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Being Boarderline And Confused!


beksmom

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beksmom Apprentice

My 13 yr old sons doctor told me today that his lab work came back showing celiac "mild" and that he feels he is boarderline ? Should he have the biopsies done? and should I put him the gluten-free diet no matter how those results come out? I am a newly diagnosed celiac with severe damage to my vili. I have had to get six infusions of ferritin to bring level back into a low normal range. My vitamin D is depleated, and am also malnurished. Also dealing with osteopenia. Any direction help for my son would be appreciated.


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mushroom Proficient

My 13 yr old sons doctor told me today that his lab work came back showing celiac "mild" and that he feels he is boarderline ? Should he have the biopsies done? and should I put him the gluten-free diet no matter how those results come out? I am a newly diagnosed celiac with severe damage to my vili. I have had to get six infusions of ferritin to bring level back into a low normal range. My vitamin D is depleated, and am also malnurished. Also dealing with osteopenia. Any direction help for my son would be appreciated.

My husband decided to go gluten free with me because he had a "borderline" response to the celiac test, and some bathroom issues. However, he certainly did not consider himself celiac and was doing it to accommodate me :wub:

When we were back at Tahoe he indulged in some sourdough french bread, and then some beer, and continued to have a beer or two when we got back here. One day he broke out on his forehead with dermatitis herpetiformis (I recognized it immediately from all the pictures I had seen on the forum). I told him to get the area adjacent biopsied immediately but they scheduled an appointment for two weeks later, by which time the lesion was starting to fade because he quit gluten again. So he cancelled the appointment and became a believer. He still has a very wide white scar on his forehead and, vain creature that he is, is convinced that he should not eat gluten.

I do not think there is any such thing as "borderline" or "mild". The analogy we use here is that you cannot be "mildly" pregnant: you either are or you aren't. A little bit pregnant is the same as being a lot pregnant--you are still pregnant!

Consider your son to be celiac. If you want further confirmation you and your son could both do genetic testing through Enterolab or Prometheus (I believe the latter requires your doctor to order it; Enterolab you can do yourself). Either way, I am not sure that most insurances will cover Prometheus; Enterolab you have to pay for yourself, about $450 per person. :o Of course, as you say, he could also have the biopsy, but that is just as likely to be inconclusive as the blood test, unfortunately, especially if they don't take the samples from the right areas.

bluebonnet Explorer

My 13 yr old sons doctor told me today that his lab work came back showing celiac "mild" and that he feels he is boarderline ? Should he have the biopsies done? and should I put him the gluten-free diet no matter how those results come out? I am a newly diagnosed celiac with severe damage to my vili. I have had to get six infusions of ferritin to bring level back into a low normal range. My vitamin D is depleated, and am also malnurished. Also dealing with osteopenia. Any direction help for my son would be appreciated.

"mild" compares to what my doctor said about my bloodwork "at best okay". i didn't do the endoscopy but had enterolabs do genetic and gluten and it came back positive. i see a lot of gi issues in my (short for his age 13 year old) and now knowing i've got the genes, i am having him tested. a postive response to gluten free diet is also confirmation. my doctor was very accepting of my outside labs and doesn't feel the need for the endoscopy if i do not. i mean the "proof" is there. chances are increased if you have it then he will. best wishes! :)

Reba32 Rookie

if Celiac shows up on a blood test, you're Celiac. Doesn't matter if they consider it "mild" or 99% positive. If you continue to consume gluten, then the damage will get worse, and the next blood test will be more definite. Why cause yourself (or your child!) more damage?

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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. 
    • trents
      NCGS does not cause damage to the small bowel villi so, if indeed you were not skimping on gluten when you had the antibody blood testing done, it is likely you have celiac disease.
    • 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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