Are you Wondering Whether You have Celiac Disease or Gluten Sensitivity?
Jul 07, 2016
You were just minding your own business and living your life when you went to a picnic on the 4th of July. You knew something was wrong as soon as you ate the cous cous salad. You felt sick to your stomach, or maybe you felt a nap attack coming on, or maybe some brain fog kicked in. Or you joints started hurting… Oh wait!!!! Cous cous has GLUTEN in it right? “D’oh! I did it again! I got cous cous mixed up in my mind with quinoa!”. “Maybe”, you think, “I just can’t handle any wheat or gluten at all, even a little bit!”
Janine, a 45 year old mother of 3 noticed worsening gas and bloating after she ate wheat. She had read online about celiac disease and asked me about it. Does this sound familiar? It seems like a lot of people are reacting negatively in their guts to wheat and gluten products. She did notice that she felt better when she took gluten out of her diet entirely. Her stomach didn’t blow up so much but she also wondered how strict she really needed to be to maintain her health. Couldn’t she have some birthday cake or some great bread once in a while? Celiac patients can have serious health repercussions even with trace cross contamination and can manifest in more serious issues such as malasorption, anemia, liver involvement, and an increased risk of developing cancer. So for Celiac Disease sufferers the answer is an unequivocal NO! And some people with gluten sensivity also have severe reactions so for them the answer is NO also. As well as for those with an autoimmune disease, but for others, they won’t make the change without further testing, so this is for them!
Gluten is a protein that is found in many grains. It is the protein that makes dough stick together so that you can have nice chewy breads, flaky crusts. If you have had many gluten free baked goods, you will notice that the breads tend to crumble a lot. That is because they don’t contain gluten! And a lot of gluten free baked goods contain a lot of added sugar because sugar also helps foods stick together. Gluten is found in wheat, spelt, barley, kamut, oats and rye, as well as things you may not think of such as soy sauce. Caramel coloring and other food additives.
The problem is that many people now, not just people with Celiac Disease, are reacting to gluten. Why this is, we are not sure, but it could have to do with modern agricultural practices such as the use of Glyphosates and GMO’s which make the protein in the grain pretty indigestible. Gluten is often implicated in worsening autoimmune diseases as well as exacerbating inflammation and joint pain. There is also some ridiculous backlash among more conventional docs who say that gluten intolerance and Celiac Disease is a made up disease and all in your head. Though for practitioners like myself who do Naturopathic and Functional Medicine, we know that many of the illnesses we see in our office everyday have a relationship to gluten as part of the cause or trigger. And also we see miracles happen every day when people change their lifestyle and diet and start to heal!
So how do you determine whether what you have is run of the mill gluten sensitivity or the more serious Celiac Disease?
There is a simple blood test, right? Well not really. Because if you are like me and have been avoiding gluten for decades the test will come out as a false negative. In order to have a positive Celiac test, you need to have been consuming gluten at the rate of 4 slices of bread for the 6 weeks prior to testing. That is a LOT of bread, right? If you are like most gluten sensitive and celiac patients, that would make you quite ill. Who needs that?
I am going to break it down for you, so that you can decide how and if you want to test to rule out Celiac Disease. Because knowledge is power!
- Blood Testing – This blood test is testing for Serum Tissue Transglutaminase Antibodies, otherwise known as the tTG-IgA This is often the first line of Celiac Disease testing that doctors order. If positive, you will usually be recommended to go on to the gold standard Celiac Test, which is the biopsy, but more on this later. Your serum tTG-IgA will come back negative if you have been actively avoiding gluten so there are a lot of false negatives out there with this test so take with a grain of… something gluten free!
- The Biopsy – An endoscopic biopsy of the small intestine is often done next. This officially confirms the diagnosis of Celiac Disease. It is , as I said above, the GOLD STANDARD in Celiac testing, but again, there will be false negative if you are actively avoiding gluten, and… Geez! Who really wants to go through with that! But if you had a positive serum test and you pinky swear to avoid gluten for the rest of your days, you may just decide to skip this test. Many people do just that. If you have been actively eating lots of gluten and you have to know you are Celiac in order to completely avoid gluten you most certainly should do this test. It is usually covered by insurance and if you won’t give up your delicious pasta and bread unless this test comes back positive then you should go ahead and do it. Because, like I said, knowledge is power!
- Genetic Testing for susceptibility. This is for those of us (I fall in this category!) who have symptoms when we consume gluten, but have felt so great off gluten, that we just aren’t going to start eating it again for a lousy test! We just won’t do it. So for us, there is genetic testing. The culprit gene in this case is the HLA DQ2 and HLA DQ8 People with celiac disease carry one or both of the HLA DQ2 and DQ8 genes. Having one of both of these genes does increase your risk of developing Celiac Disease or at the very least having gluten sensitivity. Those of us off gluten who weren’t already tested may never really know if we have Celiac or not, but at the same time you lessen your chances of going on to develop Celiac Disease, and other autoimmune diseases , if you don’t eat gluten.
If you have been diagnosed with Celiac Disease or you have other gut issues that aren’t responding to removing gluten from your diet, just know that gluten is really just the tip of the iceberg! Often there is an associated Leaky Gut Syndrome that occurs as a result of the damaged villi of the intestine (tiny finger like structures in the intestine where your food gets absorbed) so you may also react to other foods also. Obscure foods that aren’t common allergens. So in order for the treatment to be very effective, more comprehensive testing is in order. Testing for delayed food allergies, a comprehensive stool analysis which would also test for inflammatory markers, maybe even a SIBO breath test if the other tests are inconclusive and there are still issues. And then a concerted full plan with various supplements is the best way to heal the gut.
If any of these issues ring a bell, and you wish to explore them further with me, I am available for a FREE 15 minute phone consult. You can now schedule that online at https://intakeq.com/booking/NaURW8 or the old fashioned way by calling (303) 443-2206 M-F 8:30-5 Mountain Time. Whether you are a current patient, or someone I haven’t seen in quite a while, or brand new to my practice, I would love to connect!
Hope to hear from you soon!
