Are Gluten Intolerance Tests Misleading?

People often ask me how we got tested for gluten intolerance.  The most common blood test requested by your physician is the Celiac Panal.  This test measures both your immune system’s response to gluten and whether there is damage to the intestinal tissue.  The Celiac Panel consists of tests for the following: Anti-gliadin antibodies (AGA) for both IgA and IgG (IgA and IgG have a role in controlling the immune system); anti-endomysial antibodies (EMA)—IgA; anti-tissue transglutaminase antibodies (tTG)—IgA, and total IgA level.  However, it has been reported that this test records a false negative 7 out of 10 times.  These false negatives are due in part to the physician’s interpretation as well as the patient’s condition at the time of the test.  Physicians may interpret the test as negative if the test for intestinal tissue damage (anti tTG and EMA) is negative—even if the blood test results indicate a positive immune reaction.  The intestinal tissue tests will only come back positive if there is severe damage or atrophy to this tissue—the kind found in end-stage celiac disease.  If there is only partial atrophy, the accuracy of this test goes down to 27-30 percent.

Another issue with the Celiac Panel test is that it does not account for those with IgA deficiency, which occurs 10 to 15 times more commonly among people with celiac disease than the general population. Patients with IgA deficiency will lack IgA antibodies, so this blood panel shows up negative.  In addition, this panel only screens for one part of the gluten protein called alpha gliadin, when there are approximately 60 parts of the gluten protein.  If you have an intolerance to one of the other parts of the protein in gluten besides alpha gliadin, this test will also come back as negative.

However, gluten-sensitivity without the presence of celiac disease does exist. And research confirms that gluten sensitivity is different from celiac disease at both the molecular level and in the immune system’s response.  However, research is still underway to best diagnose and treat the gluten-sensitive, non-celiac individuals.

As an autoimmune disease, celiac disease is the consequence of the interplay between genes and the environment, in this case gluten.  Two genes, HLA DQ2 and HLA DQ8 are absolutely necessary to develop celiac disease. Since one third of the general population have one of these genes, the presence of DQ2 or DQ8 does not, by itself, mean that the person will develop celiac disease; rather, that they have a genetic predisposition for celiac disease.

Other ways to test for celiac disease and gluten sensitivity include stool test and salivary tests.  These tests can be ordered on-line and performed at home without a doctor ordering the test.  Enterolab’s unique test screens for gluten sensitivity, as well as for many other antigenic food sensitivities. Enterolab’s method uses stool rather than blood as the testing substrate because the immunologic reactions to gluten proteins occur in the intestinal tract, and not in the blood.  Enterolab’s salivary test also identifies the presence of genes associated with celiac disease and gluten sensitivity.

A more invasive test for celiac disease is small intestine biopsy.  However, this is not recommended as the test of choice because of the number of biopsies that need to be taken to confirm accuracy of the test.  It is recommended that at least four biopsy samples be taken of the patient to confirm celiac disease, however most doctors take only one.  This accounts for as many as 65% of patients being under-diagnosed for celiac disease.

Lastly, if you are not willing to go through the trouble, time and money of getting tested for gluten sensitivities, listen to your body.  Remove gluten from your diet for a couple of months and see how you feel.  My husband did not have a choice when we removed gluten from our household, but he did notice significant changes in his overall health and well-being.  I know some people like to get tested so they have some sort of incentive for giving up all their favorite foods and desserts.  But if you are willing to give it up, then the test is a waste of time and money.  Gluten sensitivities and intolerance can cause a whole slew of health problems, many of them I have addressed in my articles, and the only definitive way to rid yourself of them is to stop eating gluten.  You will not die from being gluten free, I promise.  So give it a try..6 months out of your life…come on, I dare you!

Carob Rice Granola Bars

Ingredients:

6 cups Puffed Rice Cereal

18 Pitted Dates

¼ cup Natural Peanut Butter

1 T Egg Replacer

¼ cup warm water

2 T Honey

1 T Carob Powder

2 tsp Vanilla

 

Directions:

Combined the above ingredients into a food processor.

Mix for 2-3 minutes.

Press mixture into a 9 X 11 baking dish.

Bake for 15 minutes at 350 degrees.

Cool and serve.

Store in an air-tight container in the refrigerator.

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