Best Blood Test to Diagnose Gluten Sensitivity

New Research Argues There IS a Test for Gluten Sensitivity

Mainstream literature continues to state there is no blood test for gluten sensitivity. While it may not be perfect (but what tests are?) some researchers offer a differing opinion, and I wanted to share their results with you.

While there is no further argument of the existence of gluten sensitivity, having a blood test that everyone can agree on has not yet occurred. In a 2012 study published in Clinical Reviews in Allergy & Immunology entitled “Serological Tests in Gluten Sensitivity”, the authors set out to characterize a potential pattern in blood testing that would be helpful in diagnosing gluten sensitivity as compared with celiac disease. They took 78 patients with gluten sensitivity and 80 patients with celiac disease, and retrospectively tested their blood for four standard tests, three of which are classically used for celiac disease, and one that is more commonly thought to be accurate for gluten sensitivity.

For those of you who like the specifics, the tests used were: 

1) IgG DGP-AGA (deamidated gliadin peptide antibodies)

2) IgA tTGA (tissue transglutaminase antibodies)

3) IgA EmA (endomysial antibodies)

4) IgG/IgA AGA (anti-gliadin antibodies)

And the Winner Is...

Here are the findings: The  IgG AGA test was the winner in detecting gluten sensitive patients—56.4% were positive. The test doesn’t rule out the presence of celiac disease however. 81.2% of celiac patients were also positive. The IgA version of the same AGA test yielded vastly different, although not unexpected, results. The test was elevated in only 7% of gluten sensitive patients while 75% of those with celiac disease were positive. Why is that not a surprise?

IgA is found on the mucous membranes of the body where it is exposed to outside foreign substances: nose, lungs, GI tract, ears, eyes, etc. 

Since celiac disease mostly affects the lining of the GI tract, it isn’t unexpected that the IgA part of the immune system might be most affected. But when you compared the "classic" celiac tests against the gluten sensitive patients, the results were rather definitive—only one gluten sensitive patient was positive for DGP-AGA and zero gluten sensitive patients demonstrated a positivity for tTGA or EmA. But the celiacs showed a positivity rate of 88.7%, 98.7% and 95% respectively for these three tests.

What Do We Know From This?

A couple of things: 1) Ensure that when you are tested you receive a complete panel of tests, including all those mentioned above. Additionally both the IgA and IgG versions should be included, especially for the AGA test. 2) When interpreting the tests, remember that you are doing more than just ruling out celiac disease.

For many doctors that is their goal. Despite international research knowledge to the contrary, many doctors still don’t appreciate the existence of gluten sensitivity. While no single test is perfect, if you’re suspecting celiac and you test positive for the classic celiac panel of tTGA, EmA and DGP-AGA, then you’ve likely identified your condition. If you know that you do poorly with gluten and test positive for AGA, especially the IgG version, and negative for the rest of the celiac panel, you can feel more assured of a gluten sensitive diagnosis.

Some other tell-tale signs of gluten sensitivity, according to the researchers, are a varied clinical picture, meaning many symptoms occurring at the same time. And while many of these symptoms are similar to another disease, IBS, the authors warn against considering gluten sensitivity as a subtype of IBS. The "extraintestinal" symptoms so common with gluten sensitivity are not typically seen in those patients suffering with IBS, making the distinction clear, in these researchers’ opinion.

The common complaints associated with gluten sensitivity include:

• abdominal pain, bloating, diarrhea, constipation

• foggy mind, tiredness

• eczema/skin rash

• headache

• joint/muscle pain

• numbness of legs/arms

• depression

• anemia

• together with a normal or mildly abnormal lining of the small intestine

In conclusion, when you’re building a case for gluten sensitivity, you need to look at several factors: blood testing, symptoms, and reactions to eating and eliminating gluten.


New Information on Celiac Genes

In the past, the rule of thumb was that "you could never have celiac disease if you didn’t carry the genes for it". That remains true, but these researchers cited findings from 2010 that demonstrated a full 40-50% of gluten sensitive patients possess the same genetic profile as those with celiac disease—HLA DQ2 or DQ8. And with that we watch another stable datum ‘bite the dust’. This opens the door to a new interpretation of genetic testing that doctors should be aware of. Instead of being too quick to tell a patient that while they may have the genes for celiac disease, considering that their blood tests are negative for the disease they’re fine to eat gluten; we now understand that such genes can be present in a case of gluten sensitivity as well. And as we now know, the classic celiac blood tests would be negative in such a case.

I believe we’ll be seeing a wide array of genes responsible for these diseases in the future. But knowing that almost half of those with gluten sensitivity demonstrate the exact same genetic profile as someone with celiac disease is important to know when a patient or their doctor is trying to make an accurate diagnosis. Based on this common gene profile, it is then not surprising to learn that gluten sensitivity can be found in celiac disease family members. In this study almost 13% of the gluten sensitive patients were first degree relatives of celiac patients.

What Might the Future Hold?

As a clinical nutritionist, I have been speaking of celiac disease and claiming the existence of gluten sensitivity for over two decades now. We continue to discover more and more about these conditions. One day there will be a near perfect test and one day we will readily and easily diagnose most all of those suffering. And that my friends, will be a good day! I hope you found this informative.

Find Out Your Gluten Sensitivity Level!

Get diagnosed!—contact us for a FREE CONSULTATION. 

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

To your good health,
Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Celiac Disease vs. Gluten Sensitivity—Are They Different?

70-80% of Medical Research is Funded by Pharmaceutical Companies

We live in a society where medical treatment efficacy is gauged by two major standards:

1) Make a diagnosis, then

2) Find the drug best suited to treat the symptoms associated with that diagnosis

Fully 70-80% of all medical research is funded by pharmaceutical companies. Where does celiac disease fit into this paradigm? Celiac disease is considered to be a rare disorder and there is no drug to treat it. You can imagine where that puts it on the hierarchy of most medical practitioners.

In addition, the “face” of celiac that most doctors are taught, is a patient presented with chronic diarrhea and severe weight loss. Is it any wonder that little emphasis is put on its diagnosis? Once the patient with severe weight loss has been ruled out for cancer and other serious diseases, then their doctor might consider celiac disease.

What’s the Difference Between Celiac Disease and Gluten Sensitivity?

In my opinion, very little. The problem we have encountered is that celiac disease is the only manifestation of gluten sensitivity that medicine has been able to diagnose. And not very well at that—considering it takes the average celiac patient as long as 10 years before they're even given the proper diagnosis.

So what is the problem?

Is it that something considered rare is not often looked for?  Partially.

Is it because there's no drug to treat it, so there's no “easy fix”?  Partially.

Is it the fact that the only treatment for it is a dietary change—and no one really wants to “condemn” a patient to never eating wheat, rye or barley again?  Definitely!

Is Celiac Disease Just a Subset of Gluten Sensitivity?

Celiac disease is just the tip of the iceberg of the greater issue called “gluten sensitivity”. 

In this case, the tip is 1/40 of the whole iceberg—because research has been telling us that while celiac disease affects 1% of the population, gluten sensitivity’s incidence is anywhere from 7% to up to 40%. 

Estimates vary widely. But even conservative estimates take it right our of the “rare” category with higher estimates putting it squarely in the category of obesity which is considered to be an epidemic!
 
The Problem with “Diagnosis”

The “gold standard” for diagnosing celiac disease has been a positive intestinal biopsy that reveals severe degradation of the surface of the small intestine. But damage has to occur for many years before such a test is positive, not to mention all the secondary problems that have likely arisen during that time. Yet we wait and wait for that positive test during which time it's considered “perfectly good medicine” to tell a patient to continue eating gluten if their test is negative!

Is It Malpractice?

I have been saying that, within the decade, the current protocols being used to diagnose and treat celiac disease will be looked upon as malpractice. Is that too strong a statement? I don't think so. 

Do we wait for a patient to have a heart attack before we assess risk factors for cardiovascular disease? Of course not!

So why is it acceptable to allow a patient to get to the point of severe atrophy of their intestine with concomitant malabsorption, inflammation, and risk of autoimmune disease before we make a diagnosis? It isn't!

Gluten Intolerance Puts You at Risk for Many Severe Diseases

I've been working with gluten sensitive patients for around 20 years and even co-authored a book on the subject, "The Gluten Effect". What I have come to find out through research and clinical experience has taught me that we have an obligation to our society to change our procedures and strategies.

We are creating many ill patients by missing the diagnosis of gluten sensitivity.

Such things as: obesity, depression, anxiety, fatigue, migraines, IBS, and autoimmune disease (such as arthritis, lupus, diabetes, thyroid disease, and osteoporosis) are all implicated with gluten sensitivity. The list is long and growing as we learn more.

Everyone Should Be Screened

I believe everyone should be screened for gluten intolerance, which includes both celiac disease and gluten sensitivity. It involves a simple lab test which should be evaluated by an experienced clinician. The reasoning behind this is that interpretation of these tests requires some experience and it's often not a simple “yes” or “no” proposition.

Most researchers and clinicians prefer also using a blood test, although the efficacy of saliva testing has been validated. Personally, I use blood and saliva testing both for my patients, with a stool test recommended for those living too far away to come into the office.

What if the test is equivocal? What if it’s in the gray “suspicious but not confirmed” area? The TRUE gold standard test is evaluating a dietary change—it's called elimination and provocation. Eliminate gluten completely from your diet for a minimum of 30 days and see how you feel. If you notice a change, that is considered a positive test.

We are committed to spreading the word about gluten and are here to help you, your family and friends. Patients come to see us from around the country and internationally.  

Our clinic is in Sunnyvale, California. Please let us know if you want to visit. Or call to schedule a FREE CONSULTATION: (408) 733-0400.
I look forward to hearing from you.

To your good health,
Dr. Vikki Petersen, DC, CCN

IFM Certified Practitioner

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

New Research Argues There IS a Test for Gluten Sensitivity

Best Blood Test to Diagnose Gluten Sensitivity

Mainstream literature continues to state there is no blood test for gluten sensitivity. While it may not be perfect (but what tests are?) some researchers offer a differing opinion, and I wanted to share their results with you.

While there is no further argument of the existence of gluten sensitivity, having a blood test that everyone can agree on has not yet occurred. 

In a 2012 study published in Clinical Reviews in Allergy & Immunology entitled “Serological Tests in Gluten Sensitivity”, the authors set out to characterize a potential pattern in blood testing that would be helpful in diagnosing gluten sensitivity as compared with celiac disease.

They took 78 patients with gluten sensitivity and 80 patients with celiac disease, and retrospectively tested their blood for four standard tests, three of which are classically used for celiac disease, and one that is more commonly thought to be accurate for gluten sensitivity.

For those of you who like the specifics, the tests used were:

1) IgG DGP-AGA (deamidated gliadin peptide antibodies)

2) IgA tTGA (tissue transglutaminase antibodies)

3) IgA EmA (endomysial antibodies)

4) IgG/IgA AGA (anti-gliadin antibodies)

And the Winner Is…

Here are the findings:

The  IgG AGA test was the winner in detecting gluten sensitive patients—56.4% were positive. The test doesn’t rule out the presence of celiac disease however. 81.2% of celiac patients were also positive.

The IgA version of the same AGA test yielded vastly different, although not unexpected, results. The test was elevated in only 7% of gluten sensitive patients while 75% of those with celiac disease were positive. Why is that not a surprise? IgA is found on the mucous membranes of the body where it is exposed to outside foreign substances: nose, lungs, GI tract, ears, eyes, etc. Since celiac disease mostly affects the lining of the GI tract, it isn’t unexpected that the IgA part of the immune system might be most affected.

But when you compared the “classic” celiac tests against the gluten sensitive patients, the results were rather definitive—only one gluten sensitive patient was positive for DGP-AGA and zero gluten sensitive patients demonstrated a positivity for tTGA or EmA. But the celiacs showed a positivity rate of 88.7%, 98.7% and 95% respectively for these three tests.

What Do We Know From This?

A couple of things:

1) Ensure that when you are tested you receive a complete panel of tests, including all those mentioned above. Additionally both the IgA and IgG versions should be included, especially for the AGA test.

2) When interpreting the tests, remember that you are doing more than just ruling out celiac disease. For many doctors that is their goal. Despite international research knowledge to the contrary, many doctors still don’t appreciate the existence of gluten sensitivity. While no single test is perfect, if you’re suspecting celiac and you test positive for the classic celiac panel of tTGA, EmA and DGP-AGA, then you’ve likely identified your condition. 

If you know that you do poorly with gluten and test positive for AGA, especially the IgG version, and negative for the rest of the celiac panel, you can feel more assured of a gluten sensitive diagnosis.

Some other tell-tale signs of gluten sensitivity, according to the researchers, are a varied clinical picture, meaning many symptoms occurring at the same time. And while many of these symptoms are similar to another disease, IBS, the authors warn against considering gluten sensitivity as a subtype of IBS. 

The “extraintestinal” symptoms so common with gluten sensitivity are not typically seen in those patients suffering with IBS, making the distinction clear, in these researchers’ opinion.

The common complaints associated with gluten sensitivity include:

• abdominal pain, bloating, diarrhea, constipation
• foggy mind, tiredness
• eczema/skin rash
• headache
• joint/muscle pain
• numbness of legs/arms
• depression
• anemia
• together with a normal or mildly abnormal lining of the small intestine

In conclusion, when you’re building a case for gluten sensitivity, you need to look at several factors: blood testing, symptoms, and reactions to eating and eliminating gluten.

New Information on Celiac Genes

In the past, the rule of thumb was that “you could never have celiac disease if you didn’t carry the genes for it”. That remains true, but these researchers cited findings from 2010 that demonstrated a full 40-50% of gluten sensitive patients possess the same genetic profile as those with celiac disease—HLA DQ2 or DQ8.

And with that we watch another stable datum “bite the dust”. This opens the door to a new interpretation of genetic testing that doctors should be aware of. Instead of being too quick to tell a patient that while they may have the genes for celiac disease, considering that their blood tests are negative for the disease, they’re fine to eat gluten; we now understand that such genes can be present in a case of gluten sensitivity as well. 

And as we now know, the classic celiac blood tests would be negative in such a case.

I believe we’ll be seeing a wide array of genes responsible for these diseases in the future. But knowing that almost half of those with gluten sensitivity demonstrate the exact same genetic profile as someone with celiac disease is important to know when a patient or their doctor is trying to make an accurate diagnosis.

Based on this common gene profile, it is then not surprising to learn that gluten sensitivity can be found in celiac disease family members. In this study almost 13% of the gluten sensitive patients were first degree relatives of celiac patients.

What Might the Future Hold?

As a clinical nutritionist, I have been speaking of celiac disease and claiming the existence of gluten sensitivity for over two decades now. We continue to discover more and more about these conditions. One day there will be a near perfect test and one day we will readily and easily diagnose most all of those suffering. And that my friends, will be a good day!

I hope you found this article informative. If your health is not to the level you desire, consider contacting us for a FREE Health Analysis. Call 408-733-0400.

We are a Destination Clinic and treat patients from across the country and internationally. We are here to help!

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,
Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Reference:
1. Clinical Reviews in Allergy & Immunology 2012
Serological Tests in Gluten Sensitivity (Nonceliac Gluten Intolerance)
Umberto Volta, MD, Francesco Tovoli, MD, Ronny Cicola, MD, Claudia Parisi, MD,
Angela Fabbri, MD, Maria Piscaglia, MD, Erica Fiorini, MD, and Giacomo Caio, MD

2. Clinical Reviews in Allergy & Immunology 2010
Cutting-edge issues in celiac disease and in gluten intolerance.
Bizzaro N, Tozzoli R, Villalta D, et al.