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Gluten Sensitive? Neg Test Results


birdie22

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birdie22 Enthusiast

Could I still be gluten sensitive with few symptoms and normal test results?

About a year ago (about 6mos after the birth of my 2nd child) I started having daily heartburn. I attributed to hormone fluctuations. In Sept 2010 I had the Mirena IUD inserted and a month or so later started having severe bloating episodes a few times a month, I was also having cyclical headaches, extreme fatigue and canker sores. After about 9mos I had the Mirena removed thinking that it was causing these symptoms. A few months after removed the symptoms continued. The bloating seems to happen about once a week or 1-2x's every other week. The canker sores happen at least monthly. The bloating makes me look pregnant and I feel great discomfort right under my rib cage. The heartburn I notice most at the base of my throat. It isn't severe, but noticeable. Since the symptoms hadn't resolved I took up the issue with my GP. She had me do a 6wk trial of prilosec and an upper GI to rule out GERD and hernia. Prilosec corrected the heartburn, but not the bloating. Upper GI was normal. Had blood tests for liver profile, CA 125, anti-tTG IgA and IgA. All results were normal.

Anti-tTG IgA was <10 (reference range 0-19)

IgA was 221 (reference range 70-400)

Since those tests were normal but discomfort continued I had an abdominal CT done. Results were also normal (aside from a few incidental benign findings).

GP suggested a trial of elimination diet. She first had me do only chicken, rice, banana for a week then slowly add in veggies, meats, dairy, gluten, etc. Right now I am doing gluten-free, but have added in everything else.

Could I be gluten sensitive if only symptoms seem to be bloating that gets worse as day progresses and resolves overnight, plus monthly canker sores? My GI health is otherwise normal. I'm not constipated, nor do I have diarrhea. No cramping. No painful gas. Just stomach bloating that is visible and uncomfortable.


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nora-n Rookie

The most common form of celiac nowadays is patchy celiac, and the ttg test is known to only be close to reliable with total villous atrophy. even then it misses 20% or more (depending on how hight the trhreshold in the lab is set) of those with severe celiac.

With patchy celiac, only 40% will test positive.

Now the newest test, the deaminated gliadin test, is much better at picking up patchy celiac.

chrissyinnj Apprentice

Also, I have read on several sites (plus my lab) now that the AGA (anti-gliadin antibody) is an indicator of gluten sensitivity (NCGS) You might want that test run as well.

My son's results were negative for the celiac tests and strong positive for the AGA. (He was back on gluten for 9 weeks when the test was run). The lab noted that it was an indicator of gluten sen and he may want to try a gluten free diet. btw- He had responded to the gluten-free diet before we decided to run the tests.

birdie22 Enthusiast

Thank you for those two suggested tests. I am assuming that as with the other tests I would need to have gluten in my diet at the time of testing?

nora-n Rookie

Yes you would still need to eat gluten, but the IgG versions of these antibodies often hang around much longer, up to a year. I can

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    • trents
      Not necessarily. The "Gluten Free" label means not more than 20ppm of gluten in the product which is often not enough for super sensitive celiacs. You would need to be looking for "Certified Gluten Free" (GFCO endorsed) which means no more than 10ppm of gluten. Having said that, "Gluten Free" doesn't mean that there will necessarily be more gluten than "Certified Gluten" in any given batch run. It just means there could be. 
    • trents
      I think it is wise to seek a second opinion from a GI doc and to go on a gluten free diet in the meantime. The GI doc may look at all the evidence, including the biopsy report, and conclude you don't need anything else to reach a dx of celiac disease and so, there would be no need for a gluten challenge. But if the GI doc does want to do more testing, you can worry about the gluten challenge at that time. But between now and the time of the appointment, if your symptoms improve on a gluten free diet, that is more evidence. Just keep in mind that if a gluten challenge is called for, the bare minimum challenge length is two weeks of the daily consumption of at least 10g of gluten, which is about the amount found in 4-6 slices of wheat bread. But, I would count on giving it four weeks to be sure.
    • Paulaannefthimiou
      Are Bobresmill gluten free oats ok for sensitive celiacs?
    • jenniber
      thank you both for the insights. i agree, im going to back off on dairy and try sucraid. thanks for the tip about protein powder, i will look for whey protein powder/drinks!   i don’t understand why my doctor refused to order it either. so i’ve decided i’m not going to her again, and i’m going to get a second opinion with a GI recommended to me by someone with celiac. unfortunately my first appointment isn’t until February 17th. do you think i should go gluten free now or wait until after i meet with the new doctor? i’m torn about what i should do, i dont know if she is going to want to repeat the endoscopy, and i know ill have to be eating gluten to have a positive biopsy. i could always do the gluten challenge on the other hand if she does want to repeat the biopsy.    thanks again, i appreciate the support here. i’ve learned a lot from these boards. i dont know anyone in real life with celiac.
    • trents
      Let me suggest an adjustment to your terminology. "Celiac disease" and "gluten intolerance" are the same. The other gluten disorder you refer to is NCGS (Non Celiac Gluten Sensitivity) which is often referred to as being "gluten sensitive". Having said that, the reality is there is still much inconsistency in how people use these terms. Since celiac disease does damage to the small bowel lining it often results in nutritional deficiencies such as anemia. NCGS does not damage the small bowel lining so your history of anemia may suggest you have celiac disease as opposed to NCGS. But either way, a gluten-free diet is in order. NCGS can cause bodily damage in other ways, particularly to neurological systems.
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