2 questions for this brainy bunch: IgE vs IgA and histamine

wmonique2 · Post by **wmonique2** » Fri Sep 07, 2012 2:32 pm

Hi everyone!

under what conditions would you test for IgA vs. IgE and how to you assess histamine levels in the gut?

Thank you my dear friends,

Monique

Post by **tex** » Fri Sep 07, 2012 3:35 pm

Hi Monique,

The first question is easy, the second one, not so much.

You would test for IgA antibodies in the stool when looking for food sensitivities. The serum IgA tests are only useful for detecting fully-developed celiac disease, and they're so insensitive that they will only catch roughly 70% of all fully-developed celiac cases. They won't detect any celiac cases if the Marsh level of damage is still below 2.

You would test for IgE antibodies when experiencing upper respiratory or skin symptoms. IgE reactions are short-lived so you would need to check within a couple of hours of the initiation of a reaction, ideally, because they peak within a couple of hours and then decline over a day or two.

Histamine levels are a little trickier, because I'm not aware of a simple test that is effective for accurately measuring them. One way to go about it is to have your doctor measure your tryptase enzyme level with a blood test, because whenever mast cells degranulate to release histamine, tryptase is also released, and it will be in the blood. That makes it a reliable (though indirect) marker of histamine levels in the blood. Again, these levels peak within a couple of hours, so you would need to have a sample of blood taken within a couple of hours of the initiation of a reaction, ideally, because the levels will decline from that point, over a couple of days.

To actually check for histamine levels in the gut would be a bit tricky, because that would presumably require the analysis of mucosal biopsy samples taken from the gut, while the reaction was near the peak. Taking samples for tryptase testing (either in the blood or by biopsy) at random times is seldom productive, because of the tendency of histamine reactions to spike and then fade away. Unless a sample is captured at a high point, the results will always be normal. That's one of the things that makes the diagnosis of systemic mastocytosis so difficult — it's not easy to get a sample during an optimum time frame.

You're most welcome,
Tex

wmonique2 · Post by **wmonique2** » Fri Sep 07, 2012 4:31 pm

Hi Tex,

I don't know how to answer except to say that you amaze me...I am digesting your information...thank you so very, very much.

Monique

Leah · Post by **Leah** » Fri Sep 07, 2012 6:47 pm

I am reading a lot about histamines right now and it can be very tricky. I was looking into maybe trying DAO supplements, but you have to take them with your meals to work. Not very convenient. I think I have decided to try to cut back on high histamine foods ( but I just can't give up avocados) and take an antihistamine once a day at least until I hit the 8 week mark of being off Entocort. I don't want to relapse!

Leah

wmonique2 · Post by **wmonique2** » Fri Sep 07, 2012 6:59 pm

Hi Leah,

I am reading a lot about histamine too...It's amazing how much information you can find right here. I tell you I could live another 50 years and never hear a word about it from either my doctor or any other source.

YES, please don't relapse! I have had the week from hell! I am doing better today but I went back to entocort 2 days ago. I will wait a while before I try it again.

I suppose you read Carol's post on DAO and Quercetin. Tex covered these topics recently somewhere (if I could only remember where). I am bookmarking all these topics for when I am ready to reduce my meds and get off of them. Can't wait for that day!

Regards,

Monique

Leah · Post by **Leah** » Fri Sep 07, 2012 7:36 pm

Hi Monique. I am so sorry that you relapsed. All I can say is that getting off of them was a very SLOW process. I went from 3 pills to 2 in about a month. I stayed on two for another couple of months. I went to one pill a day for about two months. Then I dropped it to one every other day for a month or so. One every 2-3 days and so forth. I don't know how slowly you did it last time, but hopefully, when you are ready to do it again, you will have better results. Are you feeling better now?

Leah

wmonique2 · Post by **wmonique2** » Fri Sep 07, 2012 7:52 pm

Hi Leah,

I have been going very slow on entocort as well---I have been on 1 pill for over 2 months...I believe I relapsed because I was exposed to gluten last sunday...
Today I had a pretty good day. I even had a friend come and visit which cheered me up. I had acupuncture everyday this week. I believe that by sunday I'll be able to go out (I better don't go back to that mexican restaurant where I had the tilapia that sent me over the edge!!! No mexican restaurants for me for a long time! I don't even like mexican restaurants, I went with friends ;-)

I hope you stay well. Let us know what you're doing with the antihistamine thing.

Regards,

Monique

carolm · Post by **carolm** » Fri Sep 07, 2012 8:10 pm

Monique and Leah,

If you haven't read it already, I think you'll want to take a look at this article Mary Beth shared. I was impressed with the scope of information in this one article.

http://alford.grimtrojan.com/Mast_Cells ... isease.htm

Carol

wmonique2 · Post by **wmonique2** » Fri Sep 07, 2012 9:09 pm

Tex,

referring to your answer re IgA...If the tests are so insensitive, would I be wasting my money when I send in my sample next week? Or are they just insensitive when it comes to celiacs?

Thank you, Tex for enlightening me.

Monique

wmonique2 · Post by **wmonique2** » Fri Sep 07, 2012 9:28 pm

Carol,

I just briefly read it. THANK YOU SO MUCH. I am amazed at the amount of sources and scope of this article. I will reread more carefully tomorrow.

Regards,

Monique

Post by **tex** » Fri Sep 07, 2012 9:29 pm

Apparently I've managed to confuse you, and I apologize for that. It's the blood tests that are insensitive.

The stool tests offered by EnteroLab are very sensitive and generally reliable. Compared with the blood tests, the stool tests are several orders of magnitude more sensitive. For example, if you should have fully-developed celiac disease, and you decide to cut gluten out of your diet, after about 2 or 3 months, the odds of a blood test detecting gluten antibodies in your blood would range from extremely slim to zero. On the other hand, the stool test offered by EnteroLab is capable of reliably detecting IgA antibodies to gluten for at least a year after gluten has been completely removed from the diet, and in most cases, their stool test can still detect gluten antibodies in stool samples for up to two years after adopting a GF diet.

In fact, the test shows the same sensitivity for the type of gluten sensitivity that those of us with MC who are not celiacs, have. No blood test is capable of detecting non-celiac gluten sensitivity, but the EnteroLab test can always detect it for up to a year after gluten is removed from the diet, and in many cases it can still detect it up to to two years. That's unprecedented sensitivity, as medical tests go.

The other antibodies, such as casein, soy, etc., don't last that long, but the EnteroLab tests can still typically detect them for at least a couple of months or so after they have been withdrawn from the diet. No blood tests are capable of accurately and reliably detecting IgA antibodies to any food sensitivities other than gluten, (and as noted above, even the gluten blood tests have very low sensitivity).

I hope that clears up the confusion that I apparently caused.

Tex

wmonique2 · Post by **wmonique2** » Fri Sep 07, 2012 9:40 pm

Hi Tex,

Thanks for explaining it all. I get easily confused since this is all so new to me

And thank you so very much for taking the time to answer to each one of us. I appreciate you answering before I hit the sack, that question would have kept me thinking half of the night :-)

Regards,

Monique