The Latest on Gluten Sensitivity Testing

by Melissa Diane Smith

If you’re confused about how you can find out if you’re gluten intolerant or not, here’s a rundown on the subject from three top experts.

Walk into your doctor’s office to try to find out if you’re gluten sensitive and you’ll almost always have trouble getting an answer. For one thing, your doctor may not want to run blood tests to test for the condition. If he does, he’ll probably only pay attention to tests that screen for tissue damage in the gut, an indicator of celiac disease. If the tests for tissue damage are negative, it’s common for a physician to ignore the test results that indicate an immune reaction (IgA and IgG gliadin antibody levels), even if those immune reaction tests come back positive. Many doctors simply tell their patients that they don’t have celiac disease and should keep eating a diet that contains gluten.

New tests to screen for gluten sensitivity may be developed in the future. In the meantime, doctors who are knowledgeable about gluten sensitivity and about how many people aren’t being diagnosed with the condition are using similar but slightly different ways to look for it.

Alessio Fasano, MD, medical director of the Center for Celiac Research in Baltimore, MD, recommends that patients get blood tests for celiac disease. If those tests are negative, he recommends getting tested for a traditional, IgE-mediated allergy to wheat. If that test is negative too, Dr. Fasano asks his patients to try a gluten-free diet and see if their symptoms abate. If they do, Dr. Fasano considers that the best test of gluten sensitivity right now.

Stephen Wangen, ND, author of Healthier Without Wheat and founder of the Center for Food Allergies in Seattle, WA, goes further in his testing. He has a laboratory analyze patient blood samples for IgA, IgG and IgE antibody levels to gluten and also to wheat and the other gluten grains. This panel of tests is a more comprehensive way to identify not just gluten sensitivity (also called gluten intolerance) but also an allergy to gluten or an allergy to grain components other than gluten. The latter two reactions exist but are less common than gluten sensitivity, Dr. Wangen says. Unfortunately, few doctors will run this spectrum of tests. That’s why more and more people are taking matters into their own hands and eliminating gluten from their diets on a trial basis to see if their symptoms improve or go away.

Rodney Ford, MD, a specialist in gluten illness from New Zealand, says instead of people having a “belief” in gluten sensitivity, there needs to be more widespread knowledge about the condition so it is acknowledged and diagnosed and people don’t needlessly suffer. Many practitioners may look for celiac disease but most simply are not looking for gluten sensitivity and therefore miss it.

Intestinal biopsy and celiac blood tests that detect tissue damage – the main tests used today – don’t identify gluten sensitivity. The IgG gliadin antibody test, which is used but commonly overlooked, is the best blood test to identify gluten sensitivity. The best clinical test is to try a gluten-free diet for three months, Dr. Ford says.

The focus with gluten-related illness should not be gut damage, nutritional deficiency, or intestinal biopsy results. The focus should be treating the symptoms that develop from eating gluten and that go away when gluten is no longer eaten, Dr. Ford says.

These three top experts agree that gluten sensitivity affects far more people than celiac disease and that a gluten elimination diet trial provides valuable information and sometimes the only information that is needed to detect gluten sensitivity.

One caution: If you happen to have silent celiac disease – a condition in which there is damage to the gut but few or no clear-cut symptoms – you might not notice a difference in how you feel by going gluten free. Therefore, if you have a condition that is a common complication of celiac disease, such as iron-deficiency anemia, osteoporosis, infertility, or an autoimmune disease, act from a place of knowledge and be sure to get the blood tests to screen for celiac disease first before eliminating gluten from your diet.

Melissa’s Comments:

I first wrote this information in my new book Gluten Free Throughout the Year and then again in this article that appeared in Better Nutrition magazine. The information I wrote last year (and in 2002 in Going Against the Grain) still holds true.

It’s increasingly clear that the best test to determine gluten sensitivity is whether you eliminate gluten in your diet and feel better. Unfortunately, people aren’t getting that message. I decided to run this article covering what top experts in the field of gluten intolerance are saying. In my next post, I’ll cover what was written in a recent medical journal article that confirms this information even more. I hope this two-step effort by me will show that it doesn’t matter whether you don’t test positive for celiac disease or wheat allergies. What matters is whether uncomfortable health symptoms lessen or go away when you eat gluten free. Although there are new tests, such as the one to test for autoantibodies against deaminated gliadin peptides, that test is another test to test for celiac disease, not gluten sensitivity that is not celiac disease, which affects far more people. So many people write me and say they didn’t test positive for celiac disease or wheat allergies, so their doctors tell them they aren’t gluten intolerant and should keep eating gluten, even though they feel better eating gluten free. To put it simply, those people’s doctors aren’t staying up to date on the latest information to help their patients.

Do you (or does your doctor) need more convincing? See the next post.

Copyright © 2011 Melissa Diane Smith


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