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Follow Up Testing

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i recently moved to a new town and have not established with a PCP yet (or any other kind of doctor, for that matter). i am going back home in a few weeks for a follow up with my regular doctor. my insurance will be lapsing shortly after the appointment and it could be months before i have coverage again.

i will be 11 weeks gluten free at that point. is it too soon to re-test for antibodies?

5/23/2008 - blood positive for antibodies

6/24/2008 - negative biopsy

8/11/2008 - DQ2 gene present

7/1/2008 - gluten-free

(and dairy-light until 12/1/2008)

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I think the norm is to be tested at 3 months, 6 months and a year, but my dr. retested me after 1 month. When I questioned her about it, she said that if I was doing everything correctly my antibodies would have begun to drop and if I wasn't, she didn't like to wait 3 months to see, because it would be wasting alot of time. And, yes, there was a marked drop in my numbers. I was well over 100 and I dropped to 60 in 4 weeks time. Hope tihs helps.


Gluten Free - February 16, 2008

Diagnosed with positive bloodwork and biopsy.

No digestive symptoms for the past 25 years, but did have severe anemia, osteoporosis, lactose intolerance and RLS at time of diagnosis.

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It won't hurt and may be informative. If you did not get a base line for your iron, folic acid and vitamin levels at diagnosis you should have her throw that in also. It can be checked at a year to make sure you are absorbing again normally. Throw in a bone density scan too if that wasn't done at diagnosis. No matter what your age.

Courage does not always roar, sometimes courage is the quiet voice at the end of the day saying

"I will try again tommorrow" (Mary Anne Radmacher)

Diagnosed by Allergist with elimination diet and diagnosis confirmed by GI in 2002

Misdiagnoses for 15 years were IBS-D, ataxia, migraines, anxiety, depression, fibromyalgia, parathesias, arthritis, livedo reticularis, hairloss, premature menopause, osteoporosis, kidney damage, diverticulosis, prediabetes and ulcers, dermatitis herpeformis

All bold resoved or went into remission in time with proper diagnosis of Celiac November 2002

 Gene Test Aug 2007

HLA-DQB1 Molecular analysis, Allele 1 0303

HLA-DQB1 Molecular analysis, Allele 2 0303

Serologic equivalent: HLA-DQ 3,3 (Subtype 9,9)

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From: http://www.celiacdisease.net/testing

Follow-Up Testing

What does follow up testing do?

Follow-up testing is conducted to ensure that antibody levels are returning to normal, indicating that the intestine is healing on the new diet. For this reason, repeat intestinal biopsies are no longer necessary. These tests also indicate the extent to which a celiac is avoiding gluten, and can detect when hidden gluten has entered the diet

How often should follow up testing occur?

New celiacs should receive follow-up testing twice in the first year after their diagnosis. The first appointment should occur three to six months after the diagnosis, and the second should occur after 1 year on the gluten-free diet. After that, a celiac should receive follow-up testing on a yearly basis.

What tests are needed to follow up appointments? How are they interpreted?

New guidelines on the diagnosis and treatment of celiac disease by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition state that tTG-IgA testing should be used for follow-up care. Interpreting this test result is straightforward-a celiac on the gluten-free diet should have a negative test. The numerical value of the test is not important.

Follow Up Test #1

tTG-IgA: This test result should be negative

The numerical value of the test doesn't matter as long as the result is negative.

The University of Chicago Celiac Disease Center recommends additional testing, because the tTG test can sometimes be inaccurate in people with autoimmune disorders like Type 1 diabetes and thyroid disease. In addition, the tTG can sometimes become negative before a celiac has actually experienced significant healing.

For these reasons, Anti-Gliadin Antibodies (AGA) are also important. There are two types that need to be run: AGA-IgA, and AGA-IgG. In this circumstance, the numerical values of the tests are very important. The numbers should be as close to zero as possible, indicating a minimal antibody response to gluten. The additional advantage of these tests is that the blood can be drawn by any physician and sent to any laboratory.

Follow Up Test #2

Anti-gliadin IgA: This result should have a very low negative value

In this case, the numerical value does matter because a high negative test result still indicates that a patient is eating gluten. A low negative indicates that the diet is working well.

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