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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 Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  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 What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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Hi all,

I'm a newbie to the forum, thank you already for the valuable information I've read from this web site.

I'm currently in the middle of a nine month gluten free diet, and drawing blood every few months for the antibodies.

My question is about the genetic profiles. I am HLA-DQ2 and HLA-DQ8 negative, but positive for the

HLA DQA1 05 allele. My understanding is that to get celiac with this profile is rare, and that when someone has celiac with half the DQ2 heterodimer it is most often with the Beta subunit, not the alpha (which I have).

Does anyone else have this profile with being positive for only the alpha subunit?

After 4 months of the diet, my TTGA has stayed around 25 (in the past it's been 25-35). My gliaden IGG in the past has been in the 40's, after 1 month it was still in the 40's, and after 4 months it became negative.

The vague GI symptoms I've had have improved since being on the diet. No more foul smelling gas or BM's. I've never had diarrhea.

Thank you.

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http://www.celiac.com/articles/21628/1/Cel...tics/Page1.html

What is this alpha and beta subunit typing and why is it important?

HLA DQ typing consists of two subunits of the DQ molecule, an alpha and beta subunit. So, both DQ types that indicate a risk of celiac disease, DQ2 and DQ8, are made up of two protein subunits designated alpha and beta. They determine the complex letter and number combinations reported. For example, the full DQ2 molecule is typically HLA DQA1*05xx DQB1*02xx. The A1 is the alpha unit and the B1 is the beta subunit.

The beta subunit is the most important component of the DQ molecule, but the alpha subunit has also been shown to carry an increased risk for celiac disease. Unfortunately, since testing for both is more complicated and expensive it is not always done.

Also, some think that since the beta subunit carries most of the risk and the alpha unit only minor risk, testing for only the beta subunit is adequate. Several clinical laboratories have chosen this approach. They only test for, and report on, DQ2 and DQ8 based on beta subunit types, so their results typically look like this: HLA DQB1*02 detected, DQ2 positive, etc. This is the policy of the laboratory at Bonfils, who also does testing for Quest Diagnostics and Enterolab as well as many hospitals. However, the alpha subunit of DQ2 also carries some risk for celiac disease.

What were your results?

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Thank you for your reply.

I do not have a specific haplotype (?) result. All I have from Prometheus is that HLA DQA1 05 was detected, and that I am DQ2 and DQ8 negative. They state that some celiacs do have half the DQ2 heterodimer.

Your reply confirms my reading in that most half DQ2 celiacs have the beta subunit and that celiacs with the alpha unit only are rare.

I have had two biopsies done (one with a longer scope) and both came up negative. A capsule endoscopy showed some villi that appeared blunted, but they looked more normal the further you went down the small intestine, and a comment on the report said this COULD be an atypical celiac presentation.

Also, the reason I had the celiac antibodies done in the first place was that I had some elevated liver enzymes most likely related to a minocycline induced hepatitis. In the liver doctor's workup she ran the celiac panel. I also have had a chronic inflammation pattern on the serum electrophoresis with IGG level at one point around 4,000, but now down to about 2,400 (still elevated). They also showed small monoclonal spikes, so I was worked up for myeloma, but that has come back negative, thank god.

The liver enzymes have come back to normal, but they were normal before the diet started.

I guess one concern I have is it possible the chronic inflammation I have giving some false positive celiac antibody tests, or is it more likely it's related to celieac disease.

My doctors have so far been kind of stumped and they hope the celiac diagnosis will tie things together.

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DQ7.5 is the only "non-celiac" gene with a *05 alpha allele. It's not as common to have celiac disease in the absence of DQ2 and DQ8, but it's definitely possible... especially with DQ7.5.

Here's what Wikipedia has to say about it:

http://en.wikipedia.org/wiki/HLA-DQ7

A lot of people think the effects of celiac disease are limited to the digestive system, but actually it can cause inflammation in any part of your body... liver, skin, joints, etc... Ever since I figured out my problem with gluten, SO many things are making sense. :)

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DQ7.5 is the only "non-celiac" gene with a *05 alpha allele. It's not as common to have celiac disease in the absence of DQ2 and DQ8, but it's definitely possible... especially with DQ7.5.

Here's what Wikipedia has to say about it:

http://en.wikipedia.org/wiki/HLA-DQ7

A lot of people think the effects of celiac disease are limited to the digestive system, but actually it can cause inflammation in any part of your body... liver, skin, joints, etc... Ever since I figured out my problem with gluten, SO many things are making sense. :)

Thank you for the link about DQ7.5. I have a science background, and it's fascinating for me to read about these genes and their proteins, even though some of the details are hard to grasp.

I'm going to research DQ7.5 celiac to see if there are any particular presentations associated with it. If anyone has any special knowledge, please chime in. Thanks.

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Half the gene--it is not extremely rare. I guess many are missed by the standard tests for DQ2 or 8.

http://www.ncbi.nlm.nih.gov/pubmed/12651074

"HLA types in celiac disease patients not carrying the DQA1*05-DQB1*02 (DQ2) heterodimer: results from the European Genetics Cluster on Celiac Disease.

Department of Tissue Typing, Finnish Red Cross Blood Transfusion Service, Helsinki, Finland.

Genetic susceptibility to celiac disease is strongly associated with HLA-DQA1*05-DQB1*02 (DQ2) and HLA-DQA1*03-DQB1*0302 (DQ8). Study of the HLA associations in patients not carrying these heterodimers has been limited by the rarity of such patients. This European collaboration has provided a unique opportunity to study a large series of such patients. From 1008 European coeliacs, 61 were identified who neither carry the DQ2 nor DQ8 heterodimers. Fifty seven of these encoded half of the DQ2 heterodimer. ........"

Here is more on DQ7 (who have the 05 in the alpha chain) http://www.clinchem.org/cgi/content/full/44/8/1755

For more explanation on HLA DQ, and a list of the alpha and beta chains, and what they are, go to wikipedia and find the HLA DQ page, and the HLA DR page too. Often in medical literature they use DR instead...like in http://www.ncbi.nlm.nih.gov/pubmed/11061289

By the way, I wonder what a gene test sent to enterolab would show. Probably Dq7. They tell you all the beta chain results, not just positive or negative for Dq2 or 8.

nora

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Thank you for the great article on haplotypes of celiacs.

Here are some statistics from the 1008 celiacs from Europe.

DQ2 positive 88%

DQ8 only 6%

DQ2 and DQ8 negative 6%

(1/2 DQ2 heterodimer)

no part of DQ2 heterodimer 0.4% (4 out of 1008 celiacs).

Of the 1/2 DQ2 heterodimer celiacs:

Alpha subunit 28%

Beta subunit 72%

The Alphas all have DQ7.5, of these 19% are homozygous (DQ7.5/DQ7.5).

The Betas all have DQ2.2, of these 27% are homozygous (DQ2.2/DQ2.2).

Of the 1/2 DQ2s that are heterozygous, the other haplotypes break down as:

DQ4 9%

DQ5 47%

DQ6 21%

DQ7 5%

DQ9 19%

Of the four celiacs that had no DQ2 or DQ8 association, three had a DQ5 haplotype.

What suprises me about the data, is that a good percentage (28%) of the 1/2 DQ2 celiacs had the alpha subunit. Everything I had read said the Beta unit was much more important, and that the alpha subunit types (which is me) was much rarer than the Beta type.

This data definitely does not say that.

This data is starting to make me dizzy, time to party.

Happy New Year !!

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I see you had access to the article.

There was much involvement with half a celiac gene plus DQ1, I see.

(DQ5 and DQ6 are DQ1)

and three of the non-half DQ2 were DQ5. Wonder what the fourth was, probably Dq6.

So many 2,2.

It is counted as a gluten sensitive gene only, but here they are, celiacs with 2,2 and without the alpha chain of DQ7,5 (=05*)

(about the DQ1: Hadjivassiliou found that 20% of his gluten ataxia patients were DQ1)

nora

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The 4 celiacs with no part of dq2 heterodimer break down as follows:

DQ5/DQ5

DQ4.4/DQ5.1

DQ4.4/DQ5.1

DQ7.3/DQ9.2

Sorry, no DQ6. But with only 4 samples, I don't know if you can draw any conclusions.

With DQ2.2, it depends what is paired with.

DQ2.2/DQ2.5 can produce the DQ2.5 heterodimer and 50% of the produced isoforms are dq2.5.

DQ2.2/DQ7.5 can produce the DQ2.5 heterodimer and 25% of the produced isoforms are dq2.5.

DQ2.2/DQ2.2 can NOT produce the DQ2.5 heterodimer, but produces 1/2 (Beta subunit) of it.

In the article, there were actually more DQ2.2/DQ5 (14) than DQ2.2/DQ2.2 (11),

and more DQ7.5/DQ5 (6) than DQ7.5/DQ7.5 (3).

So after the DQ2, DQ8, and the 1/2 heterodimer (DQ2.2 and DQ7.5), it appears DQ5 is next in being prevelent.

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I see the last one was DQ7 and DQ9.

We have at least one DQ9 here who got very sick prior to figuring out gluten was the problem. (ravenwoodglass) (she would be interested in this thread, I think, as it has an example of a DQ9 celiac)

and some DQ7.

Usually we do not know our alpha chains here, and we sometimes wish we knew it (for example to know wether one is 7,5 or another type of7)

I see from another tread now here that some can be resolved by DR testing.

I see you got your testing done at Prometheus, and that they did not tell you what the actual beta chains were.

Maybe you are DQ7,5 then.

About the DQ7: DQ7, 8 and 9 are subtypes of DQ3 and differ from each other only by a few amino acid positions:

"..........The DQ8 molecule is highly homologous to two other naturally occurring alleles, DQ7 (DQA1*0301/B1*0301) and DQ9 (DQA1*0301/B1*0303). These three alleles share an identical {alpha} chain (DQA1*0301) and have nearly identical

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I must be DQ7.5, since Prometheus reported I have DQA1 05, half the heterodimer (and DQ2 and DQ8 negative).

From what I can tell the only possibility would be DQA1 05 - DQB1 03, which is DQ7.5.

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I figure it is 7,5 too.

Both DR11 and DR13 have 0505 and 0301 according to http://en.wikipedia.org/wiki/HLA_DR , and there is a DR8- 0301 too but that one has 0601 in the alpha chain so that excludes you.

The cart on http://en.wikipedia.org/wiki/HLA-DQ says similar things.

I was only told I was negative. I think I will order a DQB1 test from Enterolab (they send it out, nowadays it is probably to the American red Cross, but they used to use Bonfils before). I am in Europe so the shipping is expensive and complicated and could cost more than the test itself...I phone d the lab (the very lab that the celiac disease researchers Lundin and co. are using to find out wheat my genes actually were, but they said I should contact my doctor and he is not interested. I asked the lab if they actually could tell me, and she muttered something on DR3 (which just means DQ2) so I do not even know what type of test they did, nor if they can find out what is in the beta chain, or even alpha chain. (that way it would be free for me here, it would not cost anything)

nora

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What do my results mean? I *JUST* had genetic results from LabCorp which came back DQ8 positive. They didn't report the allele's so I called them up and they told me on the phone I am this:

DQA1*0302, DQB1*0402 -> DQ4 -> DR4/DQ4 gene haplotype

DQA1*0302, DQB1*0302 -> DQ8 celiac gene -> DR4/DQ8 gene haplotype

BTW I am caucasian and the rep said it was rare to have a DQ4 gene....

I also note that the alpha component is the same as DQ2.3 part and I have THREE copies of the 0302 -> does this put me at a higher risk?? Does this have any bearing on my condition? Also, 100% of my children have some form of gluten intolerance or celiac. According to genetics, EVERY one of my children would receive the DQA1*0302 from me.

Also the DQ4 is SUPPOSED to be some sort of protective gene but I have a rare varient apparently that has a same isomer as a DQ2.3 gene? (but is this alpha sequence a susceptibility to celiac?) Also does this 'protective' gene make it so my blood tests and other tests are seronegative. Yet when I eat gluten I get debilitating back pain such that I cannot move or walk.. and I'll never eat it again obviously!

Of a more interesting note, both the DQ8 and DQ4 genes above encode on the DR4 haplotype and give a double susceptibility to arthritis and diabetes and heart trouble - which I already have! :( (oh yippee).

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dad of five boys,

you only have 2 genes: DQ8 and DQ4

DQA1*0302, DQB1*0402 is the full name of DQ4

DQA1*0302, DQB1*0302 is the full name for DQ8

The 0302 in the alpha part of the DQ4 gene does not confer gluten intolerance.

Just because they numbers are the same, doesn't mean they act the same. You have to look at the entire code and the placing of it.

your children can either get DQ8 or DQ4 from you.

Then they get their other gene from their mom.

I've read the study quoted before. I have the half gene DQ2.2 and DQ5.

I never got blood work or biopsy, so no clue on that, but I had symptoms across many systems in my body that are better now.

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I see the last one was DQ7 and DQ9.

We have at least one DQ9 here who got very sick prior to figuring out gluten was the problem. (ravenwoodglass) (she would be interested in this thread, I think, as it has an example of a DQ9 celiac)

This was an interesting thread. Thanks for posting this info. The genetics of this disease involve so much more than just the DQ2 and DQ8. So many, including my DD, have been told that if those 2 genes are not involved it can't be celiac. I am so thankful I wasn't gene tested during the diagnosis process.

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dad of five boys,

you only have 2 genes: DQ8 and DQ4

DQA1*0302, DQB1*0402 is the full name of DQ4

DQA1*0302, DQB1*0302 is the full name for DQ8

The 0302 in the alpha part of the DQ4 gene does not confer gluten intolerance.

Just because they numbers are the same, doesn't mean they act the same. You have to look at the entire code and the placing of it.

your children can either get DQ8 or DQ4 from you.

Then they get their other gene from their mom.

I've read the study quoted before. I have the half gene DQ2.2 and DQ5.

I never got blood work or biopsy, so no clue on that, but I had symptoms across many systems in my body that are better now.

We also had my middle son tested that was diagnosed with failure to thrive - so it will be interesting to see what HIS gene's are and to see if mom contributed any to it. As a side note, one of my wife's sisters has celiac and her dad had colitis (which we think may have actually been celiac) from a young age... so my wife probably carries a gene as well. I will probably post his results when I get them on here too - they aren't done yet.

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Interesting to see that a lab actually tests DR types as well now, so one can both deciper the alpha and beta chains, and that they also provide you with alpha and beta chains.

thefooddoc.com has written about a few patietns who were celiac but lacked the right genes, and he wanted to get the labs to do tha alpha chains as well for that reason.

What worreis me is that we never had anyone report half a celiac gene before, yet there should be many of them according to the study of 1008 cweliacs.

Maybe we will get more reports of half genes now that some labs have started reporting the alpha chains and/or DR types now.

About the DQ4, it is not exclusive to asians. By the way, japanese have a lot of DQ9 and therefore they have some DQ9 celiacs

If you check the DQ types of the 1008 european celiacs, some had DQ4 in combination with other genes.

nora

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Interesting to see that a lab actually tests DR types as well now, so one can both deciper the alpha and beta chains, and that they also provide you with alpha and beta chains.

thefooddoc.com has written about a few patietns who were celiac but lacked the right genes, and he wanted to get the labs to do tha alpha chains as well for that reason.

What worreis me is that we never had anyone report half a celiac gene before, yet there should be many of them according to the study of 1008 cweliacs.

Maybe we will get more reports of half genes now that some labs have started reporting the alpha chains and/or DR types now.

About the DQ4, it is not exclusive to asians. By the way, japanese have a lot of DQ9 and therefore they have some DQ9 celiacs

If you check the DQ types of the 1008 european celiacs, some had DQ4 in combination with other genes.

nora

The lab didn't give me a DR type on the results, they gave me a negative/positive for DQ2/DQ8 only. Labcorp (where I had the test done) doesn't report the alleles on the 'doctor' form - they just said I was DQ8 positive... so I called the HLA testing lab (they provide a contact number) and the woman there said they do the full allele set and was more than happy to provide me my alpha and beta units for both alleles. She said they use very sensitive testing and are fairly accurate. The lab which does this also does HLA tests for organ transplants, DNA testing for paternity, etc. It was the Labcorp HLA lab in Burlington NC that did the testing. The DR subtype I got on the internet comparing my set of alpha/beta to those that are in the DR4 gene type. I COULD be DR8 as well if the testing incorrectly marked my 0302 alpha chains....

However, given I have a very rare cardiac defect at birth (which would be more prevalent in a DR4/DR4 homozygote) I tend to believe the numbers are accurate. My cardiologist said that with the rare cardiac defect at birth, in other patients with similar symptoms, he's been finding undiagnosed celiac after having to undergo valve replacement surgery for aortic stenosis - which is one of the problems associated with the DR4 gene set! (I have a bicuspid aortic valve - which is NOT very common to have this!) Although I don't have diabetes, my uncle DOES and it was helped when he visited by a gluten-free diet (still trying to convince him to go gluten-free). Also my severe muscle pain (in my 30's!) is probably an inflammatory response. My first and only indication I was celiac was an elevated IgA Anti-gliadin which came back "equivocal" and was 2 points under positive (25-50 was equivolcal and I was 48). My wife had similar testing and her IgA was 1. My TTG was also 20 and <=20 was normal and >20 positive.. so I was definitely borderline. Not sure if my DQ4 portion has anything to do with my tests though. Two of my sons had no signs of gluten problems but when I took them off gluten and they got cross-contaminated they had a CLASSIC case of Dermatitis Herpetiformis - broke out to the point of bleeding over their entire buttocks and and welts on the knees and elbows - I find it VERY interesting they only broke out AFTER GOING gluten-free and then being re-contaminated by it! The peditrician was extremely surprised by the quick onset and manifestation of the rash and even said "she's never seen anything like that before..!"

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Ah I see they did not give you the DR resutls (but there was a recent posting where someone's doctor ordered DR instead of DQ and interesting things came up)

Very interesting information.

I am sure there are lots of people who would like to or need to know their alpha chains too, and the beta chains.

About the DH rash they got after getting glutened after going gluten free, the reason is the fresly activated T cells:

http://gut.bmj.com/cgi/content/full/54/9/1342 and some groups are doing trials with small patient selections in order to investigate if they can use these freshly activated T cells to diagnose celiacs. There was something like that going on here where I live. You can find more on pubmed.

About diabetics, and gluten, Alba Therapuetics, wo are doing clinical trials for the new medicine, the zonulin antagonist, also researches zonulin and diabetes. Should be on their website (google it)

Here is a recent thread where we ended up on insulin and gluten and zonulin :

http://www.celiac.com/gluten-free/index.php?showtopic=54390

and search for zonulin on pubmed.com

and the thread about DR:

http://www.celiac.com/gluten-free/index.php?showtopic=53996

nora

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Out of interest sake - I got my son's genetic results.

Sure enough he inherited my DQ8 (0302) gene and has a DQ5 gene (0501). I guess this proves he's my son ;) LOL. Anyways I heard the DQ5 gene is a 'gluten intolerant' gene - is this true?

Anyway he is doing fine as long as we NEVER EVER feed him gluten (sounds kinda like the gremlins movie... Laugh) We actually don't feed that much milk to any of the kids either (drink organic Soy milk instead) as they seem to get constipated with too many milk products. We stick to natural yogurt and hard cheeses and of course ice cream - i.e. let them get the 'good' stuff.

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About the DH rash they got after getting glutened after going gluten free, the reason is the fresly activated T cells:

http://gut.bmj.com/cgi/content/full/54/9/1342 and some groups are doing trials with small patient selections in order to investigate if they can use these freshly activated T cells to diagnose celiacs. There was something like that going on here where I live. You can find more on pubmed.

nora

Timely, b/c dd must have had trace gluten exposure last week, and within an hour or so, she had a horrible angry looking rash between her legs and stomach cramps. Of course, if you believe all of the recent media on attention-seeking parents torturing their children, she should still be on gluten because she did not test positive by traditional blood tests.

Two years ago, during a gluten-free elimination period, she was with my mother who, being of the belief that it wasn't a big deal, gave her fried dough and she promptly had diarrhea.

It's frustrating to know that there are so many out there who would benefit from gluten-free living, but don't try because the mainstream medical community dismisses their symptoms and/or results (my dd did have a high IgG, but all of her other blood tests were "normal"). Her TtG was elevated when her stool was tested.

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    • Hello all! I am new on here, and I was wondering if it worth a look for me to get tested for celiac disease. I've been experiencing severe stomach aches accompanied by issues with loose stool, constant fatigue, lots of infections, worsening of skin on my face, frequent nausea, lots of trouble losing weight. I'm asking because I was feeling better at home from vacation after having a very rough semester at school and I'm not very good at keeping track of what I eat typically, but at home it is mostly vegetables and meat, with the occasional rice thrown in. This morning I had my first bagel in months and was extremely nauseous with severe pains and urges to run to the bathroom.  Do y'all think it is worth a try to get tested for celiac disease or some type of gluten intolerance? I'm so tired of being sick and not knowing why... Thank you <3 
    • LexieA, I agree with Plumbago. The symptom's of low stomach acid and high stomach acid are similar so it is easy to confuse the symptom's of one as the other. Dr. Myatt explains this well in her online article about stomach acid. http://healthbeatnews.com/whats-burning-you/ quoting "But My Symptoms Feel Like Too Much Acid…" Strong stomach acid and pepsin quickly "emulsify" fats and proteins, making them ready for the next step of digestion, passage into the small intestine. When these digestive factors are weak, food remains in the stomach for longer and it begins to ferment. Gas pressure from the fermentation can cause bloating and discomfort and can can also cause the esophageal sphincter to open, allowing stomach contents to "backwash" into the esophagus. Even though weak stomach acid is the central cause of this, even this weak stomach acid, which has no place in the esophagus, will "burn." This burning sensation confuses many people, including doctors, who then "ASSuME" that excess acid is to blame. Too little acid, resulting in slowed digestion, and gas which creates back-pressure into the esophagus is the real cause of almost all "heartburn" and GERD." so  you can see how they can easily be confused for each other. you no doubt are having stomach acid issues but it is because it is too little or too much? Timeline helps us determine which it is. If it happens when we eat something it is already to low to  digest the food we are eating. if eating something cause the heartburn/gerd to improve (especially meat) then your stomach acid is really too high especially if this happens between meals. because eating something will naturally dilute/lower the stomach acid pH. I wrote about my stomach acid being misdiagnosed on my celiac.com posterboy blog. ( have summarized most of what you need to know in this reply but the post is still there if you want to study it more for yourself. if your not taking an antacid now then taking BetaineHCL should improve digestion. If it does then raising your stomach acid by lowering you pH should improve your digestion. study on the best way to take powdered stomach acid before trying this. but I found taking 3 to 4 capsules in the beginning was easier than taking only 1 or 2 in the beginning .. .  until I could back it down to only needing one per meal or now none per meal to aid digestion. which is what we are shooting for.  The place where our body is now producing our stomach acid naturally at a healthy level. if you feel a "warm sensation" in your stomach you have reached a good level. I hope this is helpful. I only know it helped me. *** this is not medical advice but I hope you have as a good experience with it as I did. Usually peopledon't  have a trouble taking BetaineHCL unless they have an ulcer or already taking PPI's which are actually lowering  their stomach acid contributing to a viscous cycle of being locked into taking PPI's long term. if PPIs are taken for more than 6 months they can be almost impossible to stop/quit because of the acid rebound people experience when trying to stop taking them cold turkey and why they recommend stepping back doses by 1/2 gradually so they don't get overwhelmed by the stomach acid your stomach is  able to produce again naturally itself (hopefully). . . if taking betaineHCL jump started your ability to produce stomach acid again. . . if not taking betaineHCL (Powdered Stomach Acid) can replace what the body is missing much like taking a hormone. chris kresser has a good online article on this subject as well. https://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd/ he says it well. quoting chris kresser. "If heartburn were caused by too much stomach acid, we’d have a bunch of teenagers popping Rolaids instead of elderly folks. But of course that’s the opposite of what we see." **** this is not medical advice but I hope it is is helpful. posterboy by the grace of God, 2 Timothy 2:7 "Consider what I say; and the Lord give thee understanding in all things".  
    • Lex_ I agree with Ennis_Tx. You need to take some Magnesium.  It works best as a Magnesium Citrate or Magnesium Glycinate. Magnesium Citrate are easiest to find. Take it 2/day for the first couple weeks to see how much more energy you have. Then you can take it with each meal or 2/day and one hour before bedtime if it is not convenient to take it at work. If it is working you (right form of as a Magnesium Citrate or Glycinate) you will will experience vivid dreams. And wake up with enough energy to take on the day. **** this is not medical advice but it really helped my chronic fatigue symptom's. It is good for leg cramps too also known as charley horse's. posterboy,
    • I am sorry that I was not clear.    I only mentioned  your diagnostic background, not to discredit you, but because without any lab results (other than a positive gene test), how can you be sure that gluten (shampoo containing wheat protein) was the actual culprit (not a guess) of your symptoms?  It is common for celiacs to receive follow-up antibodies to monitor their dietary compliance.  This is not perfect, but it is the only tool in the toolbox for now.   My husband has been gluten free 12 years prior to my diagnosis.  He went gluten free per the poor advice of his GP and my allergist.  So, I am not trying to discount your diagnosis at all.  I am just trying to see if other lab tests (e.g. liver tests that were elevated previously for you when you were still consuming gluten) were measured after your shampoo exposure.   I am curious because I have had issues over the last year.  I was glutened last January, had the flu, a tooth infection, a cold and a tooth extraction, three rounds of antibiotics (verified to be gluten free) within a month or so.  Like, you, I am very careful.  I have no idea as to how I was exposed.   The last time I ate out was a year ago and even then it was at at 100% gluten free restaurant.   My hubby did not have any symptoms at this time.  He is like my canary.    I went to my GI and my DGP IgA was off the charts even some three months later.   My celiac-related symptoms diminished in three months, but I struggled with autoimmune hives for six.  My GI offered to do an endoscopy in the summer.  Instead I chose to follow the Fasano diet.  I still was not feeling well.  In December, my antibodies were 80.  They were either on a decline or they were increasing again.  I opted for the endoscopy.  My biopsies revealed a healed small intestine (you could see the villi on the scope too).  But I was diagnosed with chronic gastritis and had a polyp removed.   So, all this time I thought my celiac disease was active, but it was NOT the source of my current gut issues.   Again, my apologies.  I just wanted to know how you know for SURE that hydrologized wheat protein from someone else’s shampoo and conditioner could reach your small intestine to trigger an autoimmune reaction.  Maybe, like me, Gluten was not the actual culprit.    
    • The reason I think it was the shampoo? Process of elimination. Our house is almost entirely gluten free (except for this shampoo which slipped through the cracks until I read the ingredient label). My husband has bread that he eats at lunch, but he practices something that resembles aseptic technique from the lab when he's making his sandwiches. He's been doing this for years now and I've never been glutened from within my home. The previous week I hadn't eaten out, I cooked all my food, I don't eat processed food and I never eat something from a shared facility.  Usually if I get glutened it's a single dose sort of thing and it follows a very predictable course, to the point where I can estimate when I got glutened within 24 hours of when it happened. However, this time, I was feeling achy and arthritic and moody for about a week before it got bad enough for me to recognize it as the result of gluten exposure, at which point we went searching and found the shampoo (and conditioner, which does leave more of a residue than shampoo), which he immediately stopped using. Within three days I was feeling back to normal (which is the usual course for me).  Sure, it could have been something else, but I know how sensitive I am, and, as silly as it sounds, it was the only thing that made sense. The other thing you said: You're correct, mine was not a rock solid celiac diagnosis, but I have no doubt that gluten is the problem. I was SICK. I went through two different gluten challenges in an effort to get a more straightforward diagnosis during which I was a barely functioning human being. Consuming gluten may not have given me blunted villi or elevated antibodies, but it did inflame my gut, and actually started to damage my liver. If you look at my diagnosis thread, I had elevated liver enzymes, which have been correlated with celiac disease in the past. There was no alternative explanation for the liver enzymes, he checked EVERYTHING.  I too am a scientist and I have spent a lot of time with the literature trying to make sense of my condition.  https://www.ncbi.nlm.nih.gov/pubmed/26150087 I also have no doubt that gluten was damaging my intestines in some way, as any prolonged gluten exposure in the past has inevitably been followed by a severe FODMAP intolerance that goes away once I've eliminated the gluten and given myself a month or so to heal.  I also had a very fast diagnosis following the onset of symptoms (~1 year) so it's possible that the disease never had a chance to manifest as full celiac. I wasn't willing to eat gluten long enough to find out. As a result of my diagnosis, hazy as it was, I am *meticulously* gluten free. It is not a fad for me. I don't occasionally cheat. It is my life, for better or worse. All of that being said, I'm not sure what my diagnosis has to do with your question. You say you're not trying to be rude, but when you bring up my diagnosis in a thread that has nothing to do with diagnostics, it seems like you're trying to undermine the validity of my disease or the validity of my input in this forum. If I'm being hypersensitive, I apologize, but that's how you came across on my end. I'll admit that the fact that my diagnosis wasn't more straight forward does make me a bit defensive, but I promise that even if I didn't have a solid diagnosis, I interact with the world as though I did, and I'm not out there giving people the wrong idea about celiac disease by not taking it seriously. If there was a connection between your question and my diagnostics that I missed I would appreciate you giving me the chance to better understand what you were asking. 
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