No inflammation with celiac

[moore.amy]

I was recently diagnosed with Celiac. I have never noticed GI or any otber issues after consuming gluten but my ttg iga was very high and biopsy confirmed villi damage. However biopsy showed "no significant inflammation " and all other blood/stool test, including c reactive protein are all within the normal range. Is it common to have celiac without any inflammation? I just want to make sure I'm on the right track. 

[trents]

Welcome to the forum, @moore.amy!

The ttg-iga antibody test is an indirect measure of inflammation. Inflammation is a response to antibodies attacking the body's tissues. So, indeed this is a very odd test report. The only possible scenario that would explain this that I can think of is that you were eating totally gluten free in advance of the blood draw such that inflammation had subsided but the blood antibody count was still high. The antibodies remain in the blood for some time after inflammation subsides. They eventually dissipate but it takes time. At any rate, for this to be the actual explanation, two things would have to be true: 1. The antibody levels would have to have been very high while still consuming gluten and 2. Not too much time had elapsed between commencing the gluten free diet and when the blood draw for the test was taken and the biopsy was performed as well. 

Can you post the actual ttg-iga antibody test score along with the range used by the lab for negative vs. positive?

What led to your being checked for celiac disease in the first place since you say you had no GI issues?

I would also add that there are some other medical conditions, some non gluten foods and some medications that can cause villi blunting. 

[moore.amy]

This is what my test said 

Tissue Transglutaminase IgA

Normal range: 0.00 - 4.99 FLU

My Value >600.00

I have had lifelong gi issues but with dairy and fatty foods. I could tell immediately if I ate those foods. But I have never noticed a reaction when eating gluten. So thats why I am confused by all this. 

The biopsy said 

"short, blunted villi and increased intraepithelial lymphocytes.  There is no significant acute inflammation. "

[trents]

Many celiacs react the same way to CMP (Cow's Milk Protein) the same way they do to gluten and it also blunts the villi. The protein structures of the two are very similar.

What about your BMs. Do you have oily stools and "floaters" when you eat fatty foods?

Do you avoid dairy?

[moore.amy]

9 hours ago, trents said:

 

I avoided dairy for several years. Then I slowly reintroduced it, but only raw a2 milk and milk kefir. I haven't had any gi issues with dairy lately. I really thought I had solved my dairy problems. Fatty foods still cause pain, nausea and cramping. 

[trents]

Have you had your gall bladder checked?

[moore.amy]

I havent had it checked specifically, but that's next on my list of things to do.

I know you can have silent celiac, but I would think that there would have been more inflammation. My calprotectin levels were slightly elevated, but biopsy said no significant inflammation. I just want to make sure I'm treating the correct thing. 

[knitty kitty]

On 9/13/2024 at 6:59 PM, moore.amy said:

no significant acute inflammation.

 

There's inflammation and there's Acute Inflammation which is way worse.  Symptoms begin or worsen with acute inflammation. 

What lead you to see a doctor if you weren't having gastrointestinal symptoms?   Celiac Disease can cause over two hundred symptoms, not all of them are gastrointestinal symptoms.

[moore.amy]

12 hours ago, knitty kitty said:

What lead you to see a doctor if you weren't having gastrointestinal symptoms?   Celiac Disease can cause over two hundred symptoms, not all of them are gastrointestinal symptoms.

I have had lifelong gi issues from dairy (although not with a2 milk) and high fat foods. Nausea, vomiting, cramping, gas, etc were common with those foods.  I was seeing a gi to figure out what was going on. Celiac wasn't on my radar at all.  I've never noticed any reaction from gluten. I could throw up within 30 minutes of eating fatty meats, food with heavy cream, stuff like that.  But I could eat a bowl of pasta without any problems. It just seems odd to me. 

[knitty kitty]

@moore.amy,

I was the same way when younger.  Our bodies become adapted to pumping out anti-gluten antibodies regularly, but when dairy is added, the additional reaction can push our limits and symptoms worsen.  

Our bodies may be able to keep up for a short time, but the malabsorption of nutrients catches up with us.  

Digestive enzymes from the Pancreas, and bile from the gallbladder require lots of B Complex vitamins, especially Thiamine B1, which help us digest fats, carbohydrates and proteins.  If we're low in vitamins, we can't make as much of the digestive enzymes and bile, so things don't get properly digested, allowing intestinal bacteria to ferment the undigested food, causing gas and bloating and Small Intestinal Bacterial Overgrowth (SIBO).  

My grandmother had a Guernsey cow (A2 milk producer).  As a child on rare visits, I'd get up at the crack of dawn to milk that cow with my grandmother.  It was the only milk I liked and it didn't cause symptoms.  So long ago, A2 milk wasn't on the market then...

[moore.amy]

11 minutes ago, knitty kitty said:

@moore.amy,

I was the same way when younger.  Our bodies become adapted to pumping out anti-gluten antibodies regularly, but when dairy is added, the additional reaction can push our limits and symptoms worsen.  

Our bodies may be able to keep up for a short time, but the malabsorption of nutrients catches up with us.  

Digestive enzymes from the Pancreas, and bile from the gallbladder require lots of B Complex vitamins, especially Thiamine B1, which help us digest fats, carbohydrates and proteins.  If we're low in vitamins, we can't make as much of the digestive enzymes and bile, so things don't get properly digested, allowing intestinal bacteria to ferment the undigested food, causing gas and bloating and Small Intestinal Bacterial Overgrowth (SIBO).  

My grandmother had a Guernsey cow (A2 milk producer).  As a child on rare visits, I'd get up at the crack of dawn to milk that cow with my grandmother.  It was the only milk I liked and it didn't cause symptoms.  So long ago, A2 milk wasn't on the market then...

My sister has an A2 jersey and i get fresh milk from her. It's a game changer. 

Thanks for the info!

[Wheatwacked]

On 9/15/2024 at 9:20 AM, moore.amy said:

I have had lifelong gi issues from dairy (although not with a2 milk) and high fat foods.

Issues with fat digestion often are the result of not enough cloline in the diet from avoiding eggs and red meat.  

Quote

 

https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/#:~:text=Choline%2C%20especially%20phosphatidylcholine%2C%20is%20essential,NAFLD%20%5B44%2C45%5D.

In adults, the average daily choline intake from foods and beverages is 402 mg in men and 278 mg in women.  Adequate Intake for19+ years is 550 mg/day for males, 425 mg/day for females and 450 mg/day in pregnancy and 550 mg/day lactating.

 

On 9/15/2024 at 4:23 PM, moore.amy said:

My sister has an A2 jersey and i get fresh milk from her. It's a game changer. 

Awesome.