Help With Test Results

[Sevenoclk]

Please help me interpret my results. I do not have either celiac gene (thankfully!), but have two genes that predispose me to gluten sensitivity and I am sensitive to casein. However, my gluten sensitivity level was 10 (very close to normal). For reference, I was off gluten for a week prior to the tests, but I do not think that would affect them. I am sensitive to casein.

I wonder if I should cut way back on gluten (i.e. not worry about cross contamination, but stay away from obvious sources) and then stay away from ALL dairy (ugh???)?

Please advise.

Final Laboratory Report

Date: 11/9/2010

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

Fecal Anti-gliadin IgA 10 Units (Normal Range is less than 10 Units)

Fecal Anti-tissue Transglutaminase IgA 10 Units (Normal Range is less than 10 Units)

Quantitative Microscopic Fecal Fat Score Less than 300 Units (Normal Range is less than 300 Units)

Fecal Anti-casein (cow

[burdee]

Please help me interpret my results. I do not have either celiac gene (thankfully!), but have two genes that predispose me to gluten sensitivity and I am sensitive to casein. However, my gluten sensitivity level was 10 (very close to normal). For reference, I was off gluten for a week prior to the tests, but I do not think that would affect them. I am sensitive to casein.

I wonder if I should cut way back on gluten (i.e. not worry about cross contamination, but stay away from obvious sources) and then stay away from ALL dairy (ugh???)?

Please advise.

Final Laboratory Report

Date: 11/9/2010

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

Fecal Anti-gliadin IgA 10 Units (Normal Range is less than 10 Units)

Fecal Anti-tissue Transglutaminase IgA 10 Units (Normal Range is less than 10 Units)

Quantitative Microscopic Fecal Fat Score Less than 300 Units (Normal Range is less than 300 Units)

Fecal Anti-casein (cow’s milk) IgA 15 Units (Normal Range is less than 10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0301

HLA-DQB1 Molecular analysis, Allele 2 0604

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

Interpretation of Fecal Anti-gliadin IgA: 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: You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.

Interpretation of Fecal Anti-casein (cow’s milk) IgA: 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. This test was developed and its performance characteristics determined by the American Red Cross - Northeast Division. It has not been cleared or approved by the U.S. Food and Drug Administration.

Your assessment was accurate. You have gluten intolerance with some intestinal inflammation (indicated by positive Ttg score). You have 2 copies of gluten intolerance gene. You react positively to casein. Every lab must set a 'cut off' score. For Elab equal to or greater than 10 is 'positive'. Rather than consider your results 'almost normal', consider them positive for gluten and casein intolerance. You may have an IgA deficiency which skewed your scores downward. However, those are still positive. So you need to abstain from gluten and casein.

[Sevenoclk]

Thanks. I have read a lot about celiac, etc. and I guess I am confused because celiac damages the intestines. I can't find much talking about NCGS causing damaged/inflammed intestines. Does this mean the gluten and casein are damaging my intestines? Does it indicate any type of leaky gut? The reason I ask this is because some of my worst symptoms are fatigue and brain fog which would indicate the gluten and casein are getting into my blood stream and affecting my brain.

Also, the two genes for gluten sensitivity -- is this unusual? Also, does it mean my gluten sensitivity WILL NOT turn into celiac?

Finally, what about the Glutenease and other enzymes? I have read that they are not recommended for those with celiac, but are find for those with NCGS. The reason I ask is because I leave for vacation tomorrow and I worry about CC. I will do my best to eat non-gluten and non-casein, but it seems that away from home it CC is an issue. Should Glutenease help? Will Glutenease allow small amounts of casein and gluten?

I know I have a lot of questions and I really appreciate the help.

[GFinDC]

The effectiveness of DPP-IV, the active ingredient in Glutenease is kind of controversial on the board. Some think is it no help at all, some like myself think it can help some, but not at all allow deliberate eating of gluten. IMHO it may help to somewhat shorten CC recovery time and lessen symptoms. It does not stop the auto-immune reaction in celiac though. you can purchase the DPP-IV enzyme cheaper from other suppliers. It shouldn't hurt you any, unless you mistakenly think it can allow you to eat gluten without consequences.

[Mari]

Final Laboratory Report Date: 11/9/2010

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

HLA-DQB1 Molecular analysis, Allele 1 0301

HLA-DQB1 Molecular analysis, Allele 2 0604

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

My test from ELab were similar

Allele 1 0302 (HLA-DQ8) Yours was DQ7. This is a subtype of DQ3

Allele 2 0602 (HLA-DQ6) Yours was DQ6. This is a subtupe of DQ1

One difference between you and me is that the O302 is a main Celiac gene so I was at greater risk of developing the autoimmune problem. The 0602 put me at risk for developing non-celiac sprue also called Leaky Gut Syndrome.

This is confusing - the serology test was developed more than 20 years ago and became the usual way of reporting. The molecular analysis of the gene was developed years later then correlated with the serology test.

Wikipedia has clear discussions of the HLA-DQ s

Look at HLA-DQ first to get the overview.

HLA-DQ - Wikipedia, the free encyclopedia

HLA-DQ (DQ) is a cell surface receptor type protein found on antigen presenting cells. DQ is an αβ heterodimer of the MHC Class II type. The α and β chains are encoded by HLA-DQA1 ...

en.wikipedia.org/wiki/HLA-DQ

Then look at the individual DQ groups and subgroups.

Here's the link to DQ7

HLA-DQ7 - Wikipedia, the free encyclopedia

Serology

[Skylark]

It's only Enterolab. Those tests have not been validated as clinical diagnostic tests, and Fine's own data on his website suggests that they are not very predictive of long-term response to a gluten-free diet. Try gluten free and casein free and see if you feel better. If you don't feel better, don't worry about traces of fecal IgA. You are right at the edge of the reference ranges anyway.

Glutenease and other DPP-IV products are a scam. The enzyme does not cleave the problematic part of the gliadin molecule. It only cleaves terminal prolines (which is jargony but the only way I know to explain it). Most of the products like that are enzyme mixes, and bromelain and papian are really helpful for some folks.

Brain fog can be caused by a lot of things. Have you had your thyroid and vitamin D tested?

[Sevenoclk]

It's only Enterolab. Those tests have not been validated as clinical diagnostic tests, and Fine's own data on his website suggests that they are not very predictive of long-term response to a gluten-free diet. Try gluten free and casein free and see if you feel better. If you don't feel better, don't worry about traces of fecal IgA. You are right at the edge of the reference ranges anyway.

Glutenease and other DPP-IV products are a scam. The enzyme does not cleave the problematic part of the gliadin molecule. It only cleaves terminal prolines (which is jargony but the only way I know to explain it). Most of the products like that are enzyme mixes, and bromelain and papian are really helpful for some folks.

Brain fog can be caused by a lot of things. Have you had your thyroid and vitamin D tested?

Thanks! I wonder if any good quality digestive enzymes will help if I'm just at the edge of the ranges? I had my thyroid tested and I take Vitamin D. I am feeling a bit better the last few days and I wonder if it's because I have been using digestive enzymes when I eat? I wonder whether that's all I've ever really needed? I may try papaya and bromelain next.

[Skylark]

Thanks! I wonder if any good quality digestive enzymes will help if I'm just at the edge of the ranges? I had my thyroid tested and I take Vitamin D. I am feeling a bit better the last few days and I wonder if it's because I have been using digestive enzymes when I eat? I wonder whether that's all I've ever really needed? I may try papaya and bromelain next.

It's certainly worth a try. There are also a lot of forms of gluten and casein intolerance. Not everyone who is intolerant has a celiac-style reaction. It may be that cutting back on gluten and casein is what you needed, or that the enzymes are breaking down something you react to. It takes very specialized enzymes to break down the bit of alpha-gliadin that celiacs react to, but it may be that you are allergic/intolerant to something else that the enzyme mix is breaking down.

(As far as the celiac enzymes, there is a mix in clinical trials but they are not generally available. DPP-IV is NOT part of the mix in clinical trials.)