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Walk-In Clinic Doctor


Coinkey

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Coinkey Apprentice

Alright. I finally went to the walk-in clinic doctor about my gluten free discovery, hoping he'd do a test to formally diagnose Celiac. He just said, "so there are no more symptoms now that you don't eat gluten? Great, keep doing that." He gave me a sheet to go get tested at a lab for a whole list of things but never explained why he was testing for those things. I was hoping someone here could try and enlighten me on why these tests would be done:

CBC, routine urine analysis, electrolytes (Na, K, Cl, CO2), Albumin, alkaline Phosphatase, Alanine Aminotransferase, Bilirubin- total only, calcium, creatine kinase, creatinine, ferritin, glucose-random, GGT, Hemoglobin A1c, Lipase, Magnesium, Phosphate, Protein- Total, Thyroid (TSH and Free thyroxine), B12 and Vitamin D, E5R and something in doctor writing that starts with tissue tromglutaSCRIBBLE.

I am guessing they are all something to do with nutrition. I really wish that doctor would have been easier to talk to and explain stuff to me.


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burdee Enthusiast

Alright. I finally went to the walk-in clinic doctor about my gluten free discovery, hoping he'd do a test to formally diagnose Celiac. He just said, "so there are no more symptoms now that you don't eat gluten? Great, keep doing that." He gave me a sheet to go get tested at a lab for a whole list of things but never explained why he was testing for those things. I was hoping someone here could try and enlighten me on why these tests would be done:

CBC, routine urine analysis, electrolytes (Na, K, Cl, CO2), Albumin, alkaline Phosphatase, Alanine Aminotransferase, Bilirubin- total only, calcium, creatine kinase, creatinine, ferritin, glucose-random, GGT, Hemoglobin A1c, Lipase, Magnesium, Phosphate, Protein- Total, Thyroid (TSH and Free thyroxine), B12 and Vitamin D, E5R and something in doctor writing that starts with tissue tromglutaSCRIBBLE.

I am guessing they are all something to do with nutrition. I really wish that doctor would have been easier to talk to and explain stuff to me.

That last item is tissue transglutaminase (antibodies) which is a test for intestinal inflammation from gluten reactions. The rest are various indices for malabsorption of fats, protein, blood sugar, calcium, B12, etc. which can all occur with celiac damage to the intestines. Yes, those all are related to nutritional deficiencies which can occur with undiagnosed celiac disease.

However, his comment about gluten and 'keep doing that (avoiding gluten)' makes me wonder whether he's looking for other problems to diagnose or he's really well informed about celiac disease and the nutritional deficiencies that can occur with undiagnosed celiac. You could 'google' any of those tests for more info, to understand how those might relate to nutritional deficiencies or even celiac disease. Then you could 'explain stuff' to that doctor when you return very well informed about everything he didn't bother to explain to you.

SUE

T.H. Community Regular

First - this is an awesome doctor, IMO. :) If you can get him again, I'd go for it. I know regular doctors who don't do these tests, and they SHOULD.

I don't recognize all of them, but the ones I do recognize are for vitamin deficiencies, and I believe a couple check certain levels of 'something' that checks how certain organs are functioning. I recognize the thyroid test, for example - many celiacs have hypothyroidism.

Adult discovered celiacs often have vitamin deficiencies and can have some of their organs malfunctioning as well, so this guy is awesome!

Also, re: the celiac test? Are you still gluten free? The numbers I hear most are that you need to be eating a good amount of gluten for 6 weeks prior to the test or it can test negative, so if you are still gluten free, or have been until recently, a knowledgeable doctor wouldn't do the test.

Also, some doctors recommend you go back on gluten so they can do the test. Many people here, and some doctors, question that, since it means you have to deliberately hurt yourself (eat gluten) to the point that it affects your body so badly that they can see it in a test.

Some of us think that's seems counterproductive to being healthy, ya know?

You CAN get a genetic test done to see if you have the Celiac Gene. Many doctors will give you a celiac diagnosis if you have the gluten challenge - which you have - and the gene.

Alright. I finally went to the walk-in clinic doctor about my gluten free discovery, hoping he'd do a test to formally diagnose Celiac. He just said, "so there are no more symptoms now that you don't eat gluten? Great, keep doing that." He gave me a sheet to go get tested at a lab for a whole list of things but never explained why he was testing for those things. I was hoping someone here could try and enlighten me on why these tests would be done:

CBC, routine urine analysis, electrolytes (Na, K, Cl, CO2), Albumin, alkaline Phosphatase, Alanine Aminotransferase, Bilirubin- total only, calcium, creatine kinase, creatinine, ferritin, glucose-random, GGT, Hemoglobin A1c, Lipase, Magnesium, Phosphate, Protein- Total, Thyroid (TSH and Free thyroxine), B12 and Vitamin D, E5R and something in doctor writing that starts with tissue tromglutaSCRIBBLE.

I am guessing they are all something to do with nutrition. I really wish that doctor would have been easier to talk to and explain stuff to me.

Coinkey Apprentice

So if that last item, the tissue transglutaminase test is to do with gluten antibodies- shouldn't I be eating gluten before I do the test? It's only been 6 weeks and I've accidently glutened myself at least once a week since doing it (and once on purpose- food courts and dizzy hungry BAD combo). I get to make an appointment with the lab to get them done, so do you guys think it would be better to gluten myself for a week and then do the tests just to get a more accurate result? I don't really want to put myself through that but I don't want to get a false negative either.

burdee Enthusiast

So if that last item, the tissue transglutaminase test is to do with gluten antibodies- shouldn't I be eating gluten before I do the test? It's only been 6 weeks and I've accidently glutened myself at least once a week since doing it (and once on purpose- food courts and dizzy hungry BAD combo). I get to make an appointment with the lab to get them done, so do you guys think it would be better to gluten myself for a week and then do the tests just to get a more accurate result? I don't really want to put myself through that but I don't want to get a false negative either.

I don't know how long TtG (tissue transglutaminase) antibodies survive in the blood (assuming you get a blood test for Ttg. However I took an Enterolab stool test over 2 months after I mostly stopped eating gluten, though I still was taking a digestive supplement which I didn't realize contained barley. My Ttg test was still positive enough to diagnose gut inflammation consistent with celiac disease. If you have had some accidents, even though you're trying to follow a gluten free diet, you may still have enough gut inflammation to produce enough TtG antibodies, even though you won't produce enough gluten antibodies to leak from your gut into your blood.

Nevertheless, that's just my guess, because I got a stool test for TtG, not a blood test. Maybe someone who's had a TtG blood test could share their experience/expertise ...

SUE

summerteeth Enthusiast

You CAN get a genetic test done to see if you have the Celiac Gene. Many doctors will give you a celiac diagnosis if you have the gluten challenge - which you have - and the gene.

My doctor diagnosed me based on dietary response, medical history, and family history (history of bowel cancers). From what I gather, more and more doctors are doing this.

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    • catnapt
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    • knitty kitty
      @catnapt,  I apologize.  Obviously I've confused you with someone else.  I have vision problems due to undiagnosed Celiac complications.  Being legally blind, y'all look the same from here.   You still have not said which new medication you started taking.  Parathyroid disorders can affect antibody production.  Bone Loss Correlated with Parathyroid Hormone Levels in Adult Celiac Patients https://pubmed.ncbi.nlm.nih.gov/36619734/ Effect of vitamin B1 supplementation on bone turnover markers in adults: an exploratory single-arm pilot study https://pmc.ncbi.nlm.nih.gov/articles/PMC12075007/
    • catnapt
      during the gluten challenge I did not consume any wheat germ   the wheat germ is TOASTED - it's the only way it is sold now afiak doesn't matter I consume vast amounts of lectin containing foods PROPERLY prepared and have for well over a decade. They do not bother me in the least.    no anemia however the endo who ordered the celiac panel is the one who suggested the 2 week gluten challenge of eating at least 2 slices of bread per day or a serving of pasta- ALSO put me on a new drug at the same time (not a good idea)  I ate 4 slices because they were thin, or 2 English muffins, and just once some lasagna that someone else made since I stopped eating wheat pasta years ago. The English muffins caused some of the worst symptoms but that pc of lasagna almost killed me ( not literally but the pain was extreme) during those 12 days there were at least 3 times I considered going to Urgent Care.   This entire process was a waste of time TBH due to being on that new drug at the exact same time. it is impossible to tell if the drug I am taking for the possible renal calcium leak is working or not- given the dramatic response to the gluten challenge and resulting nausea (no vomiting) and eventually a loss of appetite and lower intake of foods so now I have a dangerously low potassium level   I don't have a simple case of celiac or no- I have an extremely complicated case with multiple variables I am seeing an endocrinologist for a problem with the calcium sensing glands - that system is very complicated and she has been unable to give me a firm diagnosis after many tests with confusing and often alarming results. She also appears to be inexperienced and unsure of herself. but I don't have the luxury of finding a new endo due to multiple issues of insurance, lack of drs in my area, money and transportation. so I'm stuck with her At least she hasn't given up    in any case I can assure you that lectins are not and never were the problem. I know they are a favorite villain in some circles to point to, but I have ZERO symptoms from my NORMAL diet which DOES NOT contain gluten. The longer I went without bread or foods with wheat like raisin bran cereal, the better I have felt. my body had been telling me for several years that wheat was the problem- or maybe specifically gluten, that remains to be seen- and stopping eating it was the best thing I could have done   I almost had unnecessary MAJOR SURGERY due to joint pain that I ONLY have if I am eating bread or related products I assumed it was the refined grains - never really suspected gluten but it does not matter I won't put that poison in my body ever again not that it is literally poison but it is def toxic to me        
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    • catnapt
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