Help Me Understand My Enterolab Results

[Edo]

So I've already been gluten(andotherstuff)-free almost a month. Not completely better yet, but loads better than I was. I got my Enterolab results Jan 25, but I have been so preoccupied that I've just gotten around to posting them:

Fecal Anti-gliadin IgA: 38 Units

Fecal Anti-tissue Transglutaminase IgA: 15 Units

Quantitative Microscopic Fecal Fat Score: Less than 300 Units

Fecal Anti-casein (cow's milk) IgA: 8 Units

HLA-DQB1 Molecular analysis, Allele 1: 0302

HLA-DQB1 Molecular analysis, Allele 2: 0602

Serologic equivalent: HLA-DQ 3,1 (Subtype 8,6)

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: 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.

So tell me if I'm understanding this right. As far as I understand, a person is called gluten-sensitive when there is an immune reaction to gluten, but it hasn't caused visible damage to villi. And a person is called celiac when there is visible damage. Is this true? And I'm definitely gluten-sensitive at the least (not that gluten-sensitivity is less of a big deal or anything!), but Enterolab can't diagnose celiac since they can't see my villi. Since I have one celiac gene and one gluten-sensitive gene, it's possible that I am celiac and not "just" gluten-sensitive, yes? Since my anti-tTG IgA is positive, is celiac more likely? Or does the fact that I am not suffering from malabsorption indicate I probably don't have severe enough intestinal damage to be considered celiac? (I know this is speculation.)

Not that I really need to know either way. I already know gluten is my problem, and whatever the technical name for it is, I need to remain gluten-free. But I'm just curious about it. The gluten-sensitive/celiac differentiation is kind of confusing so I want to have it straight. This stuff is interesting, and I might as well understand it having paid that much for the test.

According to this, I don't have a casein sensitivity. But I should still stay off it for a number of months? That sounds fine, as I think I had some kind of reaction to it anyway (I took it out before taking out gluten and felt a little better). But does this mean after I heal, I will very likely have no problem reintroducing it? That would be nice!

It's also interesting to know that I have two genes for celiac and/or gluten-sensitivity. So I got one from each parent. Now I can think of a few people on my dad's side (including him since he's always had digestive issues) that probably have it. Maybe they'll wise up and go gluten-free and become happier, healthier people. My dad is estranged and everyone on his side of the family is pretty psychologically messed up and unhappy.

Then, there is some autoimmune stuff happening on my mom's side and in our immediate family. Rheumatoid arthritis in my mom and aunt, ITP (a rare and incurable blood disorder in which platelets are destroyed) in my younger sister and a different aunt. And thyroid disease in an aunt and a cousin. Maybe there's a celiac connection with all these, but even if there's no celiac, I have heard that a gluten-free diet is good for all autoimmune diseases. I've already convinced my sister and mom to try it.

I live with my boyfriend and another roommate (our best friend), and we are all gluten-free now. My roommate, when she started, went through the same withdrawal symptoms and then started feeling better, just like I did when I started. I think she's celiac too! She had a lot of the same health problems as me, and now she's starting to feel better. I am so happy that I have found this all out about celiac and have been able to help others because of it.

And thanks again to this forum and its wealth of info. My roommate and I browse it for hours each day learning new things.

[ravenwoodglass]

Hello and welcome. I am glad you are starting to see improvement and I hope it continues at a good pace.

I am someone who considers gluten intolerance and celiac manifestations of the same thing. One of the reasons why I think that way is because I have DH. If you have DH you have a diagnosis of celiac and no other testing is needed. But if you have other manifestations of celiac, neuro, GI, anemias and liver impact etc the doctors want you to have a positive biopsy to 'prove' it is celiac. Since not all folks with DH have GI symptoms but they still are celiac I don't understand why the medical community cannot recognize that some might have, for example, neuro impact with perhaps depression or what we call 'brain fog' before the villi are destroyed.

It would be a good idea to spread the word amongst your family members to be tested. It is advised to test all first degree relatives. If they need a diagnosis before they can really stick with the diet they really need to be tested before they stop gluten. Otherwise if they doubt it later they will need to do a gluten challenge for at least a couple months before diagnois with blood or biopsy.

As you have seen you have found a great place for info and support. I hope you heal quickly.

[Edo]

Hello and welcome. I am glad you are starting to see improvement and I hope it continues at a good pace.

I am someone who considers gluten intolerance and celiac manifestations of the same thing. One of the reasons why I think that way is because I have DH. If you have DH you have a diagnosis of celiac and no other testing is needed. But if you have other manifestations of celiac, neuro, GI, anemias and liver impact etc the doctors want you to have a positive biopsy to 'prove' it is celiac. Since not all folks with DH have GI symptoms but they still are celiac I don't understand why the medical community cannot recognize that some might have, for example, neuro impact with perhaps depression or what we call 'brain fog' before the villi are destroyed.

It would be a good idea to spread the word amongst your family members to be tested. It is advised to test all first degree relatives. If they need a diagnosis before they can really stick with the diet they really need to be tested before they stop gluten. Otherwise if they doubt it later they will need to do a gluten challenge for at least a couple months before diagnois with blood or biopsy.

As you have seen you have found a great place for info and support. I hope you heal quickly.

Thank you.

That's also how I thought it worked. The different labels of "gluten-sensitive" and "celiac disease" were more descriptive of the different manifestations of the same root cause. I've just been referring to myself as having celiac disease to the people I know. I have heard though, that there is a difference between gluten-sensitivity and celiac. Namely, that those with non-celiac gluten-sensitivity do not actually ever develop destruction of the villi, but can have any of the other symptoms/complications aside from that. So if that is true, gluten-sensitivity and celiac disease are different in that sense. I guess I was just speculating about whether referring to myself as celiac is technically correct, not that it's very important.

But, I think the labels are kind of useless come to think of how diverse symptoms can be in different individuals. There's DH, GI symptoms, neuropathic symptoms, impact on other organs, etc... and they are all caused by the immune system's reaction to gluten, though different people have vastly different sets and combinations of symptoms. I have GI symptoms and realized I also have many neuro symptoms after reading posts on this board. In fact it seems like every weird health issue I've ever had since I was a child can be connected to celiac. I was a little freaked out when, after being gluten-free a couple days, my normally rapid, pounding heart rate got calm and slower. Nothing attests to how long I've been used to living with my symptoms than being afraid of feeling normal, lol. Anyhow, clearly there is a lot of progress to be made in the medical community's understanding of celiac disease.

I would really like my family to get tested and educated. I try to pass on information to my family as clearly as possible. They know about the testing "rules" and everything. But yeah, the problem for them would definitely be sticking to the diet. I already suggested testing before starting the diet (my sister even gets blood drawn regularly to monitor her ITP, so I figured it would be easy enough to throw a celiac panel in there). They're treating this kind of casually though, and have said they will just try the diet and see what happens. I'm having my sister stay with me to try it, because mom's house is so full of gluten that cooking will be impossible there. Darn scratched up nonstick pans. Though if this helps sister's ITP, mom will get way serious with it. I'm going to have to help mom a whole lot to do the diet properly though. As for dad, all I can really do is have the info passed along as he isn't technically in my life whatsoever, and hope he looks into it.

[nora-n]

yes with that gene (DQ8) and the high antibodies and your symptoms it does point to celiac.

Yes, the DQ6 is associated with neuro symptoms from gluten.

Interesting about the ITP, I think I have seen it connected to celiac but not sure.

I typed in ITP and celaic in www.pubmed.com and there were some abstracts, like

Open Original Shared Link

[Edo]

yes with that gene (DQ8) and the high antibodies and your symptoms it does point to celiac.

Yes, the DQ6 is associated with neuro symptoms from gluten.

Interesting about the ITP, I think I have seen it connected to celiac but not sure.

I typed in ITP and celaic in www.pubmed.com and there were some abstracts, like

Open Original Shared Link

Thanks for clarification, it makes more sense now.

That is interesting that you found something about the ITP and I'm going to have to look into the subject more. If going gluten-free helps her, we will all be so happy! Having ITP is scary, especially for a younger person (14-year-old), and it affects how she lives her life a real lot. >_<