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Many thanks to everyone who responded to my question about
doing a gluten challenge.  I went gluten
free 6 years ago when my symptoms became severe and I couldn’t find a doctor
(after several years of searching) who knew anything about celiac.   When I
saw the doctor this week, my only request was to have the total serum IgA test
done.  She had not heard of this test and
thought the gluten challenge would be more informative.  I handed her a copy of the article from the
Oct/Nov 2010 Living Without about diagnostic testing and the need to determine
whether a patient is IgA deficient.

 

Responses fell into several major categories: 

1. Advocating for longer challenge period with
recommendations for how much gluten to consume – if I wanted to proceed with
the challenge.  The one-week period my
doctor recommended was definitively too short and many people said it had to be
at least 6 months or longer.

2. Recommending genetic testing instead – Prometheus Labs,
Enterolab, Kimball Genetics

3. Don’t do it -- even to get a definitive diagnosis.  You’ll hurt your body and may not learn
anything useful.

4. Find a new doctor who is informed about total IgA and
celiac diagnosis (this is a new doctor whom I sought after my recent doctor
knew absolutely nothing about celiac or gluten sensitivity).  

 

One person provided this excerpt from the Beth Israel Hospital article (link at
reference #7 below):

 

What is a gluten
challenge? Do I need one?

A gluten challenge is recommended when an individual is on a gluten-free diet, but his/her physician is unsure of
whether or not he/she has celiac disease. In this
case, gluten is reintroduced into the diet slowly, over a period of 4-6 weeks.
At the end of this time period, the patient is given a repeat blood test and biopsy. If the individual experiences
symptoms before 4 weeks, he/she may be advised to see the physician earlier to
have a blood test and biopsy performed. Unfortunately, in this case, there is a
greater risk of obtaining a false negative result. Individuals with confirmed celiac
disease do not need to have a gluten challenge. 

There were some very good suggestions for articles and
resources, which are pasted below.

 

RECOMMENDED LINKS AND ARTICLES





You
     may want to read Dr. Peterson's take on gluten challenges.
     http://glutendoctors.blogspot.com/2010/12/gluten-and-how-it-may-affect-developing.htmlContact
     the celiac disease center in Chicago
     and they can help answer your questions. Www.celiacdisease.net. I have found their
     hotline is very helpful.Several
     responders recommend contacting the University
      of Chicago Celiac Disease Center University of Maryland program headed by Dr Fasano, who used to be a
     student of Dr Guandalini (Univ of Chicago).Link
     to a fact sheet about diagnosis and the IgA
     deficiency test: http://www.celiacdisease.net/factsheets   Print the info out and give directly to
     your doctor, with specific areas highlighted.  I
     would put this question to the University of Chicago Celiac Center. 
     I called them and they emailed my question to their renowned doctor
     specialists.  It’s my understanding that this kind of test is
     not accurate.  My daughters GI told me that reaction time varies greatly.   Article
     from Beth Israel Hospital
     (Harvard) that recommends a challenge last 4-6 weeks:

      http://www.bidmc.org/CentersandDepartments/Departments/DigestiveDiseaseCenter/CeliacCenter/FAQ/DiagnosisandTestingofCeliacDisease.aspx

8.      Some
experts disagree in principle with the Gluten
Challenge:

http://www.celiac.com/articles/979/1/Challenging-the-Gluten-Challenge---By-Dr-Ron-Hoggan-EdD/Page1.html

Call
     one of the celiac centers to get good information that you can pass along
     to your doctor - from another doctor, which they would be more likely to
     heed.You
     can go to the archives of this list/serv and do a search for gluten
     challenge.Gluten
     Free and Beyond forum: http://www.glutenfreeandbeyond.org/forum/ 
     has good information on the testing details etcForum: http://forums.delphiforums.com/celiac/start

 

I have decided to not do the challenge after receiving the
good advice from an experienced, informed group.  Thank you to everyone who responded!
To your good health,


 

Allison



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