May is Celiac Awareness Month. Some of us are aware of Celiac every single day whether we have Celiac Disease, or are sensitive to gluten, which in either case a person is intolerant. Symptoms and the remedy are pretty much the same for both as symptoms are widely variable, and the remedy is to avoid all gluten always.
I’ve noticed when talking to folks who have been told they “might have a problem” with gluten, that there are things some people don’t know about testing for Celiac, so I thought it might be helpful if I pass on what I’ve learned from reading “The Gluten Connection,” by Dr. Shari Lieberman, and also from reading several web sites. (I have links to other sites in other articles in the “Learning to Live Gluten-Free” category on this blog.)
One study has shown that in Celiac Disease, the body sees gluten as an invader and it attacks the gluten. In gluten sensitivity, the body sees gluten as an invader and puts up a defense. This is partly why things get complicated when testing for gluten intolerance.
When the blood is tested for Celiac, they are looking for antibodies – antigliadin (IgA), transglutaminase (ATTA) and anti-endomysial antibody (EMA). If the first two are present, it shows that there is a problem with gluten, but only if all of the villi in the small intestine are completely flattened will all three be present. According to Dr. Lieberman, “more than 30 gliadin peptides (molecules) are not evaluated by this test.” Everyone pretty much seems to agree that blood tests can be inconclusive. Advanced Celiac will be evident in a biopsy of the small intestine, but it can be missed if it’s not advanced to the point of completely flattened villi. Also, gluten sensitivity will not flatten the villi. I’ve read that Canada approved a pin-prick blood test for home use, but I don’t think it’s available in the US yet. Not sure about other countries. The stool test seems to be controversial, just going by what I’ve read on web sites, with some people saying it’s not reliable and others saying it was a life-saver for them.
Since blood tests are sometimes inconclusive a person will say “they said I don’t have Celiac, but I have problems when I eat gluten.” The other reason that testing is complicated is that a person can be sensitive to gluten and not have Celiac. Again, the remedy is to avoid all gluten in either case. If I had a test done and it showed negative or inconclusive results, but I noticed that I feel better off gluten, then I think I’d just blow off the test and avoid gluten. Do you think it makes sense to continue eating something that is causing symptoms ranging from pain to depression to thyroid problems to intestinal upsets of various kinds and on and on, just because the test said something different from what a person’s body says? I think I’d listen to my body over a test result. They are still learning about gluten intolerance. One thing they do know is that gluten in any amount can affect the body for months, so if a person is sensitive it may take time to feel better when coming off of it.
Something else I’ve noticed while reading different sites is that sometimes the term “allergy” is used when this is not the same thing. An allergy, such as wheat allergy, causes a release of histamines. Celiac Disease and gluten sensitivity are not allergies. They are both a type of food intolerance.
Here is another site that I just found today: http://www.celiaccentral.org/ This is a site run by The National Foundation for Celiac Awareness and it looks like one of the best ones I’ve run across. There is information on all aspects of gluten-related items from diagnosis to shopping to research and more. They even have cooking videos.
There is a lot of information on various web sites, as well as in books and magazine articles. I’ve noticed some of it is conflicting. One reason is that gluten sensitivity hasn’t been recognized for as long as Celiac Disease has been. We need to be sure to keep it straight about allergy and food intolerance when we are reading about gluten. Also, we must listen to our bodies. Serious damage can be done if we don’t.