Friday, January 2, 2009

Enterolab Results

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value
Fecal Anti-gliadin IgA 163 Units (Normal Range <10>

Fecal Anti-tissue Transglutaminase IgA 152 Units (Normal Range <10>

Quantitative Microscopic Fecal Fat Score <300>

Fecal Anti-casein (cow's milk) IgA 112 Units (Normal Range <10>

HLA-DQB1 Molecular analysis, Allele 1 0301

HLA-DQB1 Molecular analysis, Allele 2 0602

Serologic equivalent: HLA-DQ 3,1 (Subtype 7,6)

Interpretation of Fecal Anti-gliadin IgA: Intestinal antigliadin IgA antibody was elevated, indicating that you have active dietary gluten sensitivity. For optimal health, resolution of symptoms (if you have them), and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.

Interpretation of Fecal Anti-tissue Transglutaminase IgA: You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.

Interpretation of Quantitative Microscopic Fecal Fat Score: Provided that dietary fat is being ingested, a fecal fat score less than 300 indicates there is no malabsorbed dietary fat in stool indicating that digestion and absorption of nutrients is currently normal.

Interpretation of Fecal Anti-casein (cow's milk) IgA: Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation Of HLA-DQ Testing: Although you do not possess the main HLA-DQB1 genes predisposing to celiac sprue (HLA-DQB1*0201 or HLA-DQB1*0302), HLA gene analysis reveals that you have two copies of a gene that predisposes to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having two copies of a gluten sensitive gene means that each of your parents and all of your children (if you have them) will possess at least one copy of the gene. Two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity may be more severe.

C) Egg, Yeast, and Soy Food Sensitivity Stool Panel
Fecal Anti-ovalbumin (chicken egg) IgA 35 Units (Normal Range <10>

Fecal Anti-saccharomyces cerevisiae (dietary yeast) IgA 35 Units (Normal Range <10>

Fecal Anti-soy IgA 140 Units (Normal Range <10>

Interpretation of Fecal Anti-ovalbumin (chicken egg) IgA: Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation of Fecal Anti-saccharomyces cerevisiae (dietary yeast) IgA: Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation of Fecal Anti-soy IgA: Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

THE MOTHER'S GENETIC TEST

Gluten Sensitivity Gene Test
HLA-DQB1 Molecular analysis, Allele 1 0301

HLA-DQB1 Molecular analysis, Allele 2 0301

Serologic equivalent: HLA-DQ 3,3 (Subtype 7,7)

Interpretation Of HLA-DQ Testing: Although you do not possess the main HLA-DQB1 genes predisposing to celiac sprue (HLA-DQB1*0201 or HLA-DQB1*0302), HLA gene analysis reveals that you have two copies of a gene that predisposes to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having two copies of a gluten sensitive gene means that each of your parents and all of your children (if you have them) will possess at least one copy of the gene. Two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity may be more severe.

8 comments:

  1. Hi, very glad to find your blog.

    After recently doing some "library" research on gluten sensitivities for a friend who has 3 kids with varying symptoms of auto-immune or growth issues that could be food sensitivity-related, I followed a hunch and had myself and my 10 yo son tested, also by Enterolab.

    Neither of us had any of the more obvious GI and rash symptoms you describe (but I have a younger sister who had terrible diaper rash 40 years ago), but there is celiac sprue in my husband's family ( a Norwegian cousin's 20-something yo son was diagnosed in infancy).

    And I am hypothyroid (common with gluten-sensitivity, apparently), diagnosed a few years ago when HT symptoms increased a LOT after couple years of weight gain primarily from too bread machine baking and high carb consumption (bread machine recipes often have have added wheat gluten!) and then weight loss with a low carb diet (and I was eating packaged LC pita bread which also has added wheat gluten and soy flour). I ditched the LC pita bread a few years ago because of the sour flour and a desire for less packaged and more "real" food.

    There were other subtle clues to possible gluten issues with my son (though I didn't connect the dots until recently and I'm still finding possible associations), like a lot of irritability and frustration the past few years doing schoolwork when he'd been eating bread (he's the only one who eats bread in our house), especially if he ate a lot of bread after there was no bread available for a week or two. And he gets a skin fungus on his face, usually in the summer, but just two weeks ago he got a patch after a week-long visit to my family over Christmas, when he had access to a lot of foods we don't usually eat, including the local Italian bakery's wonderful bread. The pediatrician always blew off the fungus issue and said just use an antifungal cream, but my research indicated it was more typical for teenage boys and young men (and on torsos, not faces) because of oilier skin, hormones, etc. The only other predisposition was immune issues, which didn't seem very likely. Bingo!

    And I often get some dry-eye problems (possible Sjogren's Syndrome) when we are on vacation, when I somewhat relax my normal LC way of eating (sometimes I have little choice) and enjoy a bit of good bread when it is available. I noticed my youngest sister had this same issue when I was visiting her in December, though she had it a bit worse. At that point I hadn't received the test results.

    Sure enough, we were both positive to antibodies and anti-tissue transglutaminase, and my son showed some mild fat malabsorption in his stool sample (360). He has one copy of a celiac gene and one gluten sensitivity gene; I have two copies of gluten sensitivity genes, so that means my husband also has at least one copy of a celiac gene and both my parents have at least one copy of the GS genes.

    Since our household is nearly grain-free already because my husband and I eat low carb and my son only eats a moderate amount of carbs, I don't anticipate too many issues with going completely gluten-free. I only bought about 2 bread loaves a month for my son the past few years; he has friends who are gluten intolerant; and he knows I need to stick to a pretty strict low carb diet to keep my blood glucose normal to avoid diabetes. So he's familiar with the concept of eating well to stay healthy and that not everyone can eat everything.

    What was a real shock was that we were both also positive for anti-casein IgA Antibodies. That will require a huge adjustment, as we love dairy foods. For the past few years I have even been making homemade fresh cheeses like ricotta, feta, and mozzarella.

    In some ways, the necessary changes at home will be less of an issue for us, as I am already making real, whole foods a priority with my cooking and food shopping (despite being a "lazy cook"). I actually get very little already from grocery stores (olive oil, butter, good dark chocolate, seafood, nuts, etc.) and buy the majority of our meat by the half-side and produce in a farm box subscription program (CSA) direct from the ranchers/farmers. I even get our coffee and tea from a local coffee shop that roasts the beans. They have a competitive price if I buy at least 5 pounds of coffee at a time. And by not buying very many convenience and snack foods and avoiding the grocery store and "middle man", I save money and don't have to bother with coupons (which are never for the foods I want anyway). I have learned to love feeding my family this way and it takes a lot less time than it would seem once I learned a few old-fashioned techniques like slow cooking. But it looks like I have a few new things to consider in my food selection and prep.

    So I generally know what is in or not in most of the food served at my table. The few labels that I do need to read have fairly short ingredient lists and are easy to understand. And we don't eat out at restaurants much anymore, except for now and then we go to a few places that prepare everything from scratch and specialize in local, seasonal foods. Traveling is when we have to deviate from that (interstate highways and airports are the most challenging) , but even then, I try to be choosy about food quality when I can.

    But after the surprising casein result, I decided to order the soy, yeast, and egg tests (Enterolab keeps the stool samples for 6 weeks so they still had our original sample to use). I won't know for another week or two. I already have avoided soy for several years (for all sorts of reasons too numerous to write here; I don't think soy is good for anyone to consume, except maybe in small occasional condiment portions as traditional fermented soy sauce, miso, and tempeh, etc.). I'll be really bummed if egg is a problem, though; our family of three goes through 3-4 dz eggs a week from a local "backyard chicken flock" lady that works with our neighbor and we love those eggs.

    Good luck with your progress and I look forward to reading about your food sensitivity journey.

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  2. Thank you for your story! I think it will be helpful for people to read. I think doctors usually brush aside things like the fungus you were talking about because they are not seeing the whole picture like you are, and they are trained to use scientific PROOF for diagnosis rather than all of the evidence that you see all over the place. It's very frustrating. I think in our case we'll avoid the "official" diagnosis if we can to avoid the "preexisting condition" issue from medical insurance.

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  3. I was also thinking about not mentioning the test results to our HMO docs. There's kinda no point, because I'm pretty good and finding information. And my husband is a research biochemist (he's not an MD and not in this area, though) so he helps me interpret the studies, etc. Though lately he says I'm way beyond what he knows in those areas. But I try hard to blend good science with my knowledge of food and nutrition when it comes to health decisions, and this time my gut instict (ha!) was right on.

    In the past, when I've talked food/diet with them, they tend to either brush it off, give useless advice, or show real lack of nutrition knowledge and even basic biochemistry, if you can imagine that (we no longer see one of those doctors). The dietician I saw when I was pregnant and diagnosed with Gestational Diabetes gave me a diet plan (ADA) that gave worse Blood Glucose meter readings than the usual way I ate. But I was able to work with her and show her what foods gave me normal readings (meat, eggs, full fat dairy, non-starchy veggies) and which I needed to avoid because they gave awful BG readings (anything sugary, starchy, especially without enough protein or fat). The recommended Low Fat/High Carb way of eating was disastrous for my blood glucose.

    My food paradigm shifted when I realized that there were more nutrients in the naturally low carb foods that kept my BG even and normal than in the low fat foods the diet authorities push. If it's good enough for gestating a baby, it's good enough! And after all, that's more like what our paleolithic ancestors ate, eh?

    Yeah, I don't talk food very much with the docs. Wastes too much of the precious ten minutes they allot to an appt now.

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  4. It sounds like you have an advantage with such good nutritional information. All my info comes from the internet. I would like to see a nutritionist but it takes a referral, and of course, the doc doesn't see the need. Thank goodness for the internet or I'd be lost!

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