Enterolab Test Results Are In. Help Interpreting?

[hhdavid]

Well, the day I've been waiting for is finally here. Here's the verdict:

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value

Fecal Anti-gliadin IgA 26 Units (Normal Range <10 Units)

Fecal Anti-tissue Transglutaminase IgA 17 Units (Normal Range <10 Units)

Quantitative Microscopic Fecal Fat Score <300 Units (Normal Range <300 Units)

Fecal Anti-casein (cow's milk) IgA 10 Units (Normal Range <10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0201

HLA-DQB1 Molecular analysis, Allele 2 0501

Serologic equivalent: HLA-DQ 2,1 (Subtype 2,5)

Interpretation of Fecal Anti-gliadin IgA: Intestinal antigliadin IgA antibody was elevated, indicating that you have active dietary gluten sensitivity. For optimal health, resolution of symptoms (if you have them), and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.

Interpretation of Fecal Anti-tissue Transglutaminase IgA: You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.

Interpretation of Quantitative Microscopic Fecal Fat Score: Provided that dietary fat is being ingested, a fecal fat score less than 300 indicates there is no malabsorbed dietary fat in stool indicating that digestion and absorption of nutrients is currently normal.

Interpretation of Fecal Anti-casein (cow's milk) IgA: Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation Of HLA-DQ Testing: HLA-DQB1 gene analysis reveals that you have one of the main genes that predisposes to gluten sensitivity and celiac sprue, HLA-DQB1*0201 or HLA-DQB1*0302. Each of your offspring has a 50% chance of receiving this gene from you, and at least one of your parents passed it to you. You also have a non-celiac gene predisposing to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having one celiac gene and one gluten sensitive gene, means that each of your parents, and all of your children (if you have them) will possess at least one copy of a gluten sensitive gene. Having two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity or celiac disease may be more severe.

Can anyone translate this for me? I understand the casein part. I'm just beginning to learn about celiac disease, gluten intolerance, and the genetics of it all. Please bear with me. From what I understand, I have a celiac gene (DQ2) and a gluten sensitivity gene, so I am definitely gluten intolerant. But does that mean I have celiac, considering the diagnoses in my signature? I'm aware that these tests don't diagnose, just tell if predisposed to celiac. I would also appreciate any information on the HLA-DQB1*0501 and the HLA-DQ 2,1 (Subtype 2,5) parts.

Any help anyone can give is greatly appreciated.

[maile]

Hi there!

I'm nowhere near experienced at this but here's a go (hopefully the more educated will chime in!)

Fecal Anti-gliadin IgA 26 Units (Normal Range <10 Units) this means that you are reacting to gluten in your diet, anything below a reading of 10 is negative so you are mildly positive (I say mildly only in comparison as I have seen others on here with numbers in the 100's), the lower number means you probably don't have too much damage yet

Fecal Anti-tissue Transglutaminase IgA 17 Units (Normal Range <10 Units) you have an autoimmune reaction to the gluten you are ingesting....aka

Antibodies to tissue transglutaminase are found in coeliac disease and may play a role in the small bowel damage in response to dietary gliadin that characterises this condition

(wiki)

Quantitative Microscopic Fecal Fat Score <300 Units (Normal Range <300 Units) this supports the lower first number, anything under 300 shows you are still absorbing fats so the interpretation is that most of your villi are probably still working.

Serologic equivalent: HLA-DQ 2,1 (Subtype 2,5) you have one of the genes that is recognized as an actual celiac gene, this doesn't mean you have celiac, it just says you could develop it. the second gene the 5 is one of the genes associated with neurological symptoms of gluten intolerance...this one I'm getting to know as I have 2 copies of the DQB1-0501 gene

eta: what all of this together says (and you probably know already) is you are gluten intolerant and given the presence of the celiac gene it'd be a good idea to go on the gluten-free diet so that you don't develop a full blown case of celiac at some point in the future

[hhdavid]

Thanks, maile. Full blown case of celiac? Could that be: constant D (10+ times a day), constant nausea, severe stomach pain when I ate gluten, hurting so bad I could barely get out of bed, bone and heel pain, migraines, teeth practically crumbling in my mouth? I had to quit my job last May because I just couldn't handle the pain and fatigue anymore. It was real physical, lifting over 40 lb boxes, twelve hour shifts standing up the whole time except for 2 15-minute breaks and a 30 min lunch. I've had three children and six surgeries, and lost three husbands in the last ten years, so yeah, I've had plenty of stress. I've made the rounds from doctor to doctor over the years, no one ever mentioned celiac until I went to the ER last Jan and my nurse had celiac. She said she thought I had it, and the ER doctor seconded her opinion. (How often does that happen, lol?)

I went the genetic route because my health insurance went with the job, and the blood tests my doctor wanted cost the same out of pocket as the genetic tests, and I'd heard about false positives. There was no way I could afford an endoscopy, and the possibility of no villi damage showing up, etc.

But based on this, yeah, I'll stay on the gluten-free diet for sure. And my eldest DD will be getting tested, since she has alot of the same physical stuff going on, plus she's 20+ weeks pregnant.

Thanks for your reply. I really appreciate it.

[maile]

Thanks, maile. Full blown case of celiac? Could that be: constant D (10+ times a day), constant nausea, severe stomach pain when I ate gluten, hurting so bad I could barely get out of bed, bone and heel pain, migraines, teeth practically crumbling in my mouth? I had to quit my job last May because I just couldn't handle the pain and fatigue anymore. It was real physical, lifting over 40 lb boxes, twelve hour shifts standing up the whole time except for 2 15-minute breaks and a 30 min lunch. I've had three children and six surgeries, and lost three husbands in the last ten years, so yeah, I've had plenty of stress. I've made the rounds from doctor to doctor over the years, no one ever mentioned celiac until I went to the ER last Jan and my nurse had celiac. She said she thought I had it, and the ER doctor seconded her opinion. (How often does that happen, lol?)

I went the genetic route because my health insurance went with the job, and the blood tests my doctor wanted cost the same out of pocket as the genetic tests, and I'd heard about false positives. There was no way I could afford an endoscopy, and the possibility of no villi damage showing up, etc.

But based on this, yeah, I'll stay on the gluten-free diet for sure. And my eldest DD will be getting tested, since she has alot of the same physical stuff going on, plus she's 20+ weeks pregnant.

Thanks for your reply. I really appreciate it.

oh my goodness, yep, that's lots of stress!!! congratulations on being so strong.

as for full blown celiac, from your symptoms sure sounds like it!

[Mother of Jibril]

Maile gave you good advice

DQ2 (especially the specific one you have, *0201) is the most likely gene to cause celiac disease. I agree that you have the symptoms... how do you feel on the new diet?

I'm kind of in the same boat as you. All arrows point to "YES" I do have celiac disease, but I haven't been able to get an official diagnosis (long story). I could do a gluten challenge, but I don't think I need it... I feel so much better that I'm willing to stick with a 100% gluten-free diet for the rest of my life. Based on my genes I know that both of my kids are at risk too. My daughter is getting her blood test this morning.

I'm so glad that your daughter is getting tested! Untreated celiac disease can cause all kinds of complications during pregnancy like pre-eclampsia and IUGR. If she can afford it, have her get the blood test... the results come back much more quickly. Otherwise, she should give the gluten-free diet a try ASAP while she waiting for results from Enterolab. And... she should mention it to her OB (although a lot of OBs have no clue about autoimmune disorders ).

[hhdavid]

maile, thanks for the great advice and kind words.

Yes, I do think it was full-blown celiac. I'll tell you why below in my reply to.....

Mother of Jibril,

I read your signature, and my heart goes out to you for your loss.

My daughter (age 25) was on the phone to her OB the next morning after I got my results. We are almost positive she also has celiac. She has the constant breakouts that she now thinks is DH (it looks exactly like it), constant constipation, bone pain, and she's losing her dental enamel. She's on the internet constantly, researching and trying to learn all she can.

I'm going to take my results from the gene test to my doctor, and if he will give me an "official" diagnosis based on those results, so be it. If not, then....I guess I have my own "official" diagnosis. I've been on the gluten-free diet for three weeks now. I refuse to do a gluten challenge. I just can't go back to eating any gluten after this much improvement after being on the gluten-free diet less than one month. I was practically incapacitated one month ago.

The results:

depression: so much better

anxiety: so much better

stomach pain: gone

fatigue: getting better every day. I actually feel like getting out of bed, getting dressed, and doing things now!

the big D: extremely better, I don't "camp out" in the bathroom anymore

nausea: gone

heel pain: getting better

body pain: gone

migraines: gone

arthritis pain in knees: gone, thank goodness!

And I actually have hunger pangs now!

I can walk to my mailbox (aprox. 100 yards one way) without stopping to rest, and it doesn't hurt me to go get my mail anymore!

Thanks so much for your replies. At least now I know what I'm dealing with. I'm trying to learn as much as I can about celiac, the genetics, gluten sensitivity, and what all that means for me. There's no doubt in my mind I had full-blown celiac. And with the DQ1 gene, I had a lot of the neuro stuff that goes along with that. I feel like I've finally gotten my life back, and I never want to go back to feeling like I did in January. I was so extremely lucky to have that ER nurse that day, or else I would probably still be sick and not knowing what was wrong. The proof is in my response to the diet, that's for sure. I feel better and better each day.

[maile]

I am so glad you are feeling better!

And with the DQ1 gene, I had a lot of the neuro stuff that goes along with that. I feel like I've finally gotten my life back, and I never want to go back to feeling like I did in January.

I did want to point out that I should thank Mother of Jibril for the information on the DQ1 genes

MoJ, I've found your posts most informative and have helped enormously as I try to figure all of this out!!

[hhdavid]

Hmmm, I think I will go search for her posts and get some more information on DQ1!

Sometimes I feel like my head is going to explode, I'm trying to stuff so much information into it so quickly! At least I can say it's not from gluten now!

[Mother of Jibril]

MoJ, I've found your posts most informative and have helped enormously as I try to figure all of this out!!

My pleasure!

depression: so much better

anxiety: so much better

migraines: gone

It's wonderful to hear that you're having such a positive response to the gluten-free diet!

Depression, anxiety, and migraines are common symptoms associated with the DQ1 subtypes (DQ5 and DQ6)... all signs of neurological damage. Other symptoms can include ataxia (poor balance), vertigo, peripheral neuropathy (tingling/numbness in your hands and feet), seizures, MS, schizophrenia, ADHD, bipolar disorder, etc... It can take some time to see improvement on the gluten-free diet, but it definitely helps!

Another thing you might try is vitamin D supplements... I've been taking 4,000iu per day and I can't believe what a difference it makes. I don't feel depressed at ALL This is a great website for more information:

Open Original Shared Link

[hhdavid]

MoJ,

Thanks for that link! I'll check it out!

[gfb1]

[snip]

DQ2 (especially the specific one you have, *0201) is the most likely gene to cause celiac disease. I agree that you have the symptoms... how do you feel on the new diet?

[snip]

i'm sure that you may think i'm splitting hairs; and that a few may be tiring of the tirade... but; the hla/dq haplotypes DO NOT CAUSE celiac disease. these are markers which often INFLUENCE the bodies immune response to particular antigens.

also, please be very careful with self-medication with supplements/vitamins/etc. vitaminD toxicity is Open Original Shared Link (regardless of websites promoting the use/sale of vitamins). you also have to consider your full complement of supplements/medication/diet; so a visit to a registered dietician or a professional nutritionist (& NOT a supplement salesperson) is never out of order.

[Mother of Jibril]

i'm sure that you may think i'm splitting hairs; and that a few may be tiring of the tirade... but; the hla/dq haplotypes DO NOT CAUSE celiac disease. these are markers which often INFLUENCE the bodies immune response to particular antigens.

Yes... I understand that genes do not CAUSE disease, they only increase your risk. Celiac has to be triggered by something like pregnancy, trauma, overuse of antibiotics, a virus, etc... Sorry about the momentary sloppiness.

also, please be very careful with self-medication with supplements/vitamins/etc. vitaminD toxicity is Open Original Shared Link (regardless of websites promoting the use/sale of vitamins). you also have to consider your full complement of supplements/medication/diet; so a visit to a registered dietician or a professional nutritionist (& NOT a supplement salesperson) is never out of order.

The vitamin D council is not selling anything. It has extensive links to scientific (RE: peer-reviewed) articles on just about every topic you can imagine related to vitamin D. You might want to check it out before you criticize...

[sbj]

The vitamin D council is not selling anything. It has extensive links to scientific (RE: peer-reviewed) articles on just about every topic you can imagine related to vitamin D. You might want to check it out before you criticize...

The Vitamin D Council itself may not be selling anything but they are sponsored by Bio-Tech Pharmacal and that company sells vitamin D.

The 'Vitamin D Council' is merely "a group of concerned citizens [including Dr. Cannell] that believe many humans are needlessly suffering and dying from Vitamin D Deficiency." One needs to be careful because we don't know who these 'concerned citizens' are or what companies they have interests in.

Edit:

Per this site

Open Original Shared Link

"The Vitamin D Council and Dr. Cannell have partnered with ZRT Laboratory to offer selected products to you at a discount. At this time, Vitamin D Council discounts apply to the following products."

So it would appear that the founder of The Vitamin D Council does have a vested interest in selling vitamin D test kits . . .

[Mother of Jibril]

So it would appear that the founder of The Vitamin D Council does have a vested interest in selling vitamin D test kits . . .

Hmmm... and the celiac.com website is currently sponsored by Rice Chex, "Gluten Free Beauty," Alba Therapeutics, and "The Gluten-Free Mall." Another conspiracy?

Honestly, there ARE differences between the websites that provide NO scientific data or links to external articles (like this one, for example: Open Original Shared Link and genuinely useful websites like celiac.com and vitamindcouncil.org.

[sbj]

Hmmm... and the celiac.com website is currently sponsored by Rice Chex, "Gluten Free Beauty," Alba Therapeutics, and "The Gluten-Free Mall." Another conspiracy? Honestly, there ARE differences between the websites that provide NO scientific data or links to external articles (like this one, for example: Open Original Shared Link and genuinely useful websites like celiac.com and vitamindcouncil.org.

You claimed that The Vitamin D Council was not selling anything. They are. They have partnered with another company to sell vitamin d test kits.

I think you are confusing 'advertisers' on a website, with 'sponsors' of a website. In the case of the former, the advertisers pay to advertise their services or products on a site that is maintained by someone else. In the case of the latter, the sponsor is actually paying for the costs of/and maintaining the website (and may be influencing content - it is not clear). A small but significant difference. I do not allege that Celiac.com is sponsored by Rice Chex or that Rice Chex is actively attempting to influence the content of the site.

No one alleged a conspiracy ???

I have not said that the content of the vitamin D site was useful or inaccurate. I merely pointed out that they have partnered with another company to sell vitamin d test kits, contrary to your claim. Some might find this info useful when determining the validity of a site - I know I do. gfb made the important observation that vitamin D toxicity is real and dangerous and that persons should get their nutritional advice form a dietitian - good advice.

[nora-n]

I have followed the vitamin D debate for years, and the vitamindcouncil website did not sell anything for a long long time.

In fact, they say the best form of vitamin d is free sunshine. No sunscreen.

I finally managed to get my vitamin D tested, and was still low after over one year of supplementing. Lots of patients on the thyroid forums find that they need less thyroxine when they take enough vitamin D.

The people on the lowcarb forums see that their insulin resistance gets lowered and that SAD disappears.

Cases of poisoning are almost always due to industry accidents (wieth vitamin D2), or in a few cases someone that did not read the label when very strong vitamin d drops were used. (the case is discussed on the vitamin D website)