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Jaxella

Help With Enterolab Results

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Hi everyone,

I just got my results back from Enterolab and I'm a little confused. I cannot figure out what the Anti-tissue Transglutaminase IgA results mean. I realize the Anti-gliadin IgA results indicate a gluten sensitivity (and I now KNOW that I can't eat gluten having gone off of it) but I guess I don't know what everything else means. I'm gluten sensitive, not celiac?

I have fibromyalgia so a lot of the celiac symptoms are the same and I never even thought that it would be related to what I'm eating. I don't need the label of celiac to get off gluten but I want to know if that is what it looks like I may have (and again, I know stool tests can't diagnose but they can give an indication, right?).

Any help would be much appreciated! For some reason I just can't concentrate and figure out these results!

Thanks~

P.S. Also, I'm quite surprised at the anti-casein result (6 units) because I can't even have one spoonful of ice cream or milk without having severe pain and gas...I thought that meant an allergic reaction?

Here are my results:

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

Fecal Anti-gliadin IgA: 16 Units

Fecal Anti-tissue Transglutaminase IgA: 17 Units

Quantitative Microscopic Fecal Fat Score: Less than 300 Units

Fecal Anti-casein (cow's milk) IgA: 6 Units

HLA-DQB1 Molecular analysis, Allele 1: 0301

HLA-DQB1 Molecular analysis, Allele 2: 0602

Serologic equivalent: HLA-DQ 3,1 (Subtype 7,6)

Interpretation of Fecal Anti-gliadin IgA (Normal Range is less than 10 Units): 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 (Normal Range is less than 10 Units): You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.

Interpretation of Quantitative Microscopic Fecal Fat Score (Normal Range is less than 300 Units): 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 (Normal Range is less than 10 Units): 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: Although you do not possess the main HLA-DQB1 genes predisposing to celiac sprue (HLA-DQB1*0201 or HLA-DQB1*0302), HLA gene analysis reveals that you have two copies of a gene that predisposes to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having two copies of a 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 the gene. Two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity may be more severe.

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I'm not an expert, but it looks like you are definitely gluten intolerant.

The tTG IgA is also positive which means you probably have Celiac Disease. Negative tTG IgA can still have Celiac Disease and Positive tTG IgA rarely don't have Celiac Disease.

Personally I was diagnosed first with Celiac Disease and then Fibromyalgia. It is much more common for Celiacs to be diagnosed with Fibromyalgia before Celiac.

Welcome and you've come to a great place if you decide to start living Gluten-Free!

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I could be wrong and will stand corrected if so but from what I rember my doctor telling me TtG is highly specific for celiac disease (it's what they test for occasionally to make sure you are not ingesting gluten).

If yours was 17 and under 10 is normal, then I believe that means you DO have celiac disease. I think Enterolab will give you the results but not diagnose you with celiac. In other words "You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity." is their way of saying you probably do have celiac.

Here's a website that may help:

Understanding Your Lab Tests online: Celiac Testing

This is from the Enterolab website:

Do my positive results mean I have celiac sprue or that I need an intestinal biopsy?

The immune reaction to gluten is gluten sensitivity. Testing for the presence of an antibody produced against gluten is the diagnostic hallmark of gluten sensitivity (for years in the blood, and now more sensitively detected in stool with our testing). Although the immune reaction to gluten, i.e., gluten sensitivity, is the cause of the villous atrophy of celiac sprue, having these antibodies in stool, or even malabsorption, does not necessarily mean you will have detectable villous atrophy in an intestinal biopsy. But why does it matter, since it is known that a person can have every last complication from gluten sensitivity and never have villous atrophy? In other words, one can have gluten sensitivity damaging the intestine on a sub-microscopic level destroying function, or damaging other organs/tissues without having celiac sprue. Thus, there is no reason to expose yourself to the risks, invasive nature, and expense of an intestinal biopsy. This idea is not new. Some have said this for years with respect to positive antiendomysial antibodies. Now we extend this ideology to our stool testing; if you have the immune reaction, and especially if you have detectable malabsorption, symptoms, and/or immune disease, what is there to wait for to go gluten-free? And if you have none of these consequences, why wait for them to appear? Be thankful you do not, and go gluten-free.

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A note about the Casein. You could be reacting to the other protein in dairy which is whey? I only have a problem with lactose in dairy and only if I eat more than say 10 grams in a serving. Glad you have your answers towards your road to healing!

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People can be intolerant to casein (protein) or lactose (sugar). You're probably lactose intolerant, but not casein intolerant. Food intolerances are not allergies. They work differently.

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Thanks, everyone for your answers!

I'm simultaneously filled with excitement and disbelief. Excitement that I can make a difference in how I feel with food and disbelief that my life is now totally changed and I have to give up something I love for the rest of my life. Thankfully, I just finished reading Gluten-Free Girl and I love her attitude of looking at what she can eat versus what she can't. That is the kind of attitude adjustment I'm going to need!

Next up, testing for soy & eggs---I wish I had done that at the same time!

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