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How Much Gluten, For How Long, Must You Eat Before Testing?

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We are in a position to answer the original question. We are not in a position to tell his doctors how to diagnose celiac disease. We are all aware that some doctors still insist on a positive biopsy result before making a diagnosis. We don't know why the OP is concerned--maybe a documented diagnosis is needed to get accommodations at school, or for some other reason.

I see nothing in the OP to say that a diagnosis of celiac disease has already been made.

He has positive blood tests, and his medical team want to do a biopsy. He has a question about that. Let's keep our responses to that question. The member posted once, looking for an answer. He hasn't been logged on since before Tom's first reply. When he comes back, he will see this mess.

He did not ask us to diagnose--he asked about the accuracy of the biopsy under his specific circumstances. Please confine your replies to the original question.


Diagnosis by biopsy of practically non-existent villi; gluten-free since July 2000. I was retested five years later and the biopsy was normal. You can beat this disease!

Type 1 (autoimmune) diabetes diagnosed in March 1986

Markham, Ontario (borders on Toronto)

Celiac.com - Celiac Disease Board Moderator since 2007

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I would love to live in a world where each and every doctor would diagnose based on positive blood work regardless of biopsy result. I just don't think that is our current reality.

......as it was back in 2005.

I knew the minute I posted that article that the date of it would be used as a reason to dismiss it.

The truth is, it would be great if everyone had a positive blood test too. There is more work getting a "proper diagnosis" than there needs to be.

I still think the article raises one important issue: many studies conclude with a different opinion about biopsies and "how much gluten is enough".

I still can't find a definitive answer , but the “suggested” average is 2--3 months (Dr. Green) and the Univ. of Chicago Celiac Center information Karen has posted.

The most recent article I read (2012)

regarding the gluten challenge discussed a 2 -week challenge with "just 1.5 pieces of bread"

and provided this conclusion: "over 75%" of the 20 people” in the study "met the criteria for celiac disease".

However, it should be noted that these were 20 adults with biopsy-proven celiac disease, so I do not see how that is at all relevant to the OP's situation.

The article I posted, despite it being dated, says essentially the same thing Dr. Green and others have said:

“A variety of opinions have been offered regarding how much gluten, for how long, should result in a definitive biopsy. The reality is that no such recommendation is consistent with the medical literature “

If the doctor is following the protocol of the "gold standard" which requires a positive biopsy as a means of determining that someone has celiac, then what choice does someone have but to go gluten heavy (and I used that term just to differentiate it from gluten light) and hope for the best.

This whole discussion is based on the fact that the allergist said: go gluten free and now, the GI thinks 7-10 days is sufficient for a gluten challenge.

Maybe it is.

But, if the biopsy is negative, then what?

The OP still has positive blood work. Those of us who tested negative on celiac blood panels would have found that sufficient and it would have spared us years of illness.

Hopefully, s/he will adopt a strict gluten-free diet and never look back.

As more and more of these threads about the gluten challenge appear, I think maybe we all need to say "we don't really know" more often.

As for me, I will just avoid them from now on. :lol:

"Life is not the way it's supposed to be. It's the way it is. The way we cope with it makes the difference." Virginia Satir

"The strongest of all warriors are these two - time and patience." Leo Tolstoy

"If you want to lift yourself up, lift up someone else" Booker T. Washington

“If idiots could fly, the sky would be like an airport.”― Laura Davenport 

"Do or do not. There is no try. "-  Yoda.

"LTES"  Gem 2014


Misdiagnosed for 25+ years; Finally Diagnosed with Celiac  11/01/10.  Double DQ2 genes. This thing tried to kill me. I view Celiac as a fire breathing dragon --and I have run my sword right through his throat.
I. Win. bliss-smiley-emoticon.gif

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