Sunday, August 12, 2012

Gluten illness diagnosis: primarily elimination and challenge

Just been emailing yet another person who wants a certain diagnosis for gluten sensitivity.  I said:

“Many people do not get the full set of blood tests from their healthcare professional.  They, like you, often feel your frustration. However, the first thing to do is exclude celiac disease (you have now done this on several occasions, with two normal tTG tests).

The next point to understand is that the gluten sensitive test, IgG-gliadin antibody, is not a 100% accurate test.  If you have a high level of this antibody, then gluten sensitive is very likely.  But a negative test does not rule this out.

At your stage (still unwell with normal celiac disease test), your next step is to trail a gluten-free diet for the next 3-4 months to see how you feel. It is worth while, and not hard to do. The diagnosis of gluten sensitivity (or gluten-related-illness) is primarily a elimination and challenge exercise.

See this paper:
The top 15 celiac-doctors have now acknowledged that gluten-related-illness is real, it needs much better diagnostic tests, and it is common. They have released a powerful consensus statement: "Spectrum of gluten-related disorders: consensus on new nomenclature and classification."
Sapone A, Bai J, Ciacc C, Dolinsek J, Green P, Hadjivassiliou M, Fasano A, et al.
 BMC Medicine 2012, 10:13

Hope that this helps you
Cheers, Dr Rodney Ford