Gluten Challenge

[flowerpen]

I have been gluten free for approximately 12 years. It was by accident after jumping on the whole Paleo craze and realizing I felt so much better without grains in my diet. I've since loosened my diet, but gluten containing foods have always caused me issues, so I have kept them out. It's important to note that I do not worry about cross contamination and have cheat meals a few times a year. 

I have been experiencing ongoing gastro issues. I've been through every test imaginable, including scopes and two colonoscopies over the last three years. Xifaxian for SIBO has solved several issues, but I'm still not 100%.

That is why I am doing a gluten challenge. I am one week into a six week challenge for a blood test. I have fallen down a google rabbit hole, however, that has me thinking since I have been gluten-free so long, this whole thing is basically pointless because the blood test will probably come out negative no matter how much I eat. Previous celiac test have shown negative with my levels really low. That makes sense since I have been mostly gluten-free.

I feel awful and feel like I am looking for any excuse to quit. So my question is has anyone been gluten-free for a long period of time and tested positive on a blood test after a 6-8 week challenge?

 

[trents]

6 minutes ago, flowerpen said:

I have been gluten free for approximately 12 years. It was by accident after jumping on the whole Paleo craze and realizing I felt so much better without grains in my diet. I've since loosened my diet, but gluten containing foods have always caused me issues, so I have kept them out. It's important to note that I do not worry about cross contamination and have cheat meals a few times a year. 

I have been experiencing ongoing gastro issues. I've been through every test imaginable, including scopes and two colonoscopies over the last three years. Xifaxian for SIBO has solved several issues, but I'm still not 100%.

That is why I am doing a gluten challenge. I am one week into a six week challenge for a blood test. I have fallen down a google rabbit hole, however, that has me thinking since I have been gluten-free so long, this whole thing is basically pointless because the blood test will probably come out negative no matter how much I eat. Previous celiac test have shown negative with my levels really low. That makes sense since I have been mostly gluten-free.

I feel awful and feel like I am looking for any excuse to quit. So my question is has anyone been gluten-free for a long period of time and tested positive on a blood test after a 6-8 week challenge?

 

The length of your challenge is appropriate but you also need to be eating a sufficient amount of gluten daily during that time to expect a valid test result. 10 gm daily or about 3 slices of wheat bread or more.

[flowerpen]

Just now, trents said:

The length of your challenge is appropriate but you also need to be eating a sufficient amount of gluten daily during that time to expect a valid test result. 10 gm daily or about 3 slices of wheat bread or more.

I have the amount covered. I'm so scared it's not going to be accurate I'm eating gluten for every meal and even choking more down between meals just to make sure I'm good and messed up by the time I go in for the blood test. 

I used to get rashes that I'm now convinced were dermatitis herpetiformis. I'm also hoping that pops up again so I can get it biopsied before the end of the challenge. 

[Scott Adams]

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:

 

 

[flowerpen]

3 hours ago, Scott Adams said:

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

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

 

 

Thanks. 

What's got me worried is a few studies I've read that show only about 50% of adult celiacs who have been following a long-term gluten-free diet will have enough of a response to show positive on a blood test after 6-8 weeks. 

[Wheatwacked]

On 2/17/2024 at 11:28 PM, flowerpen said:

I have been experiencing ongoing gastro issues. I've been through every test imaginable, including scopes and two colonoscopies over the last three years.

I think you already know the answer to the question of you and gluten.  For your ongoing issues look for vitamin and mineral deficiencies in your diet.  Unfortunately doctors don't look for nutritional causes of our symptoms.

Top 3 that match your story:  

Have they tested your homocysteine level?  It should be less than 19.  Higher homocysteine can indicate a deficiency in choline, folate, B12 and/or B6. Are you eating or supplementing enough eggs, beef or liver for choline intake?  Taking phosphatidyl choline or eating 4 eggs a day resolved my persistant gut issues.  I went through a lot of Alka Selzer until I started taking Phosphatidyl Choline as pills.  Low choline can cause disruption of bile flow needed to digest fats. Often leading to a misdiagnosis of Gall Bladder Disease.  Difficiency can cause Non Alcoholic Fatty Liver Disease. Less than 10% of us get enough because we are advised to avoid eggs, liver and beef.  The GFD diet does not supplement Folic Acid so giving up gluten can cause the need for more choline.

“Low bile salt production can lead to bile sludge, which significantly lowers the rate of bile flow into the small intestines,” explains Dr. Berg. “This can result in digestive issues, the formation of gallstones, and may lead to gallbladder inflammation.” What Causes Sludge in Gallbladder?

Not enough Thiamine can cause subclinical Beri Beri.

"Gastrointestinal symptoms, such as anorexia, nausea, vomiting and abdominal pain, are very common in patients with Wernicke’s encephalopathy (WE). Mild thiamine deficiency may have only gastrointestinal symptoms."  Gastrointestinal beriberi: a forme fruste of Wernicke’s encephalopathy?   The simplest test is to take 500 mg Thiamine a day or more.  There is no upper limit.  Positive results can come as quickly as in hours.

What is your omega 6:3 ratio?  The typical American is greater than 14:1.  Omega 6 is inflammatory, while omega 3 is healing.  Optimum is less than 3:1.   Omega-3 and Omega-6 Fatty Acids in Vegetables:

Fermented dill pickles (NO vinegar) can help repopulate your gut with lactobacillus which excretes in return for room and board in you gut lactase.  We don't make enough lactase ourselves so many today are suffering from Lactose Intolerance.  The only two brands I know of are Batampte and Bubsies.  The rest are Quick Pickled with vinegar.  You get the taste but not the nutrition.

 

Edited February 19, 2024 by Wheatwacked

[flowerpen]

3 hours ago, Wheatwacked said:

I think you already know the answer to the question of you and gluten.  For your ongoing issues look for vitamin and mineral deficiencies in your diet.  Unfortunately doctors don't look for nutritional causes of our symptoms.

Top 3 that match your story:  

Have they tested your homocysteine level?  It should be less than 19.  Higher homocysteine can indicate a deficiency in choline, folate, B12 and/or B6. Are you eating or supplementing enough eggs, beef or liver for choline intake?  Taking phosphatidyl choline or eating 4 eggs a day resolved my persistant gut issues.  I went through a lot of Alka Selzer until I started taking Phosphatidyl Choline as pills.  Low choline can cause disruption of bile flow needed to digest fats. Often leading to a misdiagnosis of Gall Bladder Disease.  Difficiency can cause Non Alcoholic Fatty Liver Disease. Less than 10% of us get enough because we are advised to avoid eggs, liver and beef.  The GFD diet does not supplement Folic Acid so giving up gluten can cause the need for more choline.

“Low bile salt production can lead to bile sludge, which significantly lowers the rate of bile flow into the small intestines,” explains Dr. Berg. “This can result in digestive issues, the formation of gallstones, and may lead to gallbladder inflammation.” What Causes Sludge in Gallbladder?

Not enough Thiamine can cause subclinical Beri Beri.

"Gastrointestinal symptoms, such as anorexia, nausea, vomiting and abdominal pain, are very common in patients with Wernicke’s encephalopathy (WE). Mild thiamine deficiency may have only gastrointestinal symptoms."  Gastrointestinal beriberi: a forme fruste of Wernicke’s encephalopathy?   The simplest test is to take 500 mg Thiamine a day or more.  There is no upper limit.  Positive results can come as quickly as in hours.

What is your omega 6:3 ratio?  The typical American is greater than 14:1.  Omega 6 is inflammatory, while omega 3 is healing.  Optimum is less than 3:1.   Omega-3 and Omega-6 Fatty Acids in Vegetables:

Fermented dill pickles (NO vinegar) can help repopulate your gut with lactobacillus which excretes in return for room and board in you gut lactase.  We don't make enough lactase ourselves so many today are suffering from Lactose Intolerance.  The only two brands I know of are Batampte and Bubsies.  The rest are Quick Pickled with vinegar.  You get the taste but not the nutrition.

 

Thanks. I was tested for deficiencies and the only thing I was low in at the time was Vit. D and I have been taking supplements for that since. For a small while, I was low in iron as well, but that was also supplemented and is now okay. 

My GI was very thorough and tested me for things that were even just remote possibilities. I have a family history of colon cancer, IBD, and various autoimmune issues, so we didn't want to miss anything. He could not test me for celiac due to my diet, though he did run the panel once just to see what the levels were. I was mid-normal (9 where the normal cutoff was 20). 

I ended up diagnosed with IBS because nothing else could be found at the time.