Learn The Best Tests For Celiac Disease and Non-Celiac Gluten Sensitivity

Thursday Sep 1, 2016 | BY |
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caliac disease

If you think you have Celiac Disease, or want to know if you have Non-Celiac Gluten Sensitivity, don’t guess. Get tested.

You might call your aching bloated belly wheat allergy when it may be gluten sensitivity or wheat intolerance, a reaction to fructans, or something else. You may even wonder if you have Celiac disease.

Gluten gets a bad rap, and gluten-free is supposedly good. Is that really true? Are we actually in the midst of a gluten epidemic? Pinning down the number of people with gluten sensitivity symptoms is challenging.

Some experts find that wheat doesn’t affect as many people as we think. Allessio Fasano, M.D., director of the Center for Celiac Research at the University of Maryland, believes about 6 percent of people in the U.S. may be gluten sensitive.

Other researchers believe the number affected is much higher. Kenneth Fine, M.D. of EnteroLab contends that between 25 to 50 percent of Americans experience some type of reaction when eating wheat.

Though Celiac Disease is a rare, but serious medical condition, only about 1-2 percent of Americans have Celiac.

The numbers get complicated given the gluten-free diet trend, but what matters are your symptoms. The best way to know if you really have a wheat or gluten associated disease is to get tested.

Know Your Wheat Reaction Definitions

Celiac Disease (CD) – Celiac is complex autoimmune disease with severe consequences. When you eat gluten/gliadin, proteins found in wheat and other cereal grains, your immune system reacts as if the food was a life-threatening event. The tissue destruction in your small intestine and resulting imbalances in your large intestine can be intense. CD also is known to trigger autoimmune diseases like MS.

Non-Celiac Gluten Sensitivity (NCGS) – This the medical term for the emerging disorder assigned to symptoms associated with eating gluten-containing foods. NCGS is not a genetic disease. But with NCGS, you can experience most of the symptoms associated with CD.

Wheat Allergy – This is the medical term for those who have allergic reactions to eating wheat, one of the top eight allergic foods. Symptoms include asthma, eczema, and hay fever. In it’s most severe form, even inhaling wheat flour dust or eating foods cooked in pans previously used to make sauces with wheat flour can trigger reactions. IgE testing to wheat and gliadin are used to determine wheat allergy.

Wheat Intolerance – This is when your have delayed or build up reactions to eating wheat over time. Where wheat allergy is associated with high IgE levels in your blood, wheat intolerance is associated with high IgG antibody levels.

Which Tests Are Best?

Getting the right test is the most important way to learn if your symptoms come from wheat. Some doctors are more familiar than others with the laboratories that offer these specialized tests. If your doctor is not up-to-date on all these tests, request the specific test that is best for your condition.

There is no one gluten test that tells it all. However, there are a number of accurate laboratory tests that help determine what type of wheat reaction is causing your symptoms. Remember, you may find that wheat is not the fault. Your symptoms could be caused by other allergies like from dairy or eggs, or intolerance to lactose or glucans. Or, you may have inflammatory bowel disease or irritable bowel syndrome from an imbalance gut microbiome.

Laboratories That Test For CD and NCGS

EnteroLab – The advantage of EnteroLab’s method over celiac blood testing is that it’s done from a stool sample. You don’t need to be to be eating gluten foods for the test to be accurate.

Cyrex – Cyrex Laboratories focuses on arrays of immune tests for food-associated autoimmune diseases, including gluten sensitivity. Most of Cyrex’s tests are performed from a blood sample, but some are from saliva.

HLA-DQ Genetic Tests – All major laboratories can test HLA-DQ genes. People with two copies of HLA-DQ2 have the highest risk for CD. Because there are many variations and combinations of HLA-DQ genes, assessment gets complicated. A combination of HLA-DQ2 and DQ8 predicts CD.

Prometheus Therapeutics & Diagnostics – This highly sophisticated laboratory offers comprehensive testing including genetic markers to determine the difference between Irritable Bowel Disease, Crohn’s Disease, and Celiac.

GI Effects – This advanced stool test provides comprehensive information on gut health. It helps doctors determine your microbiome, if you have yeast or parasitic infection.

IgE Wheat – Immunoglobulin E (IgE) is a class of antibodies associated with allergic reactions. When you eat wheat your immune system triggers a rapid response and you experience bloating, itching, hives, asthma, and other allergic symptoms. IgE antibodies to wheat are typically tested in a RAST panel. Immunoglobulin E antibody to gliadin, the protein in gluten that is thought to cause wheat allergy, is more specific than to wheat, and is also useful in determining if you have wheat allergy.

IgG and IgA Food Sensitivity Tests – Immunoglobulin A and G antibodies help determine if you have delayed reactions to wheat and other foods. This group of tests is not specific to either wheat allergy or CD. Your doctor cannot make a determination of CD or NCGS with only IgG or IgA food results. You’ll need a specialized IgA antibody panel to gliadin. However, IgG food allergy tests are useful as part of the clinical determination for leaky gut syndrome or other conditions that mimic wheat sensitivity.

Making Sense of Your Tests

It’s not easy to find out how your immune system is reacting when you eat wheat. However, testing is the first step in determining if you have CD or NCGS, or another condition.

If you suspect wheat allergy, get an IgE wheat blood test.

If you suspect CD, get antibody screening of gliadin. If there is someone in your family who was medically diagnosed with CD, there’s a high probability that you may also be affected. Get the HLA-DQ test. Remember, not every one who carries HLA-DQ2 develops CD. Remember that celiac genetic tests are very accurate, but not perfect. Disease progression takes a variety of factors.

If your celiac tests including gliadin antibodies and genetic markers are negative, you likely don’t have CD, but may have NCGS.

To detect NCGS, ask your doctor to order tests from EnteroLab or Cyrex, or both. EnteroLab uses a stool sample and looks at IgA antibodies. Cyrex uses blood and saliva.

Gluten-Associated Conditions and Tests

  • Celiac Disease (CD):
    • HLA-DQ profile
    • Prometheus profile
    • IgA anti-gliadin profile
  • Non-Celiac Gluten Sensitivity (NCGS)
    • EnteroLab profile
    • Cyrex profile
  • Wheat Allergy
    • IgE RAST profile
  • Wheat Intolerance
    • IgG food allergy profile
    • Cyrex profile
    • EnteroLab profile
  • Irritable Bowell and Leaky Gut Syndromes
    • Prometheus IBD profile
    • EnteroLab profile
    • Cyrex profile
    • IgG food allergy profile
    • GI Effects stool profile

CD is a complex, often highly variable disease. Some people have no gastrointestinal symptoms. At least 83 percent of people with CD are undiagnosed. It can affect the nervous system and cause debilitating disease.

Diagnostic testing for gluten-associated disease is accurate, but it takes a doctor experienced in CD and related conditions to interpret the results. The only exception is HLA-DQ genetic testing results. If you have more than one copy of HDL-DQ2 and DQ8, you can assume that you have CD.

If you think you have CD, or want to know if you have NCGS, don’t guess. Get tested. Work with a knowledgeable doctor to determine the best tests and the most effective healing strategy for your condition.

Dr. J. E. Williams

J. E. WILLIAMS, OMD, FAAIM

Dr. Williams is a pioneer in integrative and functional medicine, the author of six books, and a practicing clinician with over 100,000 patient visits. His areas of interest include longevity and viral immunity. Formerly from San Diego, he now resides in Sarasota, Florida and practices at the Florida Integrative Medical Center. He teaches at NOVA Southeastern University and Emperor’s College of Oriental Medicine.

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  1. June Hanson says:

    So glad, I work with such a knowledgeable Doctor such as you. Inflammation, makes me very careful, what I eat. Years ago border line Celiac. Pretty much stay on gluten free diet. Watch which foods, cause problems, like dairy products. Do handle Ghee, some grass fed butter, sheep & goats products. So much of restaurant food causes G.I. problems

    All supplements you order, am very faithful at taking, along with green tea. Sometimes it is trial and error, in figuring out just what I ate to cause a problem. You, Dr Williams are always ready to help me. Thank you!

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