Noob here. I've been diagnosed with Celiac but not MC.
I'm suspecting I have MC, and would like advice on if Enterolab testing makes sense for me, at this point.
First off does this sound like MC?
chronic diarrhea, usually only once a day, in the morning. Sometimes twice. Sometimes more, but usually just once.
Had it off and on since I was a kid.
Very often I can't identify a trigger for D
Food intolerances to the point that I can't eat out in restaurants (unless it's a dedicated gluten free kitchen.)
Intolerant to alcohol, coffee, tea, sodas (especially corn sugar ones), sugar, processed foods.
reaynaud’s,
bloating often
watery or fluffy diarrhea, usually 1x per day, first thing in the morning. urgent.
night sweats often
night leakage sometimes
itchy rectum sometimes
fatigue most days, to the point that I can't go to work anymore.
dizziness when standing up quickly
low IGG
low testosterone
Intolerant of antibiotics (diarrhea)
regular VSL#3 helps with the D a bit
Mesacol (like Asacol) helps - I take it when I have bad D - you know, the urgent explosive messy kind, where you have to clean the toilet up afterward.
Previous Enterolab testing (for celiac)
Fecal Antigliadin IgA 45 (Normal Range <10 Units)
Fecal Antitissue Transglutaminase IgA 33 Units (Normal Range <10 Units)
Quantitative Microscopic Fecal Fat Score 1288 Units (Normal Range <300 Units)
(this has since normalized in subsequent tests)
Fecal anti-casein (cow’s milk) IgA antibody 22 Units (Normal Range <10 Units)
HLA-DQB1 Molecular analysis, Allele 1 0202
HLA-DQB1 Molecular analysis, Allele 2 0603
Serologic equivalent: HLA-DQ 2,1 (Subtype 2,6)
I've had my thyroid tested a few times for a couple of the "T" things. TSH maybe. All normal
Tested for parasites quite a few times. All negative.
I'm scheduled to see the Gastro next month to setup a colonoscopy and endoscopy (if he thinks that makes sense to do.)
Anyway, I'm thinking about getting the Enterolab Fecal Test for MC.
Anyone have advice about that? Should I wait till I run it by the Gastro next month. (I'm tempted to just do it.)
Also, after reading through a bit on the forums here, I'm thinking about also getting the food intolerance Panel C.
Any advice appreciated.
Which Enterolab test(s) makes the most sense for me?
Moderators: Rosie, JFR, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Hi,
Welcome to the board. Looking at all the information that you listed, it suggests that you very likely have MC, but not celiac disease, (since you don't have a celiac gene). Of course the extensive small intestinal damage that you obviously had initially (based on your fecal fat score), suggests that you probably had at least a Marsh 1 level of small intestinal damage (it takes at least a Marsh 3 level to meet the diagnostic criteria for an "official" celiac diagnosis). IMO, whether you have one or the other (or both diseases) is a moot point, since both syndromes are a symptom of gluten sensitivity, they both cause similar clinical symptoms, and they both cause similar histological changes in both the large and small intestines. At any rate, virtually all of your symptoms are consistent with MC.
If you schedule a colonoscopy exam, and the GI doc takes enough biopsy samples. and a pathologist carefully analyzes them under a microscope, he or she should be able to easily determine whether or not you have MC. It should be a slam-dunk diagnosis, if they both do their job correctly.
The rectal itching could be due to pin worms, but the most likely cause is a yeast overgrowth (Candida albicans). Do you have thrush (a white coating on your tongue)? That would be additional evidence of a yeast overgrowth. Many/most people who have a yeast overgrowth find that if they try to severely restrict carbohydrates or sugar in their diet, it tends to cause a very powerful craving for sugar/carbs, because the yeast is capable of actually influencing responses in the brain, in order to take care of it's nutritional needs (yeast thrives on sugar/carbs, and dies without them).
Low testosterone is often caused by an under-active thyroid. People who have MC are approximately 7 times as likely to have thyroid problems as someone in the general population. Most doctors check TSH, and maybe total T3 and total T4, but they trust TSH for determining a diagnosis, and they typically use an unrealistic "normal" range for comparing TSH results. Unfortunately hypothyroidism can also be associated with normal a TSH level, if Free T4 is low. It's rare to encounter a doctor who is knowledgeable enough about thyroid problems to be willing and able to diagnose hypothyroidism and properly treat it based on a low Free T4 result. My TSH was mid-range, but my Free T4 was below range, and my testosterone was low, so I've been taking a thyroid supplement (Armour) and androgen for over 8 years now.
The C Panel offered by EnteroLab would probably be very helpful for fine-tuning your diet. Most members here who have ordered it have found it to be very beneficial.
Tex
Welcome to the board. Looking at all the information that you listed, it suggests that you very likely have MC, but not celiac disease, (since you don't have a celiac gene). Of course the extensive small intestinal damage that you obviously had initially (based on your fecal fat score), suggests that you probably had at least a Marsh 1 level of small intestinal damage (it takes at least a Marsh 3 level to meet the diagnostic criteria for an "official" celiac diagnosis). IMO, whether you have one or the other (or both diseases) is a moot point, since both syndromes are a symptom of gluten sensitivity, they both cause similar clinical symptoms, and they both cause similar histological changes in both the large and small intestines. At any rate, virtually all of your symptoms are consistent with MC.
If you schedule a colonoscopy exam, and the GI doc takes enough biopsy samples. and a pathologist carefully analyzes them under a microscope, he or she should be able to easily determine whether or not you have MC. It should be a slam-dunk diagnosis, if they both do their job correctly.
The rectal itching could be due to pin worms, but the most likely cause is a yeast overgrowth (Candida albicans). Do you have thrush (a white coating on your tongue)? That would be additional evidence of a yeast overgrowth. Many/most people who have a yeast overgrowth find that if they try to severely restrict carbohydrates or sugar in their diet, it tends to cause a very powerful craving for sugar/carbs, because the yeast is capable of actually influencing responses in the brain, in order to take care of it's nutritional needs (yeast thrives on sugar/carbs, and dies without them).
Low testosterone is often caused by an under-active thyroid. People who have MC are approximately 7 times as likely to have thyroid problems as someone in the general population. Most doctors check TSH, and maybe total T3 and total T4, but they trust TSH for determining a diagnosis, and they typically use an unrealistic "normal" range for comparing TSH results. Unfortunately hypothyroidism can also be associated with normal a TSH level, if Free T4 is low. It's rare to encounter a doctor who is knowledgeable enough about thyroid problems to be willing and able to diagnose hypothyroidism and properly treat it based on a low Free T4 result. My TSH was mid-range, but my Free T4 was below range, and my testosterone was low, so I've been taking a thyroid supplement (Armour) and androgen for over 8 years now.
The C Panel offered by EnteroLab would probably be very helpful for fine-tuning your diet. Most members here who have ordered it have found it to be very beneficial.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks Tex! I found some of my medical records and I was tested for "T3, Free" which was 3.4 pg/mL
Thyroglobulin Antibodies <20 (out of <20 IU/mL )
Thyroid Peroxidase Antibodies 10 IU/mL
White Blood Cells in Stool
can't find any other Thyroid tests, so it looks like I was wrong about having lots of thyroid tests. So you still think I should get a test for Free T4 ?
I read Wayne's book recently; I remember it linked Thyroid problems with MC, but didn't realize I didn't have all the tests. Thanks for pointing that out.
No thrush, but I'm not as good about avoiding sugar as I am at avoiding gluten. Those cravings are gone. I only get them the day after I eat sugary foods. I avoid sugar, but maybe I should be more diligent about it.
Thyroglobulin Antibodies <20 (out of <20 IU/mL )
Thyroid Peroxidase Antibodies 10 IU/mL
White Blood Cells in Stool
can't find any other Thyroid tests, so it looks like I was wrong about having lots of thyroid tests. So you still think I should get a test for Free T4 ?
I read Wayne's book recently; I remember it linked Thyroid problems with MC, but didn't realize I didn't have all the tests. Thanks for pointing that out.
No thrush, but I'm not as good about avoiding sugar as I am at avoiding gluten. Those cravings are gone. I only get them the day after I eat sugary foods. I avoid sugar, but maybe I should be more diligent about it.
At least your test results were negative for autoimmune thyroiditis. Do you have many other hypothyroid symptoms?
Long and Pathetic List of Symptoms
IMO, the Free T4 test is very important for anyone who might be having hypothyroid symptoms, even though their TSH is normal. I'm not a doctor, though. However, it appears that even Dr. Mercola agrees with this viewpoint:
Optimum Diagnosis and Treatment of Hypothyroidism With Free T3 and Free T4 Levels
Your Free T4 might be OK, in which case this is all irrelevant, but even if it is out of range, the biggest problem is finding a doctor (whether a GP or an endocrinologist) who is willing and knowledgeable enough to treat hypothyroid patients based on those markers, (with a "normal" TSH level). They seem to be as scarce as hen's teeth. In the good old days, all doctors treated hypothyroidism based on symptoms. These days though, since the advent of the TSH test, most doctors trust the TSH test result more than they trust their own knowledge and skill level, and they have forgotten the correct way to diagnose and treat hypothyroidism. They prefer to let the lab tests do their thinking for them.
Tex
Long and Pathetic List of Symptoms
IMO, the Free T4 test is very important for anyone who might be having hypothyroid symptoms, even though their TSH is normal. I'm not a doctor, though. However, it appears that even Dr. Mercola agrees with this viewpoint:
Optimum Diagnosis and Treatment of Hypothyroidism With Free T3 and Free T4 Levels
Your Free T4 might be OK, in which case this is all irrelevant, but even if it is out of range, the biggest problem is finding a doctor (whether a GP or an endocrinologist) who is willing and knowledgeable enough to treat hypothyroid patients based on those markers, (with a "normal" TSH level). They seem to be as scarce as hen's teeth. In the good old days, all doctors treated hypothyroidism based on symptoms. These days though, since the advent of the TSH test, most doctors trust the TSH test result more than they trust their own knowledge and skill level, and they have forgotten the correct way to diagnose and treat hypothyroidism. They prefer to let the lab tests do their thinking for them.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Wow that's a long list; yeah, I have quite a few of those symptoms. There's a link to testing at the bottom of the article. It's STTM Thyroid Numbers from MyMedLab.com. It does test for TSH and Free T3 and Free T4.tex wrote:At least your test results were negative for autoimmune thyroiditis. Do you have many other hypothyroid symptoms?
Tex
https://sttm.mymedlab.com/sttm-profiles ... id-numbers
You think it's any good?
I've never tried that lab, but the website (STTM) is well respected by those of us who have thyroid issues that our doctors are often unable to resolve, so personally, yes, I would trust that lab (until/unless something happened that suggested that they don't deserve my trust). The price seems to be fair enough.
Remember that you will have to go to an affiliated lab in your area in order to have your blood drawn, if you purchase a test. If my doctor was unwilling to order similar tests locally, I would probably try that test option myself.
Tex
Remember that you will have to go to an affiliated lab in your area in order to have your blood drawn, if you purchase a test. If my doctor was unwilling to order similar tests locally, I would probably try that test option myself.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Tex, Looks like the National Institutes of Health agrees with you about the importance of testing free T4 in cases of suspected hypothyroidism, in the following brochure. It goes on to say that free T3 is not useful in determining hypothyroidism, only hyperthyroidism:
http://endocrine.niddk.nih.gov/pubs/thy ... ts_508.pdf
I ordered the test for tomorrow. I'll come back with the results when I get them.
http://endocrine.niddk.nih.gov/pubs/thy ... ts_508.pdf
I ordered the test for tomorrow. I'll come back with the results when I get them.
Here are those results:
........................................................Result................Range..../Units
TSH004264....................................... 2.85..................0.450-4.500 uIU/mL
Triiodothyronine,Free,Serum010389.....2.9....................2.0-4.4 pg/mL
T4,Free(Direct)019745........................1.14..................0.82-1.77 ng/dL
How does that look to you?
........................................................Result................Range..../Units
TSH004264....................................... 2.85..................0.450-4.500 uIU/mL
Triiodothyronine,Free,Serum010389.....2.9....................2.0-4.4 pg/mL
T4,Free(Direct)019745........................1.14..................0.82-1.77 ng/dL
How does that look to you?
Well, to me those results look pretty much OK. My results are usually similar, except that my Free T4 is always slightly below range, or barely above the bottom limit (even though I'm taking Armour thyroid supplement).
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.