Help with Enterolab results, please.
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Help with Enterolab results, please.
The combined knowledge and wisdom of everyone here is astounding and has been such an amazing help to me over the last couple of months, so I am leaning on you guys for some help in understanding my results.
I eliminated dairy last October when my mastocytic colitis came out of remission, so I know not to trust the dairy results.
I've only had eggs once in the last several months, and that was for a gastric emptying study (I braced myself for a bad reaction to them, but oddly enough it never came).
Many of the 11 antigenic foods I haven't had since October, except maybe in trace amounts (corn, walnuts, cashews, beef, pork, tuna). Chicken, rice, potatoes and almonds are staples that I eat everyday.
What's really throwing me is the gluten result. Before the test I was eating a large flour tortilla and two full graham cracker sheets a day. That was enough, right? I made the decision to go gluten and soy free after I found you guys, but I kept eating it long enough for my GI doctor to run one last Celiac blood test (it had been 7 years since my first one) and to get my IgA tested to make sure I didn't waste money on the Enterolab testing if I had been IgA deficient (which I now know I'm not). I have been completely gluten and soy free for a week and a half now, and I can happily report (with my fingers crossed that it's not just a fluke) that I have been nausea and abdominal pain free for several days now. I have also noticed a slight lifting of my chronic brain fog and a bit more energy. If it weren't for the raging sinus infection that I'm dealing with (and trying like heck to avoid antibiotics for) I would be able to say that I feel pretty awesome for the first time in a long time. I have been attributing this positive change to the lack of gluten in my diet, but to be fair I gave up soy at the same time. I have no problem staying gluten free if there is a reason for me to, and I definitely see the connection between gluten and a whole host of medical problems in many, many people. I just want to understand where my symptoms are coming from and how I need to proceed.
Comprehensive Gluten/Antigenic Food Sensitivity Stool Panel
Fecal Anti-gliadin IgA 7 Units (Normal Range is less than 10 Units)
Fecal Anti-casein (cow’s milk) IgA 9 Units (Normal Range is less than 10 Units)
Fecal Anti-ovalbumin (chicken egg) IgA 38 Units (Normal Range is less than 10 Units)
Fecal Anti-soy IgA 38 Units (Normal Range is less than 10 Units)
Mean Value 11 Antigenic Foods 14 Units (Normal Range is less than 10 Units)
While all of the foods tested can be immune-stimulating, the hierarchy of reactions detected were as follows:
Food to which there was no significant immunological reactivity:
Corn
Rice
Beef
Chicken
Pork
Tuna
Almond
White potato
Food to which there was some immunological reactivity (1+):
Cashew
Food to which there was moderate immunological reactivity (2+):
None
Food to which there was significant and/or the most immunological reactivity (3+):
Oat
Walnut
Within each class of foods to which you displayed multiple reactions, the hierarchy of those reactions detected were as follows:
Grains:
Grain toward which you displayed the most immunologic reactivity: Oat
Nuts:
Nut toward which you displayed the most immunologic reactivity: Walnut
Nut toward which you displayed intermediate immunologic reactivity: Cashew
Gluten Sensitivity Gene Test
HLA-DQB1 Molecular analysis, Allele 1 0301
HLA-DQB1 Molecular analysis, Allele 2 0603
Serologic equivalent: HLA-DQ 3,1 (Subtype 7,6)
Tex, you can feel free to add these results to the list.
I eliminated dairy last October when my mastocytic colitis came out of remission, so I know not to trust the dairy results.
I've only had eggs once in the last several months, and that was for a gastric emptying study (I braced myself for a bad reaction to them, but oddly enough it never came).
Many of the 11 antigenic foods I haven't had since October, except maybe in trace amounts (corn, walnuts, cashews, beef, pork, tuna). Chicken, rice, potatoes and almonds are staples that I eat everyday.
What's really throwing me is the gluten result. Before the test I was eating a large flour tortilla and two full graham cracker sheets a day. That was enough, right? I made the decision to go gluten and soy free after I found you guys, but I kept eating it long enough for my GI doctor to run one last Celiac blood test (it had been 7 years since my first one) and to get my IgA tested to make sure I didn't waste money on the Enterolab testing if I had been IgA deficient (which I now know I'm not). I have been completely gluten and soy free for a week and a half now, and I can happily report (with my fingers crossed that it's not just a fluke) that I have been nausea and abdominal pain free for several days now. I have also noticed a slight lifting of my chronic brain fog and a bit more energy. If it weren't for the raging sinus infection that I'm dealing with (and trying like heck to avoid antibiotics for) I would be able to say that I feel pretty awesome for the first time in a long time. I have been attributing this positive change to the lack of gluten in my diet, but to be fair I gave up soy at the same time. I have no problem staying gluten free if there is a reason for me to, and I definitely see the connection between gluten and a whole host of medical problems in many, many people. I just want to understand where my symptoms are coming from and how I need to proceed.
Comprehensive Gluten/Antigenic Food Sensitivity Stool Panel
Fecal Anti-gliadin IgA 7 Units (Normal Range is less than 10 Units)
Fecal Anti-casein (cow’s milk) IgA 9 Units (Normal Range is less than 10 Units)
Fecal Anti-ovalbumin (chicken egg) IgA 38 Units (Normal Range is less than 10 Units)
Fecal Anti-soy IgA 38 Units (Normal Range is less than 10 Units)
Mean Value 11 Antigenic Foods 14 Units (Normal Range is less than 10 Units)
While all of the foods tested can be immune-stimulating, the hierarchy of reactions detected were as follows:
Food to which there was no significant immunological reactivity:
Corn
Rice
Beef
Chicken
Pork
Tuna
Almond
White potato
Food to which there was some immunological reactivity (1+):
Cashew
Food to which there was moderate immunological reactivity (2+):
None
Food to which there was significant and/or the most immunological reactivity (3+):
Oat
Walnut
Within each class of foods to which you displayed multiple reactions, the hierarchy of those reactions detected were as follows:
Grains:
Grain toward which you displayed the most immunologic reactivity: Oat
Nuts:
Nut toward which you displayed the most immunologic reactivity: Walnut
Nut toward which you displayed intermediate immunologic reactivity: Cashew
Gluten Sensitivity Gene Test
HLA-DQB1 Molecular analysis, Allele 1 0301
HLA-DQB1 Molecular analysis, Allele 2 0603
Serologic equivalent: HLA-DQ 3,1 (Subtype 7,6)
Tex, you can feel free to add these results to the list.
Well, it looks like to me that you only have to stay away from soy, egg, Oats, walnuts and cashews. Not a bad result! I am pretty sure that you are feeling better because you have removed soy from your diet.
I'm sure Tex will chime in, but even though you may not be producing antibodies to gluten, that doesn't necessarily mean that you aren't reacting to some other component in wheat.
When it comes to dairy, it looks like you are in the clear, but just know that when we have an inflamed gut, ANYONE can have a hard time with lactose. Hard cheeses should be fine though ( I'm so jealous). Foods like milk, ice cream, yogurt, and puddings might still be a problem…… and if you do have issues with lactose, don't be surprised if different sugars also give you problems.
Because you have mastocytic colitis, mast cells are obviously your problem. That means that histamines could also be something you need to watch.
Seems like you are on the right track. Glad you are already feeling better
Leah
I'm sure Tex will chime in, but even though you may not be producing antibodies to gluten, that doesn't necessarily mean that you aren't reacting to some other component in wheat.
When it comes to dairy, it looks like you are in the clear, but just know that when we have an inflamed gut, ANYONE can have a hard time with lactose. Hard cheeses should be fine though ( I'm so jealous). Foods like milk, ice cream, yogurt, and puddings might still be a problem…… and if you do have issues with lactose, don't be surprised if different sugars also give you problems.
Because you have mastocytic colitis, mast cells are obviously your problem. That means that histamines could also be something you need to watch.
Seems like you are on the right track. Glad you are already feeling better
Leah
Hmmmmmmm. Those are veeeeeeerrrrrrry interesting results. It seems almost unfathomable that you could be so sensitive to oats (avenin), and yet not be sensitive to wheat (gluten), because the molecules of those two proteins contain allergenic sequences (peptides) that are very similar.
However, as Leah pointed out, there are at least several hundred known peptides in wheat, rye, and barley, to which celiacs are known to react. In order to keep the cost of the tests affordable, EnteroLab only tests for antibodies to the single peptide in the primary protein, to which most people react. No tests exist that will detect antibodies to any of the other peptides.
IOW for wheat, only antibodies to the alpha gliadin peptide are detected by the test. Likewise, only antibodies to casein are detected by the EnteroLab test for milk. And the egg test will only detect antibodies to the primary protein in the albumen of chicken eggs. In probably 99.9 % of cases, those tests are more than adequate.
But it's not impossible for someone to be sensitive to some other protein (or a different peptide in the same protein being tested for), and at the same time not be sensitive to the most common allergenic peptide in the primary protein of any given food. That condition is uncommon, but certainly not impossible, so maybe that applies here.
It's also possible that you might be allergic to wheat. IOW, you might produce IgE antibodies to wheat, but not IgA antibodies. If the IgE antibodies are generated in the gut (rather than in the mouth and esophagus, as would be the case with conventional allergies), then it's quite possible for IgE antibodies to cause digestive issues similar to IgA antibodies. And since you have ME, that raises the odds that this might be the case (since IgE antibodies trigger mast cell degranulation to produce histamine, cytokines, etc.). While there's not much information available on this, ME definitely complicates the issues associated with food sensitivities. IOW, histamine might be causing some (or all) of your GI symptoms, but the histamine is a result of IgE reactions (not IgA reactions).
Bear in mind that the EnteroLab tests would not detect IgE antibodies, nor would the tests detect any other source of histamine production. There are no tests available anywhere that are designed for that purpose, to my knowledge. There are skin tests and blood tests that detect IgE antibodies, but those tests have very limited value for digestive system issues.
While eggs and milk are not high-histamine foods, both of the them can trigger the degranulation of mast cells, thus creating a histamine problem. Your test results show that you produce IgA antibodies to eggs, but not to milk. However, it's certainly possible (actually, it's very likely) that both foods would cause mast cell/histamine issues for you. And that suggests that eggs may impose a double-jeopardy threat for you.
Thanks, I'll add your results to the list.
Tex
However, as Leah pointed out, there are at least several hundred known peptides in wheat, rye, and barley, to which celiacs are known to react. In order to keep the cost of the tests affordable, EnteroLab only tests for antibodies to the single peptide in the primary protein, to which most people react. No tests exist that will detect antibodies to any of the other peptides.
IOW for wheat, only antibodies to the alpha gliadin peptide are detected by the test. Likewise, only antibodies to casein are detected by the EnteroLab test for milk. And the egg test will only detect antibodies to the primary protein in the albumen of chicken eggs. In probably 99.9 % of cases, those tests are more than adequate.
But it's not impossible for someone to be sensitive to some other protein (or a different peptide in the same protein being tested for), and at the same time not be sensitive to the most common allergenic peptide in the primary protein of any given food. That condition is uncommon, but certainly not impossible, so maybe that applies here.
It's also possible that you might be allergic to wheat. IOW, you might produce IgE antibodies to wheat, but not IgA antibodies. If the IgE antibodies are generated in the gut (rather than in the mouth and esophagus, as would be the case with conventional allergies), then it's quite possible for IgE antibodies to cause digestive issues similar to IgA antibodies. And since you have ME, that raises the odds that this might be the case (since IgE antibodies trigger mast cell degranulation to produce histamine, cytokines, etc.). While there's not much information available on this, ME definitely complicates the issues associated with food sensitivities. IOW, histamine might be causing some (or all) of your GI symptoms, but the histamine is a result of IgE reactions (not IgA reactions).
Bear in mind that the EnteroLab tests would not detect IgE antibodies, nor would the tests detect any other source of histamine production. There are no tests available anywhere that are designed for that purpose, to my knowledge. There are skin tests and blood tests that detect IgE antibodies, but those tests have very limited value for digestive system issues.
While eggs and milk are not high-histamine foods, both of the them can trigger the degranulation of mast cells, thus creating a histamine problem. Your test results show that you produce IgA antibodies to eggs, but not to milk. However, it's certainly possible (actually, it's very likely) that both foods would cause mast cell/histamine issues for you. And that suggests that eggs may impose a double-jeopardy threat for you.
Thanks, I'll add your results to the list.
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.
Thank you Leah and Tex! You have both been so much help to me through all of this.
When I started watching my high histamine foods and degranulation triggers I did notice a difference, especially when I stopped eating chicken that wasn't cooked that same day. I did choose to keep bananas because of the potassium, but I try to just have one a day.
I thought the oat result was pretty odd, too, and I can't help but feel suspicious of wheat if I know my body doesn't like oats.
I think the best thing for me to do is just stay the course, which right now is a very basic, bland diet of chicken, potatoes, rice, almond butter, almond milk and bananas. I'll hopefully test in a few other safe foods soon, but I think for the most part my body just needs time to rest and heal. Even with the negative result, I just feel like gluten free is the right thing for me to do. I have had so many health issues crop up over the last several years and with nearly all of them there is research to be found that says gluten could be a possible culprit. I'm probably not going back to dairy either - I think milk is gross.
By the way, Tex, I finished your book and wanted to tell you that I really enjoyed it. You have a gift for making very complicated and technical issues not only understandable, but really interesting.
When I started watching my high histamine foods and degranulation triggers I did notice a difference, especially when I stopped eating chicken that wasn't cooked that same day. I did choose to keep bananas because of the potassium, but I try to just have one a day.
I thought the oat result was pretty odd, too, and I can't help but feel suspicious of wheat if I know my body doesn't like oats.
I think the best thing for me to do is just stay the course, which right now is a very basic, bland diet of chicken, potatoes, rice, almond butter, almond milk and bananas. I'll hopefully test in a few other safe foods soon, but I think for the most part my body just needs time to rest and heal. Even with the negative result, I just feel like gluten free is the right thing for me to do. I have had so many health issues crop up over the last several years and with nearly all of them there is research to be found that says gluten could be a possible culprit. I'm probably not going back to dairy either - I think milk is gross.
By the way, Tex, I finished your book and wanted to tell you that I really enjoyed it. You have a gift for making very complicated and technical issues not only understandable, but really interesting.
Remember that as bananas ripen, the histamine level increases significantly. I wouldn't eat them when they're still green, but I wouldn't wait until they're dead ripe, either, because by then the histamine level is fairly high. And you're correct — histamine is a dosing problem, so limiting the total amount of higher-histamine foods helps to prevent a reaction. And you're also right on target with your observation that healing of the digestive system takes a considerable amount of time. Patience is definitely a virtue when dialing with these issues.alcyone wrote:I did choose to keep bananas because of the potassium, but I try to just have one a day.
Thank you so much for the kind words about the book. I'm glad that you found it to be interesting reading. That makes my day.
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.
Yes, Leah, I take 20mg of famotidine morning and night. I had to settle for an H2 blocker only because I can't find an H1 that doesn't mess with my heart. I also take 500mg of Ester-C (the kind without the added citrus bioflavonoids) to help slow down the degranulation process. I learned that tip from a mastocytosis group, and it does seem to help.
Thanks for the tip on the bananas, Tex. I thought the riper ones were giving me trouble, but wasn't sure if I was just being paranoid. My sweet husband goes to the store for new bananas every other day so I can have some that are "just right", and he and the boys eat the older ones. All of the rules and restrictions make me feel like Goldilocks.
Thanks for the tip on the bananas, Tex. I thought the riper ones were giving me trouble, but wasn't sure if I was just being paranoid. My sweet husband goes to the store for new bananas every other day so I can have some that are "just right", and he and the boys eat the older ones. All of the rules and restrictions make me feel like Goldilocks.