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Verbal Diagnosis--Push For More Testing?


Kerceli

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Kerceli Newbie

Hello!

I'm posting in need of some advice. I have been mostly gluten free for years now (and now strict gluten free since my recent problems..to be explained). I would always take bites of non gluten free things here and there if I wanted a

taste and never worried about contamination, but probably within the last 6 months I noticed I could no longer take little bites of things with gluten because I got horrible stomach aches and headaches. In August, I went out for dinner with friends and it was family style. I was stupid and didn't speak up about my needs so I ended up eating a lot of gluten containing food thinking oh well I'll just bear the stomach ache (this was the most non gluten-free I had had in a longggg time). Well it made me so horribly sick for a week. I couldn't eat at all. I was nauseas 24/7, had C and D, depression, anxiety, cloudy head, body aches.... Just overall felt like HELLLLL.

I called my doctor asking for a blood test. It came out negative. I then asked for a endoscopy. My doctor said I would have to eat gluten for two weeks in order for anything to show up regarding celiacs. I told him the sickness I endured was so horrible I couldn't do it again. He said there is no other option for testing though. He placed 'celiac disease' in my medical record. I am now living as a celiac... Worried about contamination, checking labels feveriously... I have found since being more careful, I react to contamination issues now, which is a first. I feel like I have all the symptoms of celiacs, but do I just go about my life saying I'm celiac when I don't really know for sure?? Any advice or thoughts would be helpful. Thanks so

much guys.


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ravenwoodglass Mentor

Your doctor has confirmed you are celiac and it is in your medical record plus your body tells you clearly when you eat gluten. IMHO you have a great doctor. Make sure he does a vitamin and mineral panel on you to check your levels and do urge 1st degree family members to get tested.

Takala Enthusiast

You can at least call yourself severely gluten intolerant. You could also opt for over the counter genetic testing, if you were curious to see if you do indeed have the official genes which go along with celiac. That doesn't prove anything, but can put you in the class of celiac disease being the more likely probability. You could say your diagnosis is based on a gluten challenge failure. But the "celiac" in the medical records will in some regards help you in the future if you develop related conditions, because then there is an official "reason" to test you or suspect that you may have said related conditions, because you are at higher risk. And it also means that when you undergo any medical procedures or get a pharma prescription, you have a reason to tell them to be sure you don't come in contact with gluten. Be sure to put this information in at anywhere you get prescriptions filled, also, under the "allergic to" warnings- to avoid gluten, wheat, rye, barley.

If your relatives and friends take it more seriously with the "celiac" label, then that may also be a factor in what you chose to use.

DavinaRN Explorer

My blood test was negative (my endocrinologist ran it for me because I would feel sicker once I ate to raise a low blood sugar than I did with the low). She explained that the test wasn't 100% accurate, but there really is non-celiac gluten intolerant. She offered referral to GI for further testing if I needed diagnosis. I opted not to and have been gluten free almost 10 weeks; feeling better than I have in a very long time. With research, I'm thinking I have had issue since late teens possibly. Wondering what my primary doctor will have to say.

Kerceli Newbie

Hey guys thank you all so much for your responses and advice. Takala i didnt think about putting in my med record an allergy to wheat, rye, barley, etc. thanks everyone this community is invaluable!

gatita Enthusiast

I agree you have a very advanced doctor. Because I don't have the word "celiac" in my record, I'm having a hard time getting a GI referral that my insurance will cover. It's very frustrating....

So it sounds like your diagnosis is a good thing that may help you get any additional testing you need.

Kerceli Newbie

Hi gatita, my doctor told me there is nothing more that can be done if I don't want to have gluten for two weeks and then go get a endoscopy. So I guess other than signaling doctors of my "allergy" (at the least) its good. But I wish I could actually find out. I need to check out the over the counter genetic testing.


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ravenwoodglass Mentor

Hi gatita, my doctor told me there is nothing more that can be done if I don't want to have gluten for two weeks and then go get a endoscopy. So I guess other than signaling doctors of my "allergy" (at the least) its good. But I wish I could actually find out. I need to check out the over the counter genetic testing.

Please do keep in mind that genetic testing is only a small part of the diagnostic process. There are folks with the celiac associated genes that don't develop celiac and there are diagnosed celiacs that don't carry one of the two most commonly tested for genes. In the long run it is your bodies response to gluten that is the best diagnostic tool we have at present.

Madagascar Rookie

i had the genetic test run by prometheus labs - they test for 2 genes. the one that came up positive was the "A" gene. interestingly, we were going to have my DH tested by Xterra (not sure if i have that name right, but they do a cheek swab for $150) and discovered that they don't test for the A gene, only the B gene.

in other countries they test for up to 23 genes. so . . . genetic testing can be helpful, but it's not everything.

also, Prometheus labs said i was not likely to have celiac disease based upon where on the genetic strand my gene was, but i clearly have it. i think there is value in having the genetic test done if you have children, but there is obviously so much room for error that you can't go solely on it. i also had the antibodies done and my only positive response was in the TTG that came in at 29 with a positive diagnosis at 30. the Prometheus lab test for antibodies and genes cost . . . dun dun dun $940. i didn't know before i requested it how much it would cost, but because i have 3 young adult kids, we wanted to know. don't know yet how much the insurance will cover, but through me getting tested and learning i do have one gene, my brother and his kids have all gone gluten free, and my 3 kids have all gone gluten free. we all had some signs, but not all the same (some skin, some digestive, some mental). everyone is feeling better, so it was worth it.

the gold standard test, however, is how one responds to the gluten-free diet. so with or without a diagnosis, if you feel better, go with it.

kerid Newbie

you can get the stool test. since the bowels are where the damage is being done, it makes sense to test there. on the website, they even say that you don't need to eat gluten first, as that can cause devasting effects to the person, and the antibodies are usually there for a while. here's the link to read up on it: (excellent read!!!) we are all getting the test done in january.

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Kerceli Newbie

Thanks guys!!!! :)

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    • trents
      I assume that you already know that genetic testing for celiac disease cannot be used to confirm a celiac diagnosis. About 40% of the general population has the genetic potential to develop celiac disease but only about 1% actually develop celiac disease. It can be used to rule out celiac disease with a high degree of confidence, however, in the case where the genetic testing is negative for the genes. Until and unless you are actually diagnosed with celiac disease I would not raise this as an issue with family. However, if you are diagnosed with celiac disease through blood antibody testing and/or endoscopy with positive biopsy I would suggest you encourage first degree relatives to also purse testing because there is a significant chance (somewhere betwee 10% and almost 50%, depending on which studies you reference) that they will also have or will develop active celiac disease. Often, there are symptoms are absent or very minor until damage to the small bowel lining or other body systems becomes significant so be prepared that they may blow you off. We call this "silent celiac disease". 
    • trents
      If you were off gluten for two months that would have been long enough to invalidate the celiac blood antibody testing. Many people make the same mistake. They experiment with the gluten free diet before seeking formal testing. Once you remove gluten from the diet the antibodies stop being produced and those that are already in circulation begin to be removed and often drop below detectable levels. To pursue valid testing for celiac disease you would need to resume gluten consumption equivalent to the amount found in 4-6 slices of wheat bread daily for at least two weeks, preferably longer. These are the most recent guidelines for the "gluten challenge". Without formal testing there is no way to distinguish between celiac disease and gluten sensitivity since their symptoms overlap. However, celiac disease is an autoimmune disorder that damages the small bowel lining, not true of gluten sensitivity. There is no test available for gluten sensitivity so celiac disease must first be ruled out. By the way, elevated liver enzymes was what led to my celiac diagnosis almost 25 years ago.
    • trents
      Then it does not seem to me that a gluten-related disorder is at the heart of your problems, unless that is, you have refractory celiac disease. But you did not answer my question about how long you had been eating gluten free before you had the blood antibody test for celiac disease done.
    • Xravith
      My genetic test results have arrived - I’m homozygous for DQB1*02, meaning I have HLA-DQ2. I’ve read that this is one of the genes most strongly associated with celiac disease, and my symptoms are very clear. I’m relieved that the results finally arrived, as I was getting quite worried since my symptoms have been getting worse. Next step, blood test. What do these results imply? What should I tell my family? I’m concerned that this genetic predisposition might also affect other family members.
    • Roses8721
      Two months. In extreme situations like this where it’s clearly a smoking gun? I’m in LA so went to a very big hospital for pcp and gi and nutritionist 
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