With a wide variety of symptoms associated with gluten sensitivity, gaining an accurate diagnosis can be difficult in many cases. One of the best ways to pinpoint gluten sensitivity is to go on an elimination diet; other means of testing for gluten sensitivity include antibody test, genetic test or a small intestine biopsy.
The following blood panel, measuring serum antibodies
• Endomysial antibodies (EMA) • Tissue transglutaminase antibodies (tTG)
• IgG tissue transglutaminase • Total IgA antibodies
The antibody test will determine the response a patient’s body is having to the gluten protein. A person with a gluten sensitivity will have higher-than-normal antibody levels.
In addition, the following tests are often conducted by thorough doctors when evaluating patients for a non-celiac gluten sensitivity, a gluten intolerance or a verified case of celiac disease:
• Stool Fat test, to determine malabsorption level (test for Steatorrhea).
• Complete Blood count (CBC), to determine anemia.
• Erythrocyte Sedimentation Rate (ESR) to look for inflammation.
• C-Reactive Protein (CRP) to further watch for chronic inflammation
• Vitamins A, D, E and K (the fat-soluble vitamins) to check for vitamin deficiency relating to malabsorption in the proximal small intestine.
• Comprehensive Metabolic Panel (CMP) to analyze protein, calcium and electrolyte levels as well as to check liver and kidney functions.
The most established genetic test is specific to celiac disease and not necessarily for a wheat allergy, a non-celiac gluten sensitivity or a broader gluten intolerance. But it can help either verify the presence of celiac disease or identify people who may be predisposed to developing celiac disease. Because it can be done in a non-invasive manner (a saliva swab is often enough), this celiac disease genetic test is often done for at-risk children.
The test looks for the HLA-DQ2 and HLA-DQ8 genes. If one or both genes are present, the individual is at far greater risk of developing celiac disease at some point in his or her life.
Small Intestine Biopsy
If a patient receives a positive antibody or genetic test, it is recommended that he or she undergo a small bowel biopsy to determine if there is damage to the villi. The biopsy is taken using an endoscope, which is a long, thin tube that the physician weaves through the mouth and stomach to reach the small intestine.
For more information on the testing and treatment of gluten sensitivity available at The Center for Natural & Integrative Medicine, contact our office at (407) 355-9246
Our next blog will review treatment of gluten sensitivity/intolerance.