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Summary #3
I saw your e-mail. I think you need more time on gluten if you have
Been avoiding it for such a long time. Here is an extract from a Coeliac UK
newsletter which talks about this kind of thing. Hope it helps.
Antibody levels after short term gluten challenge Coeliac disease cannot be diagnosed once a person has started on a gluten-free diet. This means returning to a diet that contains gluten
before being tested - but for how long? Coeliac UK recommends people return to a gluten-containing diet for at least six weeks before being tested, either by blood test or biopsy, to avoid a false negative result. A recent small study looked at the effect of short term gluten
challenge (reintroduction). 5-10g gluten was given to patients over a 21
day period, and over this time antibody tests and tests for malabsorption were performed. The results of the tests showed that the majority of patients had carbohydrate and fat malabsorption but nochange in their antibodies was found. This study suggests that short term challenge with gluten is likely to lead to negative antibody tests, so a longer period of gluten challenge is required.
Clinical Gastroenterology & Hepatology. 3(7): 679-86 2005
Prometheus labs in San Diego has some good advice for taking a gluten challenge. They are
quite helpful through email. I will warn you that many who have taken a gluten challenge do not recover for a very long time. You can check the Delphi forums. I decided to do a gluten challenge and it took more than a year to feel normal again. I also developed peripheral neuropathy that has never gone away completely.
Maybe you can do the genetic testing. It could be worth it and save you from getting sick.
I think you would get a positive quicker from the www.enterolab.com
Website stool test than from the blood test because the gut has to be inflamed enough
For antibodies to pass into the bloodstream. It is cheaper and will get you a reading
quicker.
THE CHEATING WILL EVIDENTALLY CAUSE PROBLEMS, THE BLOOD TEST S ARE
MOSTLY FALSE NEG AND CHALLENGES ARE VERY DANGEROUS
I WOULDN'T ADVISE DOING THIS BESIDES THAT'S NOT EATING GLUTEN HEAVILY
AND YOU CAN GET MENTAL PROBLEMS FROM IT THE BRITISH HAVE DIFFERNT TESTS
THAN THIS COUNTRY DOES
COULD TAKE UP TO A YEAR IF YOU THINK YOU HAVE TO DO THIS MANY TRY AND
QUIT BECAUSE OF ILLNESS
I LIVE ON TPN FOR ELEVEN YRS NOW FROM TOO LATE A DIAGNOSIS AND IF I
COULD'VE SUSPECTED CELIAC AT ALL I'D HAVE GONE GLUTEN/WHEAT FREE AND
MAYBE STILL BE EATING.
Why are you having a test at this point when you know you have been getting gluten contamination? Would it not be just easier, at this point, to try the gf diet strictly for another 6 months and see if your symptoms disappear? I am not scolding, btw. It is just that so many cannot get a positive dx on a gluten challenge. (I personally was postively dxed by biopsy before the gf diet, but if I had not been, I would have gone gf anyway, without at dx.)
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My mother was diagnosed with Celiac in 1974. Knowing that it is genetic, I figured that one day I would follow suit. In 1989, while on vacation, I had my first & only frothy, floating stool (a classic symptom of Celiac). I had been under a lot of stress (a common precipitator of Celiac), so when I returned home, I went to a GI doctor & he did a small bowel biopsy , which was negative. I was greatly relieved.
Since I have had mouth ulcers all my life, I never thought of them as being a symptom of Celiac. Duuh! Isn’t the mouth part of the GI track? In June of 2001 I suddenly started getting 4-5 big mouth ulcers at a time. By the time one set was gone, another set was starting up. This went on for about 6 weeks. Then Mother got her Gluten Free Living newsletter & in it was a listing of symptom & diseases that could be related to Celiac. It included mouth ulcers. BINGO! I went on a gluten free diet (well, sort of) & the ulcers quit coming! When I started eating gluten again…you guessed it—they came back. Mother had seen information on Enterolab, so I decided to go that route.
My tests came back that I was gluten sensitive, have mild small intestinal malabsorption, am sensitive to yeast, & have a double gene (one from each parent). Guess you could say my test was positive!
Since Enterolab is not recognized by my insurance company, I figured they would deny payment & sent them all the information with my bill that I would have sent if they had denied payment. I sent the information about Enterolab that I got from the Enterolab website. I pointed out the fact that this test was non-invasive, not painful, & much less expensive than a small bowel biopsy. Besides, it was positive & told me what I needed to know. They paid promptly!
I took my Enterolab report to my doctor who, even though he is my mother’s doctor also, still said he didn’t think I had Celiac. He did blood work for Antigliadin IGG & C-Reactive Protein which were both positive. When he did a small bowel biopsy on me 1 ½ yr later, it was Negative.
So, even tho I am proven to have Celiac, I have had 2 negative biopsies (1 before diagnosis, & 1 after. Enterolab/Dr. Kenneth Fine has an excellent article out entitled Early Diagnosis of Gluten Sensitivity: Before the Villi are Gone. You can get it from Enterolab’s website at www.Enterolab.com.
January, 2004
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