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See My Dr. Tomorrow. What Tests Should Be Done?


jackay

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jackay Enthusiast

Advice please. I see my doctor tomorrow and wonder if I should have the Celia panel of tests run.

This past summer I had a GI panel run of stool and saliva tests. A saliva test was run for Gliadin Ab, SIgA. The result was >100 U/ml with borderline 13-15 U/ml and Positive >15 U/ml. I thought these test results were from a stool sample and I just discovered it was a saliva sample. From the reading I've done I found out a saliva sample isn't accurate. (I read that a stool sample is accurate if it is positive but that a negative result could be false.)

Since August, I have tried to avoid gluten except for slipping for about four days in October. However, my doctor said nothing about hidden gluten and gluten contamination. My symptoms didn't get worse when I slipped, but I was feeling so miserable at the time that I don't think I would have noticed if they got worse. It has been just two weeks since I have tried eliminating all gluten from my diet and only two days since I have not used an old plastic cutting board, teflon cookware and washed my dishes and hands before eating.

Some days my symptoms are better but I have a long ways to go to being healthy. Still suffer from diarrhea, insomnia, anxiety, depression, headaches, muscle pain, hands falling asleep, loud pulse, mental fog, and difficulty concentrating.

Should I go insist my doctor run the Celiac panel of tests since I have tried to avoid gluten? I have paid my out of pocket medical expenses this year so with insurance it wouldn' cost me anything. If I wait and do a gluten challenge next year, which I really don't want to do, I will have to start over with my deductible and copay.


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Jean'sBrainonGluten Newbie

This is really a judgment call. The key is you - will you believe it if you don't have a lab test confirming it? Will you believe it enough to stand firm on your gluten free diet when you have started to feel better? I didn't and it caused me a LOT of problems because I wasn't precise about cross contamination and occasionally just eating something because I hadn't planned and fed myself and got too hungry in a vulnerable place.

If you aren't sure then I would suggest eating a lot of wheat for a week or as long as you can stand it and trying to get a test right before the end of the year. It's a risk because if you have celiac you will get sick as a dog but that will give you confirmation and make it likely that the blood test will give a true result.

I'm tempted to say Merry Christmas but given what I'm advising that seems cynical - you know?

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    • Scott Adams
      This is a very common question, and the most important thing to know is that no, Guinness is not considered safe for individuals with coeliac disease. While it's fascinating to hear anecdotes from other coeliacs who can drink it without immediate issues, this is a risky exception rather than the rule. The core issue is that Guinness is brewed from barley, which contains gluten, and the standard brewing process does not remove the gluten protein to a level safe for coeliacs (below 20ppm). For someone like you who experiences dermatitis herpetiformis, the reaction is particularly significant. DH is triggered by gluten ingestion, even without immediate gastrointestinal symptoms. So, while you may not feel an instant stomach upset, drinking a gluten-containing beer like Guinness could very well provoke a flare-up of your skin condition days later. It would be a gamble with a potentially uncomfortable and long-lasting consequence. Fortunately, there are excellent, certified gluten-free stouts available now that can provide a safe and satisfying alternative without the risk.
    • MogwaiStripe
      Interestingly, this thought occurred to me last night. I did find that there are studies investigating whether vitamin D deficiency can actually trigger celiac disease.  Source: National Institutes of Health https://pmc.ncbi.nlm.nih.gov/articles/PMC7231074/ 
    • Butch68
      Before being diagnosed coeliac I used to love Guinness. Being made from barley it should be something a coeliac shouldn’t drink. But taking to another coeliac and they can drink it with no ill effects and have heard of others who can drink it too.  is this everyone’s experience?  Can I drink it?  I get dermatitis herpetiformis and don’t get instant reactions to gluten so can’t try it to see for myself. 
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    • Scott Adams
      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
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