I wanted to throw a question out there and find out if anyone knows the answer. I read a message thread on a hyperparathyroid support board from a woman who also had celiac disease. In it she stated that her serum calcium levels were never over the range and that was due to celiac disease. What I'm wondering is if that would also be true for those of us with MC as well as other types of blood tests and due to the nature of our condition, would that apply to us? I'm going in for a comprehensive metabolic panel next week. The last time my serum cortisol was checked it was at the very high end if the normal range. Is that number actually higher when MC is taken out of the equation?
Thanks for your replies,
Love,
Linda
Accuracy of serum tests with MC
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Hi Linda,
I'm wondering why she feels that celiac disease limits her serum calcium level. Is she simply saying that she is not carefully following a GF diet, and/or her gut has not yet had time to heal, so that her calcium level is limited by malabsorption? Or is she implying that celiac disease will always limit her serum calcium level, even after her small intestinal damage has healed?
In the first scenario, I would agree, and that would certainly apply to us as well, but in the second scenario, I would disagree, because the final residual damage should be minor, in most cases.
So sure, if we have active MC with malabsorption issues, then our serum tests for nutrients, electrolytes, vitamins, minerals, etc., will reflect that condition, and they will be lower than they would have been had the malabsorption issue not existed. However, the blood test results will still be reasonably accurate, because our blood levels of those items actually are reduced under those conditions.
Cortisol is a different matter though, because cortisol is not absorbed — it's produced by the adrenal glands, in-house, so to speak. That said, adrenal production can certainly be adversely affected by active MC, but that's not a given in all cases.
That's my 2 cents worth, FWIW.
Love,
Tex
I'm wondering why she feels that celiac disease limits her serum calcium level. Is she simply saying that she is not carefully following a GF diet, and/or her gut has not yet had time to heal, so that her calcium level is limited by malabsorption? Or is she implying that celiac disease will always limit her serum calcium level, even after her small intestinal damage has healed?
In the first scenario, I would agree, and that would certainly apply to us as well, but in the second scenario, I would disagree, because the final residual damage should be minor, in most cases.
So sure, if we have active MC with malabsorption issues, then our serum tests for nutrients, electrolytes, vitamins, minerals, etc., will reflect that condition, and they will be lower than they would have been had the malabsorption issue not existed. However, the blood test results will still be reasonably accurate, because our blood levels of those items actually are reduced under those conditions.
Cortisol is a different matter though, because cortisol is not absorbed — it's produced by the adrenal glands, in-house, so to speak. That said, adrenal production can certainly be adversely affected by active MC, but that's not a given in all cases.
That's my 2 cents worth, FWIW.
Love,
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.
While it's true that adrenal fatigue is associated with MC (and apparently most other IBDs and other autoimmune diseases), that's a tough question to answer, because IMO chronic stress is the one predisposing ingredient that is essential in one's environment in order to promote the development of MC (or any other autoimmune disease, for that matter). Therefore, even though it's certainly possible that MC could contribute to adrenal fatigue (because it can affect virtually any organ in the body), that isn't a foregone conclusion, because the chronic stress that's implicated in the development of the disease may well be responsible for all (or at least the lion's share) of the damage done to the adrenals in some cases. Of course, not everyone who has MC has adrenal issues, which is additional evidence that MC probably plays a subordinate role (if it has any effect at all) on adrenal problems.
IOW, these are uncharted waters, so we can only guess at the details. If it has any significant effect on the adrenals, though, I would guess that it would lean toward an increase in cortisol production (if that's what you are inquiring about), because MC is by it's very nature, an extremely stressful disease. On the other hand, it's not inconceivable that MC could cause inflammation to spread to the adrenals (as it does to the pancreas and many other organs in close proximity with the digestive system), which could interfere with cortisol production. The bottom line is that we really don't know, because I'm not aware of any research dedicated to this particular topic.
As time goes on, if MC remains untreated (or inadequately treated), it's very likely that inflammation spreads in the body, so that could eventually lead to inflammation of the adrenals, which would probably appear to be adrenal fatigue, since it would probably have the effect of curtailing cortisol production.
Tex
IOW, these are uncharted waters, so we can only guess at the details. If it has any significant effect on the adrenals, though, I would guess that it would lean toward an increase in cortisol production (if that's what you are inquiring about), because MC is by it's very nature, an extremely stressful disease. On the other hand, it's not inconceivable that MC could cause inflammation to spread to the adrenals (as it does to the pancreas and many other organs in close proximity with the digestive system), which could interfere with cortisol production. The bottom line is that we really don't know, because I'm not aware of any research dedicated to this particular topic.
As time goes on, if MC remains untreated (or inadequately treated), it's very likely that inflammation spreads in the body, so that could eventually lead to inflammation of the adrenals, which would probably appear to be adrenal fatigue, since it would probably have the effect of curtailing cortisol production.
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, this was the post I read:
"It was a GP that first alerted me... to the fact that Coeliacs have low serum calcium levels... and if I had both HPT and Coeliac that the numbers may look odd. My serum calcium only rose high ( we think - my Drs were not testing regularly before ) when I went Gluten Free..
There is so much malabsorption with Coeliac that Iron, Calcium, B12 will show trends to low.. In secondary HPT the picture is low or normal calciu with high PTH. But over time if untreated Coeliac then the PTs can get damaged.."
I never really paid much attention to my calcium levels before my HPT diagnosis. Fortunately my endo seems to be on top of it as even tho my calcium was at the highest level of normal it shouldn't have been as my PTH was way over the stated normal range and these two things are supposed to interact on a feedback sort of system. If one is high the other one must be low. When both are high there is a definite problem.
Love,
Linda
"It was a GP that first alerted me... to the fact that Coeliacs have low serum calcium levels... and if I had both HPT and Coeliac that the numbers may look odd. My serum calcium only rose high ( we think - my Drs were not testing regularly before ) when I went Gluten Free..
There is so much malabsorption with Coeliac that Iron, Calcium, B12 will show trends to low.. In secondary HPT the picture is low or normal calciu with high PTH. But over time if untreated Coeliac then the PTs can get damaged.."
I never really paid much attention to my calcium levels before my HPT diagnosis. Fortunately my endo seems to be on top of it as even tho my calcium was at the highest level of normal it shouldn't have been as my PTH was way over the stated normal range and these two things are supposed to interact on a feedback sort of system. If one is high the other one must be low. When both are high there is a definite problem.
Love,
Linda
Linda,
Thanks for the clarification. That definitely sounds right.
Catching test result clues such as that is what separates excellent doctors from also-rans. Good for her/him.
Love,
Tex
Thanks for the clarification. That definitely sounds right.
Catching test result clues such as that is what separates excellent doctors from also-rans. Good for her/him.
Love,
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.
Hi Henry,
I'm not aware of any medical research studies that have been done on this topic to specifically show that MC is associated with a lower WBC count, but it is known that in general, levels of white cells in circulation in the blood are sometimes reduced because a large percentage of the available white cells have been transported to the site of an infection, or to a site of massive inflammation, and left there to deal with the cause of the inflammation.
IOW, when so many white cells have been moved into inflamed tissue as part of an inflammatory response, the remaining levels in the blood can obviously be reduced. The reason why this can cause blood levels of WBC to remain reduced for long-term periods of time (IMO), is because inflammation is the first step in the body's healing process, and with MC, healing cannot progress beyond the first step. And as white cells do their job, they are used up, and they have to be replaced with new white cells, as long as the reason for the inflammation continues.
When damaged tissue heals normally, the immune system will try to repair slightly damaged cells, but it marks severely damaged cells for destruction, in a process known as apoptosis. So the first step in healing involves inflammation, as special white cells (killer T cells) carry out the instructions to destroy those marked cells. The second stage of healing involves clearing out all the debris, so that the third stage of actual healing can begin. Special white cells known as macrophages (and others) actually envelop the dead cells and other debris, to carry it out of the repair zone.
The reason why healing cannot get past the first step for MC (and other IBDs) is due to the fact that before healing can proceed to the cell repair or replacement stage, all of the debris left by the first stage of the process must be removed from the area. This is just my theory, and it hasn't been proven by medical research, but it seems rather obvious to me. IMO the reason why healing can't get past the first stage with MC is because the inflammation that causes the disease in the first place continues to damage cells in the epithelium of the intestines as long as we continue to ingest the foods that are causing the inflammation, namely gluten, casein, soy, etc., and for many MC patients, certain drugs can cause the inflammation. IOW, we perpetuate the inflammation, by continuing to generate new inflammation every time we eat an inflammatory food.
Anyway, that's my opinion on why some MC patients have low WBC counts. WBC counts are probably reduced somewhat for all of us, but for some of us, the effect is much more significant, as in your case.
Tex
I'm not aware of any medical research studies that have been done on this topic to specifically show that MC is associated with a lower WBC count, but it is known that in general, levels of white cells in circulation in the blood are sometimes reduced because a large percentage of the available white cells have been transported to the site of an infection, or to a site of massive inflammation, and left there to deal with the cause of the inflammation.
IOW, when so many white cells have been moved into inflamed tissue as part of an inflammatory response, the remaining levels in the blood can obviously be reduced. The reason why this can cause blood levels of WBC to remain reduced for long-term periods of time (IMO), is because inflammation is the first step in the body's healing process, and with MC, healing cannot progress beyond the first step. And as white cells do their job, they are used up, and they have to be replaced with new white cells, as long as the reason for the inflammation continues.
When damaged tissue heals normally, the immune system will try to repair slightly damaged cells, but it marks severely damaged cells for destruction, in a process known as apoptosis. So the first step in healing involves inflammation, as special white cells (killer T cells) carry out the instructions to destroy those marked cells. The second stage of healing involves clearing out all the debris, so that the third stage of actual healing can begin. Special white cells known as macrophages (and others) actually envelop the dead cells and other debris, to carry it out of the repair zone.
The reason why healing cannot get past the first step for MC (and other IBDs) is due to the fact that before healing can proceed to the cell repair or replacement stage, all of the debris left by the first stage of the process must be removed from the area. This is just my theory, and it hasn't been proven by medical research, but it seems rather obvious to me. IMO the reason why healing can't get past the first stage with MC is because the inflammation that causes the disease in the first place continues to damage cells in the epithelium of the intestines as long as we continue to ingest the foods that are causing the inflammation, namely gluten, casein, soy, etc., and for many MC patients, certain drugs can cause the inflammation. IOW, we perpetuate the inflammation, by continuing to generate new inflammation every time we eat an inflammatory food.
Anyway, that's my opinion on why some MC patients have low WBC counts. WBC counts are probably reduced somewhat for all of us, but for some of us, the effect is much more significant, as in your case.
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.
I'm wondering if you could be having problems with cross-contamination in your diet, or maybe you have additional food sensitivities. I'm guessing that you are still having symptoms or you would not be taking Entocort. Entocort does not actually prevent additional inflammation from developing, it only suppresses existing inflammation by interfering with the functioning of white cells and suppressing mast cell numbers. So yes, IMO the Entocort might be affecting your WBC count.
When a normal, healthy person is given a corticosteroid, normally their WBC count will rise. And usually, when an otherwise healthy person develops an infection, their WBC count will rise. However, when a corticosteroid is being used, if an infection (or massive inflammation due to some other cause) develops, the WBC count usually doesn't rise. So because of that, corticosteroids can not only mask the symptoms of MC, but they can also mask the markers of an infection.
At any rate, the point is, it's possible that the Entocort may be part of the reason why your WBC count is lower than normal.
Tex
When a normal, healthy person is given a corticosteroid, normally their WBC count will rise. And usually, when an otherwise healthy person develops an infection, their WBC count will rise. However, when a corticosteroid is being used, if an infection (or massive inflammation due to some other cause) develops, the WBC count usually doesn't rise. So because of that, corticosteroids can not only mask the symptoms of MC, but they can also mask the markers of an infection.
At any rate, the point is, it's possible that the Entocort may be part of the reason why your WBC count is lower than normal.
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.
I am tapering down the entocort (hope that is correct englisch). At the moment I only take one a day and are planning to stop next month. It is going pretty good the last months but I found already out that I shouldn't quit the Entocort too quickly. Let's hope the wbc count will rise after I stopped. The doctor didn't see a correlation between the MC, entocort and the low wbc. (The only thing he could make a connection to low wbc was hiv...)
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brookevale
- Adélie Penguin
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Interesting as I have a low white blood cell count below normal.
Strongly believe I have a form of MC that began to flare December 27, 2013.
44 year old married mom to three sons ages 26, 17, and 2, a 21 year old stepdaughter, and 18 year old stepson. I also have a beautiful granddaughter who is one.
44 year old married mom to three sons ages 26, 17, and 2, a 21 year old stepdaughter, and 18 year old stepson. I also have a beautiful granddaughter who is one.