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voix
Joined: 10 Apr 2008
Posts: 145
Location: Colorado
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 Posted: Tue Apr 22, 2008 7:54 pm Post subject: Being GF before a Blood Test for CD |
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I was wondering if I misunderstood something about the cd blood test.
My nurse said that gluten markers or what ever they are testing, stay in the blood for one year after you stop eating gluten. I asked her two separate times.
I thought that I read that one needs to be consuming gluten until the test (at least two weeks before) to get the indicative readings.
I went ahead with the test on Monday at noon, but since the Thursday before I have been gluten-free without any mistakes. I am pretty sure that there were no mistakes or cc's, but it seems that any solid food (no smoothies or fresh juices of veggie and fruit) results in a bigger tummy (not necessarily bloat), so there is something still going on, like a reaction to something else or healing, if anything.
Did I misread when I thought something said that one needs to consume gluten for two weeks beforehand--or is that just for the biopsy? Can anyone explain the nurses position?
Do you think that my test will be faulty from the 4.5 days of being gf? |
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aklap
Joined: 02 Oct 2004
Posts: 8350
Location: WI, USA
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| Posted: Tue Apr 22, 2008 9:59 pm Post subject: |
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To my knowledge, the blood work [antibody levels] can start to normalize in a matter of weeks. I'm looking for more info to backup my response. In the mean time have a look at this...
Clan Thompson's Ask the Doctor - Testing & their results
9. Are test results accurate if they're done after you've already gone gluten-free?
| Quote: | QUESTION: My family has a history of Celiac Disease and my mom had some of the same symptoms as the rest of us. She had a RAST allergy test with an allergist last fall and was told that she is allergic to mushrooms, bananas, corn, wheat and candida yeast. The allergist put her on a strict candida diet with the avoidance of wheat, corn and gluten at the same time. She then went to a GI who didn't think she had Celiac Disease, but, ordered the IGA and IGG as well as an endoscopy. Her IGA and IGG was taken 1 month after she had gone gluten free (she knew how to go gluten free and it was easy for her because of the family history, so no real gluten mistakes). The endoscopy was done 2 months after going gluten free. Both of these procedures were done with the doctors knowledge of her being gluten free and both came back negative.
Our question is, are these tests probably accurate even though she had been gluten free? Or, does she probably have Celiac Disease, but it didn't show up because she was gluten free?
DR. RUDERT: There is certainly the possibility that your Mom had already healed after being on a gluten-free diet for two months. From your letter, I cannot tell if appropriate blood testing was done for Celiac disease. Blood tests may also normalize after being gluten-free and depend on the degree of elevation and the type of blood test (blood tests should include antigliadin IgG and IgA in addition to antiendomysial ab and tissue transglutaminase). |
4 or 5 days I doubt would make much of a difference.
There is no standard when it comes to a gluten challenge. It time and the amount of gluten varies. Often - it's 6 - 8 - 12 weeks of gluten.
_________________
Al
“We cannot all do great things, but we can do small things with great love.” Mother Teresa
Last edited by aklap on Tue Apr 22, 2008 10:25 pm; edited 1 time in total |
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aklap
Joined: 02 Oct 2004
Posts: 8350
Location: WI, USA
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| Posted: Tue Apr 22, 2008 10:19 pm Post subject: |
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Dr. Fine of EnteroLab view on antibody normalization.
| Quote: | Do I have to be eating gluten for a gluten antibody test to be positive?
Because production of antigliadin antibodies is under genetic control, your body continues to make these antibodies for an extended period after gluten is removed from the diet, albeit, in lesser quantities the longer gluten is removed from the diet. Research has shown that these antibodies continue to be produced at lower levels for months, even 1-2 years after gluten is removed from the diet. Stool tests can continue to detect these low levels of antigliadin antibody produced in the intestine over this 1-2 year period (and longer if there is still small amounts of gluten in the diet, even hidden gluten); tests for antigliadin antibody in the blood routinely become negative after 3-6 months on a gluten-free diet. |
Now - he references antigliadin antibodies. The time frame may be different for tTG or EMA tests. It can take up to 1 to 2 years for full intestinal healing - which would result in the tTG/EMA blood work to normalize. Something also to keep in the back of your mind - tTG test accuracy goes down when there is NOT Total Villous Atrophy. What does this mean? tTG may return a false negative if the damage is not severe enough. Partial villous atrophy will be caught when examining biopsies.
http://www.ncbi.nlm.nih.gov/pubmed/10710062?dopt=Abstract
| Quote: | Am J Gastroenterol. 2000 Mar;95(3):712-4.Related Articles, Links
Disappearance of endomysial antibodies in treated celiac disease does not indicate histological recovery.
Dickey W, Hughes DF, McMillan SA.
Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern Ireland, UK.
OBJECTIVE: Although serum IgA-class endomysial antibody (EmA) has high sensitivity for villous atrophy (VA) in patients with untreated celiac disease, few studies have attempted to correlate EmA seroconversion with histological recovery after starting a gluten-free diet. We prospectively studied changes in EmA status and in duodenal histology of seropositive patients after dietary treatment.
METHODS: Patients with VA and EmA had repeat EmA testing at 3, 6, and 12 months after starting gluten-free diet, plus assessment of dietary compliance by dietitians and follow-up duodenal biopsy at 12 months. VA before and after treatment was classified as partial (P), subtotal (ST), and total (T).
RESULTS: Of 77 patients with newly diagnosed VA and without IgA deficiency, 62 (81%) had EmA: 46 of 57 (81%) with T or STVA and 16 of 20 (80%) with PVA. Of 53 initially EmA-positive patients who completed study criteria, EmA was undetectable in 31 patients (58%) after 3 months' diet, in 40 (75%) after 6 months, and in 46 (87%) after 12 months. However, only 21 patients (40%), all seronegative by 12 months, had complete villous recovery. Only three (33%) of 10 patients with persisting ST or TVA and two (9%) of 22 with PVA remained EmA positive. Four of the five patients with persisting EmA had poor dietary compliance.
CONCLUSIONS: EmA is a poor predictor of persisting VA after patients have started gluten-free diet, although it may be of value in monitoring dietary compliance. Although there are no clear guidelines regarding the need for follow-up biopsy, EmA seroconversion cannot substitute. The apparent association between dietary compliance and seroconversion suggests that gluten intake may determine whether untreated celiac patients are EmA positive or negative for a given degree of small bowel damage.
PMID: 10710062 [PubMed - indexed for MEDLINE] |
This study shows 58% of the patients had negative EmA blood work after 3 months on the diet. This doesn't mean that they were healed however.
_________________
Al
“We cannot all do great things, but we can do small things with great love.” Mother Teresa |
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voix
Joined: 10 Apr 2008
Posts: 145
Location: Colorado
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| Posted: Thu Apr 24, 2008 5:25 am Post subject: |
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| thanks, you are so thorough and use great supporting resources. this explains a lot. the two year lingering antibodies really make you think twice about cheating |
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