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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

Itchy Skin
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21 posts in this topic

Last Friday I think I had a bad gluten experience. I went out for lunch with some coworkers, and I thought I ate safely. Within an hour of returning to work I felt dizzy and then I quickly ran to the washroom to vomit. Since them I have had itchy skin on my arms, I even wake up from the itchiness. I would appreciate some feedback.

Thanks!

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I frequently have itchy skin on my arms, mostly, but sometimes on my thighs and back. Mine happens without having been glutened. I think its another symptom of Celiac. I would love to know if anyone with more experience has any thoughts on this. I have no rash--just itch.

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I'm no expert, but I can certainly tell you that my 7 year old with celiac disease CONSTANTLY complains of itching on his back and arms. We work very hard to keep him gluten-free, so I think the itching is probably just part of condition.

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Are you aware of DH? It is the itchy skin rash that frequently accompanies Celiacs. Read more here: http://www.csaceliacs.org/dh_defined.php

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I have been having the same problem. I do not have a rash or anything that looks like DH but i cannot stop itching. It is dry and windy here in So Cal so i thought maybe that was it. I havent changed soap or detergent or anything but i am so itchy. If anyone knows a way to make it stop, please let me know.

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I have been having the same problem. I do not have a rash or anything that looks like DH but i cannot stop itching. It is dry and windy here in So Cal so i thought maybe that was it. I havent changed soap or detergent or anything but i am so itchy. If anyone knows a way to make it stop, please let me know.

<{POST_SNAPBACK}>

Same here, I get itchy mostly on my lower legs and it's been happening on and off for many, many years now. And, it doesn't take much scratching to make huge welts. I've tried almost every lotion available here, and my dermatologist told me to use a couple of creams but they didn't offer much help. There is never any outward indication--no bumps, no rashes, no redness, nothing just itching. I apply lotions and more lotions which don't really help, but at least my skin isn't dry. I also have one spot on my heel that seems to itch from the inside...it has even kept me awake at night--same thing, no outward indication. I've seen two different dermatologists and two allergists for it. <_<

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This whole road of finding I was gluten intolerant started with a severe itch that I had in my legs for about ten days. I went crazy. i knew I couldn't scratch or i would have no skin left. The doctor said that i had dermographism. No one really knows the trigger but it is a general allergic like reaction in the form of itching. if i were to scratch my skin say a line with my fingernail there would become quite a raised pink line that would take 10 minutes or more to go away. that is how he knew i had it. I have found over the years that staying away from any foods that I am sensitive to especially sulphites. nitrates and preservatives helps alot. I can go months and months without an incident. Gluten doesn't seem to be the direct culprit because i have now been gluten free for three years. It is like an autoimmune reaction.

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Thanks everyone for your input. I guess I need to try to determine other things that could be causing the rash in addition to possibly gluten. :)

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This whole road of finding I was gluten intolerant started with a severe itch that I had in my legs for about ten days. I went crazy. i knew I couldn't scratch or i would have no skin left. The doctor said that i had dermographism. No one really knows the trigger but it is a general allergic like reaction in the form of itching. if i were to scratch my skin say a line with my fingernail there would become quite a raised pink line that would take 10 minutes or more to go away. that is how he knew i had it. I have found over the years that staying away from any foods that I am sensitive to especially sulphites. nitrates and preservatives helps alot. I can go months and months without an incident. Gluten doesn't seem to be the direct culprit because i have now been gluten free for three years. It is like an autoimmune reaction.

<{POST_SNAPBACK}>

Debbie, thank you so much for the name!!!! That's it exactly. One day my legs looked like a raised road map! Now at least I know what it's called.

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Last Friday I think I had a bad gluten experience.  I went out for lunch with some coworkers, and I thought I ate safely.  Within an hour of returning to work I felt dizzy and then I quickly ran to the washroom to vomit.  Since them I have had itchy skin on my arms, I even wake up from the itchiness.  I would appreciate some feedback.

Thanks!

<{POST_SNAPBACK}>

Hello there Cindy,

I was diagnosed with Celiac Disease from a (promethius blood test, and a biopsy) 2 years ago. I have had an "itchy skin ever since I was diagnosed". I always thought maybe it was due to the weather, so I used oatmeal soap 'Aveeno' anti itch body wash, thinking it might help with the itchiness. In the beginning it did seem to help for the most part. On many nights though it didn't help at all, the itchiness wouldn't go away no matter what, would keep me up till 3 or 4am in the morning, and start to seriously affect my sleep.

Of course, now I realize using Aveeno soap (because of the oatmeal) was not the smartest or best soap to use, on my skin because of the oats due to my Celiac Disease. So I have stopped using what I call now the "evil" soap, and have thouroughly checked all of my other beauty products for any traces of gluten.

I have always believed as someone who has had Celiac Disease for 2 years that my itching was a symptom of my Celiac Disease. I mean it started around the exact same time, so that made sense to me.

I've always believed in a "connection" between my itching and having celiac disease, and the most frustrating thing for me was one day asking my gastroenterologist if he believed there was a connection, and him replying that, "Oh no, celiac disease having an effect on the skin like that would be so rare". Sometimes they would just look at me like I'm totally insane for asking such a question.

Doctors do not know how much we suffer, sometimes I feel unfortunatley that we are more educated then they are when it comes to our bodies, our symptoms, and how this disease is effecting us.

Anyways, Cindy, the first thing I would do, is look at the body soap your using make sure it is safe and gluten free, use a safe lotion (helps with itching) that is gluten-free!, make sure that the shampoo and conditioner is safe, your dishwashing liquid, your laundry detergent, make up, everything that you can come in contact with, toothpaste, everything! And see if this helps at all.

When it comes to itching I know all!! I have sufferred pretty badly from it. Luckily I don't have DH, Celiac's whom have DH suffer horrendously, and worse than me. But if I accidently eat something tainted that had gluten in it, I immediately break out in Hives, not fun. Itchy, red, inflamed, hard, bumps, tingling, all over; dermatologist grade creams don't work, I'm on a high dose of Prednisone right now to help with the intense itching. If I don't take the Prednisone, I'm not even able to wear clothes, the clothes feel horrible against my skin. It keeps me up till 3 or 4am in the morning, and just makes me absoutely miserable, to say the least. This is from one accidental ingestion of a product I thought was safe, and the allergist and dermatologist don't know how long the hives will last.

I'm not itching now due to 2 antihistamines, and 2 prednisone pills a day. I'm just really DROWSY. I finally have some peace though, and I can finally sleep through the night.

So, Cindy I too know a lot about itching! And I deffinitely believe there is a correlation between the itching and this disease.

I'm learning to cope with my hives, because my doctors can't tell me how long I will have them (they hope 2-4 weeks), I'm trying to pick myself back up and not let this beat me, I've never had hives before so (during what was a very good time for me), it knocked me off my feet, should I say. But they are not going away, I keep waiting, and my life is quickly passing me by.

I realize that waiting isn't the answer, and that I need to start living again despite being very uncomfortable sometimes! And that is what I'm trying to do! I got satin sheets! My husband keeps sliding off in the middle of the night :lol: , I wear 100% cotton clothes, or sometimes nothing but my underwear and a throw if my skin is too sensitive, and I make sure that gluten mistakes don't occur, can't occur! As much as I can darn well help it. Because I never ever want to itch like this again, (so I do my best to avoid it), so I'm so much more careful, than I ever have been before.

Cindy, I guess what I'm trying to say is this, I do think itching is part of Celiac Disease for some people. It doesn't necessarily have to be DH or hives, just plain old annoying itching.

If you ever need to talk to anyone when your frustrated, and can't sleep due to itching, write me! I'll talk to you! I'm used to this symptom, me and this symptom go way back. It's a hard symptom to deal with. But it does not last forever. There is an end to it. So if you need to talk or vent to anyone about it, you can feel safe to do so with me, anytime,-

Bye, Kim.

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I do not have celiac disease. I have not yet tested for non-celiac gluten sensitivity. I am a postive Type II, Delayed Food Reactions - all grains except oats and rice.

I itched steadily for 10 years! Mostly this was in the evening and into the night. I used to have a friend spray me with Solarcane before I went to bed so I could sleep.

I had every allergy patch test known to man. All negative.

I finally found my way to a chiropractor/nutritionist who took the blood samples and sent them to Immuno Labs in FL. - thus the Delayed Food Reaction diagnosis.

No one mentioned gluten. I just stopped eating produdcts that had flour in them. Within a week the itching had virtually stopped. I would have brief 'attacks' - usually much milder than what I had for so long. This almost always happened when I went to a restaurant.

There were other foods on my reactive list. Most trigger GI issues rather than itching but to this day itching is still my first warning that I have gotten something I can't handle.

Initially I itched head to heels. Later it became localized. Sometimes an arm, then after awhile that would change to a leg. It would move around the body - always remaining in one spot for quite awhile and then change location.

It still happens but not often and nothing really serious like it once was. I am Gluten-free Casein-free and watch a whole lot of other reactive foods. Claire

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My sister and I both have suffered through this itching too. We found quite often it is set off by the water. We both had water softeners installed in our homes, which helped tremondously, we live in an area with very hard water. There are times here that I will get to itching after a shower too--it's usually worse after a shower and yes, I do read the ingreds of my soaps, shampoos, etc. Sometimes at work, out of the blue I will start itching. It gets red with streaks like all of you have stated and then goes away after a while. I to believe it to be a celiac thing. I also agree that doctors dont realize how much we go through as celiacs and yes, I also feel we know more about this disease then they do. The doctor I am going to admitted to that fact, but he also said he will be happy to learn all he can from me--that's a start. Deb

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I have to take a pair of scissors or a letter opener to scratch my back all the time. I can't get my 17 ear old son to scratch it for me ("euw mom <_< " ) There is no rash. As far as I know, I have not been glutened, but I'm still learning.

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My son had very itchy skin,he also couldn t have a proper night sleep,after eliminating gluten ,casein ,and soy, he dosen t itch at all,it took about 6 weeks to see the difference,and dot better and better with time,he gets the itchy skin if gets gluten or casein.

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Thanks for that thorough reply Kim. A couple of people have mentioned a relationship between casein and rashes. I have not heard about this before. Does anyone have any information?

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That stinks that you got sick at lunch-definitely sounds like you were glutened.

I itch like crazy, too.

No rash, but once I scratch myself raw I have scabs on my arms and feet. It's awful and it comes and goes. Sometimes I don't have it, then for awhile I will...it's odd.

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Thank you for this thread and I am glad I am not just crazy! I have never had "food allergies" and yet I know I have been affected by them in the past. I just lived with it, thinking it was just "something I ate." Now after being gluten-free for 2 months, with dramatic results (hey, I didn't know it wasn't normal to have these symptoms - they were just like other family member's symptoms! :blink: ) and improved health, I am having a serious reaction to "something." I posted the thread "weird reaction" after waking up with hives at 4 a.m. in the morning. The hives continue to drive me crazy, now a day and a half later. They worsened considerably after running through an airport to catch a flight -- head to toe red itchy splotches that felt like they were burning with itchiness. After cooling down it got better, but I'm still having an itch-o-rama after arriving home. :o

So here's my question (which Claire and others alluded to): after going gluten-free, does it make your symptoms worse when you do get gluten? Everything I have experienced seems to indicate that the answer is YES. I *never* had symptoms like I do now!!

So if you eliminate the gluten and your body's auto-immune reaction to it, does it then "kick up" the reaction to other foods you might be sensitive to? My Enterolab casein sensitivity test was positive (got it just about 3 weeks ago) but have been traveling and so was waiting to go CF until coming home -- now.

Do allergy tests indicate auto-immune responses to food proteins? I am guessing they are not too precise as my son tested negative for ALL foods, yet has celiac disease and also tested positive for casein sensitivity the same time I did. Therefore, how do you go about identifying the cause of things like hives if they are related to food protein response rather than a "traditionally identified" food allergy? Who is the appropriate professional to seek out? I refuse to live with these hives without actively searching for their cause -- but I do not believe that meds are the way to "fix" something that can be cured with finding the right culprit and changing your diet. Anyone have any experience to share with a successful diagnosis of the causes?

I was also reading about hives in general and found several places that suggested that they may be due to yeast or bacterial overgrowth. This was interesting to me in that I have had chronic bacterial issues for years. One of the "dramatic health improvements" I have experienced since going gluten-free is that the "chronic sinus infection" that I have had on and off for 3 years has abated. I need more data to conclude that going gluten-free was the exact reason, but at this point it seems fairly obvious since I had one for 3 months when I started gluten-free and now I don't. I have not changed anything else.

Sorry for the long post -- but please share if you have some advice, suggestions or experiences!

Thank you all for the time you take to share information!!! I have found more information applicable to my health from you guys than I have from any doctor I've ever visited! Thanks!

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Do allergy tests indicate auto-immune responses to food proteins? I am guessing they are not too precise as my son tested negative for ALL foods, yet has celiac disease and also tested positive for casein sensitivity the same time I did. Therefore, how do you go about identifying the cause of things like hives if they are related to food protein response rather than a "traditionally identified" food allergy? Who is the appropriate professional to seek out? I refuse to live with these hives without actively searching for their cause -- but I do not believe that meds are the way to "fix" something that can be cured with finding the right culprit and changing your diet. Anyone have any experience to share with a successful diagnosis of the causes?

I was also reading about hives in general and found several places that suggested that they may be due to yeast or bacterial overgrowth. This was interesting to me in that I have had chronic bacterial issues for years. One of the "dramatic health improvements" I have experienced since going gluten-free is that the "chronic sinus infection" that I have had on and off for 3 years has abated. I need more data to conclude that going gluten-free was the exact reason, but at this point it seems fairly obvious since I had one for 3 months when I started gluten-free and now I don't. I have not changed anything else.

Sorry for the long post -- but please share if you have some advice, suggestions or experiences!

Thank you all for the time you take to share information!!! I have found more information applicable to my health from you guys than I have from any doctor I've ever visited! Thanks!

I am reposting this piece that alerts to this possibility for continued symptoms:

High Prevalence of Small Intestinal Bacterial Overgrowth in Celiac Patients with Persistence of Gastrointestinal Symptoms after Gluten Withdrawal.

OBJECTIVE: Celiac disease is a gluten-sensitive enteropathy with a broad spectrum of clinical manifestation, and most celiac patients respond to a gluten-free diet (GFD). However, in some rare cases celiacs continue to experience GI symptoms after GFD, despite optimal adherence to diet. The aim of our study was to evaluate the causes of persistence of GI symptoms in a series of consecutive celiac patients fully compliant to GFD. METHODS: We studied 15 celiac patients (five men, 10 women, mean age 36.5 yr, range 24-59 yr) who continued to experience GI symptoms after at least 6-8 months of GFD (even if of less severity). Antigliadin antibody (AGA) test, antiendomysial antibody (EMA) test, and sorbitol H2-breath test (H2-BT), as well as esophagogastroduodenoscopy (EGD) with histological evaluation, were performed before starting GFD. Bioptic samples were obtained from the second duodenal portion during EGD, and histopathology was expressed according to the Marsh classification. To investigate the causes of persistence of GI symptoms in these patients, we performed AGA and EMA tests, stool examination, EGD with histological examination of small bowel mucosa, and sorbitol-, lactose-, and lactulose H2-breath tests. RESULTS: Histology improved in all patients after 6-8 months of GFD; therefore, refractory celiac disease could be excluded. One patient with Marsh II lesions was fully compliant to his diet but had mistakenly taken an antibiotic containing gluten. Two patients showed lactose malabsorption, one patient showed Giardia lamblia and one patient Ascaris lumbricoides infestation, and 10 patients showed small intestinal bacterial overgrowth (SIBO) by lactulose H2-BT. We prescribed a diet without milk or fresh milk-derived foods to the patient with lactose malabsorption; we treated the patients with parasite infestation with mebendazole 500 mg/day for 3 days for 2 consecutive wk; and we treated the patients with SIBO with rifaximin 800 mg/day for 1 wk. The patients were re-evaluated 1 month after the end of drug treatment (or after starting lactose-free diet); at this visit all patients were symptom-free. CONCLUSIONS: This study showed that SIBO affects most celiacs with persistence of GI symptoms after gluten withdrawal.

Blood testing for reactive foods can be helpful but is far from foolproof. It tends to error on the side of false positives. It does usually identify the real culprits but it is hard to sort them out if it gives you too many that are not valid. In my case there were foods that I already knew were a problem, some that I didn't know about that were genuinely problematic. There were also about 10 that I had doubts about. Those are the ones you subject ot a personal elimination test. Take each one away for a week or two - then reintroduce. If there are no symptoms - keep that food in your diet and go on to test the next 'suspicious' one. Claire

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What do you guys do for itchy relief? It usually takes about an hour for me to feel not compelled to cut off my skin. I scratch so much it turns to welts. I stand in the shower and let cold water run on my legs. I take allergy pills like allertec. I the put DML lotion on and stand in front of the fan. It's unbarable. There is usually no rhyme or reason for the itchiness.

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What do you guys do for itchy relief? It usually takes about an hour for me to feel not compelled to cut off my skin. I scratch so much it turns to welts. I stand in the shower and let cold water run on my legs. I take allergy pills like allertec. I the put DML lotion on and stand in front of the fan. It's unbarable. There is usually no rhyme or reason for the itchiness.

This thread is 7 years old so these posters are not around any more. There are more current threads about this. Look under the DH section.

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I just came across this post on Google actually, so i know it's not exactly one that has been answered anytime recently.

 

I have struggled with this though, and i couldn't seem to figure out why (i was told i was gluten sensitive, but that was with idiotic doctors who both did my blood test while i was on a gluten free diet, so i need to consult with a physician who knows what they're doing to differentiate). Anyways. 

 

At first i was going insane, as the itching would be so bad that it would keep me up at night. Often times i'd wake up with bruises on my legs and skin under my nails. I'd tried every moisturizing cream, every medication, every anti-itch cream and every holistic suggestion. Absolutely NOTHING has worked outside of taking a warm shower, but that only works for about 5/10 minutes (basically it soothes it for a very short period of time). Whenever my skin acts up with any sort of problem, a warm shower always seems to help. Sometimes it'll be so bad i'll take a sleep aid, and when i feel really drowsy hop into the shower so during that ten minute period i can finally fall asleep. it can I digress.

 

It's nice to know that this may be tied to my inability to consume gluten. Being on this board has taught me more and more that my physicians were (sadly) unable to. For anybody who's okay with holistic treatments/oils - i have found that eucalyptus helps a small bit to reduce the itching, but by means does it cure it. I've already looked at every area of my life to make sure i wasn't having a reaction to anything or cross contaminating, and this seems like it may finally be an answer to what doctors told me was me 'whining over dry skin'. 

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    • Feeneyja and Captain NCGS, and Ironictruth It could be SIBO or it could be NCGS as Captain NCGS pointed out. see this research that matches your 84% of SIBO patients. https://www.celiac.com/articles/24058/1/Large-Number-of-Irritable-Bowel-Syndrome-Patients-Sensitive-to-Gluten/Page1.html Below I summarize their findings I quote “nearly 84% of the gluten- free placebo group showed a significant improvement in symptoms compared to just under 26% for the gluten consuming group.  This study confirms that a large number of patients diagnosed with irritable bowel syndrome are sensitive to gluten.  The team (of doctors) suggest that the term of IBS might be misleading (you think) and may change or delay an “effective and well-targeted treatment strategy in gluten sensitive patients”. “ This is in IBS patients already who fulfilled Rome III (lesion) criteria.  They should at least be considered Non-Celiac Gluten Sensitivity (NCGS) but that would be to admit NCGS is a real condition. If you are having NCGS symptom’s (Marsh Lesion) aka Rome III lesions then why is the diagnosis not NCGS instead of IBS?  The problem is most NCGS (apparently 84%) is misdiagnosed as IBS in a large number of cases or possibly SIBO in your case Feeneyja. Even when 84 % of those with IBS show sensitivity to gluten the diagnosis of Non-Celiac Gluten Sensitivity is not confirmed by a simple gluten antibody test and people  consider Non-Celiac Gluten Sensitive (NCGS at least in the medical community apparently) a myth rather they diagnosis someone’s digestive problems with IBS of an unknown cause instead of admitting gluten is the trigger thus allowing them to avoid what is considered a mythical diagnosis to some in the medical community. By all means if  you have been given an IBS or SIBO diagnosis insist at the least on a gluten antibody test and you may save yourself many years’ of suffering before the doctor’s figure out that Gluten is the trigger then you have hope for recovery if you get the right disease. And I don't mean NCGS. Because even this too is confusing low stomach acid I believe with IBS, NCGS and even SIBO. See my posterboy blog post about why  I think this is. JMG aka Captain NCGS I referenced the Columbia University Medical Center (CUMC)  research on NCGS that I think proves your point and mine. here is the care2 article that I think summarizes it well. http://www.care2.com/causes/new-study-confirms-existence-of-non-celiac-gluten-sensitivity.html NCGS is on the "Celiac Spectrum". quoting dr. hyman from the huffpost 5+ years ago and still people seem them as different diseases (or at least deny the existence of the one over the other) http://www.huffingtonpost.com/dr-mark-hyman/gluten-what-you-dont-know_b_379089.html "When you get these tests, there are a few things to keep in mind. In light of the new research on the dangers of gluten sensitivity without full blown celiac disease, I consider any elevation of antibodies significant and worthy of a trial of gluten elimination. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be “false positives.” That means the test looks positive but really isn’t significant. We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems." and the columbia research bears this out. ironictruth you want to catch it at the NCGS stage before it becomes full blown (villi burned to the ground) Celiac disease. You are right to run from the burning house (antibodies) causing you a weak but "positive" diagnosis. This concept of the biopsy "proven" diagnosis is archaic at best and barbaric at worse in this age of serology proven diagnosis of NCGS before the villi burns to the ground so to speak. see this online article by dr. rodney ford that discusses why this is today. http://drrodneyford.com/extra/documents/236-no-gold-standard.html and he too (though in minority) is forward enough thinking to diagnose his patients with serology alone. Why would we use a standard 60+ years old when modern medicine can diagnose the disease much better and much, much sooner than what till there is stage 3 marsh lesions. The dgp test you had can diagnose it the intraepithelial lymphocytes (IEL)  stage. That is good news.  The villi are already smoking (using my analogy) of a burning house from antibodies attacking the body. Problem is and I mean this as a complement to SIBO girl and Captain NCGS (I was this in an article about the ZIKA outbreak patients talking how much more they (those affected by the disease) knew than their doctor's who where treating them at the time) we (us) have become doctor's without diplomas'. One of us each has become an expert at recognizing SIBO, NCGS and Pellagra. The question is which one is right??? Maybe we are all right by degrees. I believe NCGS can be confused for SIBO. But I also believe and the research confirms it in my mind that low stomach acid mimics many of the symptom's of both SIBO and NCGS. So that tells me there is still a disease not yet correctly identified. To me the disease that answer's the most questions in my mind is Pellagra. Ironictruth, Freneyja, JMG taking a b-complex can disprove or prove this theory. here is the full paper by Prousky. http://orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml decide for yourself but people routinely get better in 3 months time of taking  niacinamide 2 to 3 times daily or a b-complex and niacinamide 3/day for 3 months. The dosage does not matter.  It is the frequency. And a month will be enough to see improvement (100 count bottle).  I used to recommend to my friends a 100 count bottle because it was the most common way to find either Niacin/Niacinamide or a b-complex but when I found out your body could store 3 months worth in the liver and my experience with b-2 (riboflavin) and angular cheilitis (look it up on google images if you don't know what it is) for years probably 5+ I could not get rid of it for nothing. And I took b-2 (for a 100 count round) once before but learned b-vitamins needed to be taken frequently for best effect. So I bought a 300 count bottle (3 months worth) and took them (b-2/riboflavin) 2 to 3 day and the angular cheiliitis (leaking lips, cracked fissures at the side of the mouth) and it was nice and crusty went away and they have never come back since. but this was after I took the B-3 Niacinamide for a couple months firsts then I was able to absorb the b-2 (riboflavin) now and I put this condition in remission (i did not say cure) because if I get low again it might come back but remission. The same thing happened to my GI problems associated with NCGS (serology positive celiac diagnosis) without a biopsy proven (thank God) diagnosis. And that is my story. I would suggest jmg, feeneyja and you too too ironictruth buy a b-complex and see if a couple three months regimen might help put your GI symptom's in remission. we already know from research 5+ years ago that b-vitamins help celiac's with their well being. https://www.celiac.com/articles/21783/1/B-Vitamins-Beneficial-for-Celiacs-on-Gluten-Free-Diet/Page1.html quoting "For 6 months, patients received daily doses of either a placebo, or of B vitamins in the amount of 0.8 mg folic acid, 0.5 mg cyanocobalamin and 3 mg pyridoxine." They summarize quoting "These improvements, the normalization of tHcy levels, together with the substantial increase in well-being, led the research team to conclude that people living gluten-free with long-term celiac disease do indeed benefit from daily supplemental doses of vitamin B, and that doctors should consider advising the use of B vitamins supplements for these patients." So I am just saying what the doctor's recommend when recommending Niacinamide for your GI problems that Pellagra could be mimicking (masking the true cause) hence the 58% of celiac also have pellagra (that a majority) of Celiac's also are known to have. I am not a doctor.  But You can be a professor though with a masters so while I do preach Pellagra as a co-morbid condition of NCGS/Celiac disease it is only because the doctor's with diploma's research bears this out. So I try and make more people aware of this fact. (no I do not have  a master's either though a friend once said who has a masters said my research would qualify me if I had taken the courses) (And yes I know B-3 was not studied in this paper) but maybe now is the time to point out it should bee! Or SIBO girl, and Captain NCGS you can try it (B-3) for yourselves and see if it helps you the way it did the Pellagra kid/posterboy. If you want to study this topic more I summarized many of thoughts in this posterboy post https://www.celiac.com/gluten-free/blogs/entry/2103-why-and-how-pellagra-is-often-confused-with-celiac-disease-andor-other-gidigestive-problems-the-science-of-pellagra-a-hidden-epidemic-in-the-21st-century-presentingrevealing-as-ncgs-andor-possbily-celiac-disease/ I wrote a blog post that also said "I had Celiac disease but developed Pellagra" but I really think it is the other way around. (it is linked in the above post) if you want to read it there so I won't post it again. I was a pellagrain who was diagnosed first as a celiac.  The same way a SIBO might first be diagnoses as a IBS or NCGS patient.  Or the way a NCGS is first diagnosed as a IBS patient 84% of the time. Remission is possible I believe if and when you find the right/correct disease. And any of these GI conditions can be confused for the other and SIBO girl and Captain NCGS makes good points. But it seems to me Pellagra can be confused for not only the SIBO, NCGS, but if the research is right 58% (the majority) of Celiac's and it is easily reversible in 3 months time. You will not know if you are not willing to try it. **** this is not medical advice just deep research and my own experience with taking Niacinamide. But I will say  I am not the only one who has been helped on this board taking Vitamin B-3. I want you Iroinctruth, Feeneyja, Jmg to be the next ones. I know this post is way too long as usual but I had a lot of ground to cover. quoting a friend 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included. posterboy by the grace of God,
    • After my crash and burn gluten challenge of 2016, I wander off yet again Into the land of eastern and alternative medicine to heal. While I am grateful to many (not all) western medicine  Dr s of the past , for the past 2 decades the ones who give me relief for my lifetime ails are the alternative/eastern practitioners. I'm not starting a debate as both branches have their strengths, often the shame is they are seperated in healthcare, for likely humanity and public health imo would be best served by their encouraged collaboration/mutual recognition,but alas not my problem to solve. Much bigger then me and quite frankly, I'm too busy healing to tackle that mountain. Regardless, I now have "shoes that fit my carpet bag " of decades of multiple misdiagnosis /undiagnosis collection. They can be combined and labeled celiac and fibromyalgia. I was shocked at first at the news, I consider those really serious. Is AWOL really that ill? I've read up more  on both disciplines descriptons etc for these conditions, I'm in shock for the "shoes" fit perfectly . I know based on western test results I'm far from textbook/ gold standard celiac (but I failed to get past day 6 of my gluten challenge -likely speaks for itself) and fibromyalgia is quite demeaned/dismissed from my past knowledge amongst the western medicine world and greater society. (Friends /family in western medical fields) Is this still the case? My lifetime gi issues, the 30 plus years multiple chemical sensitivities ( go back to childhood-I keep very close to the vest), 20 plus years symptoms of muscle issues / myalgia, now have the names of celiac & fibromyalgia. Mixture of feelings of relief to be recognized, but also knowing my named illnesses are likely not recognized or are minimised by my western medicine trained family and friends and greater society. Can anyone offer some encouragement to help me cope at this time of healing? My accupuncture visits have been truly helpful, but my last visit is giving me a lot to process chemically, biologically, and spiritually. It's like someone unleashed the flood gates of all the symptoms of both illnesses at once in a combined package for me to experience in a one transparent package.  Very enlightening and to be blunt I feel like crap. So it's time to accept the package names and all, the curtain was lifted and the waxing and waning symptoms of fibromyalgia we're released. Please share any positive support or stories you have on coping with celiac recovery, celiac/fibromyalgia, and  healing by accupuncture. It will be much appreciated. As it is abundantly clear AWOL is here to stay on the celiac.com forums. Thanks  
    • https://www.celiac.com/gluten-free/topic/116482-supplement-and-foods-you-take/ ^ I did this a while back where some of us have posted what we take and eat to get our nutrients. Mines changed a bit since then since I can not eat any grains, sugars or fruits.
    • I take 2 Slice of Life gummy multivitamins and drink 2 Ensure high protein per day. Both are gluten free.
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