The Gluten Challenge

[peeptoad]

Hello. I'm new and I'm trying to determine if I have a gluten sensitivity/intolerance/whatever since I've been having moderate GI issues for about 5 years now. I've been gluten-free for about a month now, and plan on going another month before I "challenge" myself. So far, so good I do feel better overall and many of my GI issues have been reduced dramatically.

Anyhow, in regards to the actual challenge does anyone know the proper method for going about this?

Is a single serving of bread/pasta/etc enough or should I eat gluten for a few days and then revert back to gluten-free? Or is everyone different? I just want to do things properly, so I'm not wasting my time.

Thanks...

[Austin Guy]

I also felt really good after going gluten free, but now (100 days in) even the smallest amount of gluten just destroys me. I wouldn't eat a bread crumb for any amount of money.

[PainfulSpaghetti]

Welcome Peeptoad! Once your body begins to heal from the damage the gluten causes, it can be very hard on your system to introduce gluten back into it. Be very careful with your challenge, and try a small portion. Such as 1 cookie, or cracker. NOT a whole sandwich as I did. That was a bad idea for me!

[pain*in*my*gut]

Hello. I'm new and I'm trying to determine if I have a gluten sensitivity/intolerance/whatever since I've been having moderate GI issues for about 5 years now. I've been gluten-free for about a month now, and plan on going another month before I "challenge" myself. So far, so good I do feel better overall and many of my GI issues have been reduced dramatically.

Anyhow, in regards to the actual challenge does anyone know the proper method for going about this?

Is a single serving of bread/pasta/etc enough or should I eat gluten for a few days and then revert back to gluten-free? Or is everyone different? I just want to do things properly, so I'm not wasting my time.

Thanks...

Hi! It's not clear to me from your post if you are planning on self-diagnosis or getting actual testing done. If you are going to get the blood tests and/or biopsy, you will need to be eating gluten for at the minimum 6-8 weeks ahead of time (most docs prefer 3-4 months to avoid false negative test result).

There is no official amount of gluten you need to consume for a gluten challenge, but the equivalent of 3-4 slices of bread a day seems to be the recommended "dosage".

[peeptoad]

Thanks for the responses you guys.

Hi! It's not clear to me from your post if you are planning on self-diagnosis or getting actual testing done. If you are going to get the blood tests and/or biopsy, you will need to be eating gluten for at the minimum 6-8 weeks ahead of time (most docs prefer 3-4 months to avoid false negative test result).

There is no official amount of gluten you need to consume for a gluten challenge, but the equivalent of 3-4 slices of bread a day seems to be the recommended "dosage".

I was tested about two years ago when I originally went I went to my new (and current) doctor with GI complaints (chronic diarrhea, bloating, cramps, etc). She told me that I was negative for celiac and I was mailed some test results (I had many tests done for parasites, full blood chemistry, CBC, etc as well). The only test I can locate on my results that would have anything to do with celiac was a fecal test in which they looked for IgA. It was within the normal range, so I assume this means that I'm negative... however the GI issues continue to this day, and my GI doctor (not my primary care doctor who ordered the original test) has nothing else to offer, so I'm down to experimenting by myself.

But, anyway, on the challenge I guess I will try a small serving at first and see what happens over a few hours. Then maybe a bit more (like a full serving of food)? I did read on one site that for the challenge they recommended eating full servings of gluten at all 3 meals for an entire day. Just wanted to get some other opinions...

[ravenwoodglass]

Gluten reactions can be delayed. When I did my doctor guided elimination and challenge I was told to eat the suspect food in as pure a form as possible three times a day for a week or until I reacted. I challenged with Cream of Wheat and triscuts. It was day 3 before I reacted and then I called the doctor and asked if I should keep going for the rest of the week. His reply 'Good heavens no!'.

[peeptoad]

Gluten reactions can be delayed. When I did my doctor guided elimination and challenge I was told to eat the suspect food in as pure a form as possible three times a day for a week or until I reacted. I challenged with Cream of Wheat and triscuts. It was day 3 before I reacted and then I called the doctor and asked if I should keep going for the rest of the week. His reply 'Good heavens no!'.

Thanks a lot ravenwoodglass. That's helpful, especially since you were working with your doctor on the elimination.

[ravenwoodglass]

Thanks a lot ravenwoodglass. That's helpful, especially since you were working with your doctor on the elimination.

That doctor literally saved my life since I show a false negative on blood work. My GI wouldn't even consider celiac until I had seen the other doctor and once I was referred back to that GI he demanded another challenge that had very dire consequences. I hope you get some answers and some relief soon.

[peeptoad]

That doctor literally saved my life since I show a false negative on blood work. My GI wouldn't even consider celiac until I had seen the other doctor and once I was referred back to that GI he demanded another challenge that had very dire consequences. I hope you get some answers and some relief soon.

Thanks. I actually feel better already from being gluten free for a month.

Do you happen to know if the fecal antibody test is similar to the blood test in terms of accuracy? I think that's the only test I had done...

[ravenwoodglass]

Thanks. I actually feel better already from being gluten free for a month.

Do you happen to know if the fecal antibody test is similar to the blood test in terms of accuracy? I think that's the only test I had done...

You mention that the fecal test was for fecal IGA. Do you know if your total IGA was done with any of your blood work? If you have low total IGA then that would throw off the fecal IGA.

The best test is how you feel off of gluten. If your feeling better and symptoms are resolving then you have your answer. If you do want to have testing redone then that would require going back to gluten for about 3 months.

[peeptoad]

You mention that the fecal test was for fecal IGA. Do you know if your total IGA was done with any of your blood work? If you have low total IGA then that would throw off the fecal IGA.

The best test is how you feel off of gluten. If your feeling better and symptoms are resolving then you have your answer. If you do want to have testing redone then that would require going back to gluten for about 3 months.

No, I don't know for sure if I had bloodwork done for IgA, but I don't recall seeing anything else that looked like an antibody test anywhere on my lab results. Will need to check again. Regardless, you're right, the best test is how I feel.

I did just discover that the digestive enzymes that I take once in awhile have wheat in them though, but I still have 5 weeks before I plan on challenging, so hopefully it's completely out of my system by then. I think I've taken the enzymes maybe two or three times in the last month. Drats.

[peeptoad]

My "gluten challenge" officially started this morning. I just ate a poppy seed bagel with cream cheese and tomato. That's my favorite breakfast and I missed it over the last ten weeks. I'm going to keep eating gluten for about 7-14 days, or until I get a reaction, whichever comes first. I guess delayed reactions to gluten are common, and my reduction of symptoms when I went gluten-free happened gradually over about 2 weeks, not all at once.

Have to say I'm expecting a reaction. If I don't have one, then I'm not sure what to think...

If anyone has any advice, then fire away. Otherwise I'll just gluten myself 3x/day until something bad happens.

[Takala]

If anyone has any advice, then fire away.

Kinnickkinnick and Udi's makes gluten free bagels if you do react, but if you've contaminated your cream cheese with the regular ones, feed it to someone else

[peeptoad]

So, I'm now on day 5 of my challenge and my GI symptoms seem to gradually be returning. Is this normal for a gluten challenge? (as opposed to a sudden reaction, even if delayed by a few days).

The only thing that has returned "suddenly" so far is the skin issue I was having on my legs. That started back up yesterday and has gotten worse since yesterday morning. So I know that's definitely because of gluten at least.

[ravenwoodglass]

So, I'm now on day 5 of my challenge and my GI symptoms seem to gradually be returning. Is this normal for a gluten challenge? (as opposed to a sudden reaction, even if delayed by a few days).

The only thing that has returned "suddenly" so far is the skin issue I was having on my legs. That started back up yesterday and has gotten worse since yesterday morning. So I know that's definitely because of gluten at least.

Yes it can be normal. Not everyone has a sudden return to full blown GI distess.

[peeptoad]

Yes it can be normal. Not everyone has a sudden return to full blown GI distess.

Thanks. That's actually encouraging to me (sounds weird I know). I was actually relived to see the skin problems return because now I know there is at least one determined cause for something going on in my body. I'm so tired of negative lab tests and being told there is nothing really wrong with me.

[ravenwoodglass]

I'm so tired of negative lab tests and being told there is nothing really wrong with me.

You sure aren't alone there.

I have DH and for me the DH used to show up before the tummy issues. For me it is a three day wait for a reaction but in my particular case the GI reaction is sudden and nasty.

Everyone's body is different though and for some the build up is more gradual. Do keep your doctor in the loop and maybe do a diary of food injestion, days, and symptoms as that can be helpful at times.

[peeptoad]

You sure aren't alone there.

I have DH and for me the DH used to show up before the tummy issues. For me it is a three day wait for a reaction but in my particular case the GI reaction is sudden and nasty.

Everyone's body is different though and for some the build up is more gradual. Do keep your doctor in the loop and maybe do a diary of food injestion, days, and symptoms as that can be helpful at times.

I probably should keep my GI doctor in the loop... maybe will send him an email next week after I finish my challenge. I started a food diary yesterday, mainly just to keep track of what symptoms started up when and how severe (or mild) they are.

[peeptoad]

Well, the GI symptoms gradually returned over the past 7 days, and the past two mornings I was woken up by painful abdominal cramps. Also, oddly enough, I began to feel very depressed late last week (about 5 days into my glutening). Maybe this is a coincidence, but I see no reason to continue with the challenge. That's enough to convince me that I have some sort of issue with gluten. Back to the gluten-free sanctuary!

[peeptoad]

Alright, last update:

By day 7 of my gluten challenge the following IBS symptoms returned:

abdominal cramping (painful, these woke me up both Saturday and Sunday morning)

feeling of incomplete evacuation

mild nausea

bloating

fatigue (even after sleeping 9 hours on Friday night)

heartburn, which I never get and I got it without eating/drinking anything acidic (like alcohol)

plus the "hives" that were on my legs are back (these are mild, not really a problem, but interesting that gluten seems to trigger them)

So, I'm going back gluten-free and if all of this stuff goes away again, then I have the answer to the cause of my IBS.