to help or not.

[trents]

Benadryl is an antihistamine. It should have no bearing on celiac antibody levels.

[Scott Adams]

If you have DH you will likely also want to avoid iodine, which is common in seafoods and dairy products, as it can exacerbate symptoms in some people. This article may also be helpful:

 

[Wheatwacked]

On 2/12/2024 at 7:20 PM, Kwallen said:

celiac screening test with reflex.

This test is a reflex test, which means that if your screening results return as abnormal (they fall outside the normal range for this test), then an additional confirmation test will be performed, on the same blood sample provided, in order to confirm the original screening result. Reflex tests provide the convenience of performing an additional test to confirm your results, without you having to return to the lab a second time to have the additional test performed.

Did your doctor tell you to start GFD after testing seven months ago?  He may be looking to confirm improvement after six months.  Double check with him.  While GFD will mess the results on original screening tests, he may be doing this test as follow up to see if your levels are responding.  In which case eating gluten would be not good for his purpose.

Have symptoms improved for you? Ask for vitamin D and homocysteine tests to check your intake of D, Choline, B6,  B12 and Folate, often found low in Celiac Disease.

A dermatologist can test skin next to the rash for dermatitis herpetiformis.  dermatitis herpetiformis is a skin form of Celiac Disease that a lot of patients have negative blood tests and endoscopy biopsies and no obvious gastrointestine symptoms, yet still have Celiac Disease.