<<Disclaimer: Verify this information before applying it to your situation.>>

I just got back the results of my blood tests, and they show negative for
sprue. (This was from an HMO lab, not one that specializes in CD.)

My blood test results were as follows:

Endomysial IGA Antibodies   None Detected
Gliadin IGG Antibody        < 7.0
Gliadin IGA Antibody        < 3.0

Now, my understanding is that if the endomysial titer is negative, then you
won't have noticeable changes in the gut to detect in biopsy, right? To
quote a recent post from "Technical Service":

  "These antibodies are found in ... essentially 100% of patients with
  active CD.... Antibody titers are found to parellel morphological changes
  in the jejunum."

I was GF for about 7 or 8 weeks in the spring, but have been eating about
2-3 pieces of whole wheat bread daily (usually - sometimes more,
occasionally none when I felt too sick) for about 8 weeks. Considering I
was GF for so short a time, I doubt much healing would have taken place,
although I was definitely starting to feel better - more energy, less hair
loss, etc.

First question: At this point, is it necessary for me to have a biopsy?
(The biopsy would also be done by an HMO gastroenterologist and lab, not
one specializing in CD.)

I'm thinking that I should just go GF for a period and then do food
challenges to find out if I am just sensitive to wheat and oats, or to
gluten in all forms. I was hoping to have a clinical diagnosis for the sake
of my kids and siblings, but if I already know that the biopsy will
probably be negative, I don't want to go through it.

Second question: Is it possible to have CD and it not show on blood test or
biopsy because it is not yet in acute stages?

I do *not* have full-blown symptoms of CD, just a history of minor problems
that possibly point that way:

* definite sensitivity to wheat
* definite sensitivity to oats
* childhood diarrhea
* adult constipation/diarrhea
* excessive flatulence
* lactose intolerance
* gallstones (attacks since birth of second child)
* for 3 years (since birth of first child) an increase in:
  * heavy hair loss (volume down by about 1/4, I'd guess)
  * mental fuzziness
  * joint aches and pains
  * muscle weakness
  * physical and mental fatigue

As I said, most of these were improving on the GF diet. Any advice is
appreciated! I'm scheduled for biopsy on September 3, so I've got a couple
of weeks to decide what to do.

Thanks,
Carma in Phoenix (US)
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