Enterolab results are in - feedback appreciated

[JamesEcuador]

Hi folks.

I finally managed to order my Enterolab tests from Ecuador and just got the results back today which I´ve posted below. I would be really grateful for a second opinion since I ordered this on the recommendation of forum members and not via a doctor. My Anti-gliadin is the only elevated range (13 units) although I have been strictly gluten free for 11 months (and before that "mostly" gluten free for 6 months prior). Since I went gluten free I have been living on a very basic diet consisting of only the following ingredients: rice, potatoes (although gave those up 4 months ago) meat, fish, parsnips, pumpkin, green beans, banana, kiwi and papaya. I limited myself to those fruit and veggies as I found no concrete reactions from them and they are the only ones I can source on the Galapagos Islands where I live.

I have been strictly soy free for 8 months, casein 10 months (I´m also lactose intolerant), eggs 6 months, and potato 4 months. I´m really surprised that I show no evidence of problems with potato as they always leave me with cramps. The rest, I´m relieved about and it probably goes to show that much of my symptoms are still caused by the dirty water here in Galapagos and the parasites I no doubt have inside me and the havoc they are playing with my LC. The good news is that after 6 months since applying and lots of stress and worrying in-between, my wife received her UK spouse visa last week so we are moving back to the UK next month and with it, my body will receive a proper detox!

So long term, am I right in saying keep ditching the gluten but slowly start introducing the other foods I gave up? Also I am a little confused how to interpret my gluten gene testing results. The results below state "HLA gene analysis reveals that you have one copy of a gene that predisposes to gluten sensitivity, in your case HLA-DQB1*0301" but also listed at the top of the page is "HLA-DQB1 Molecular analysis, Allele 2 0402" but not sure whether I have that copy also or if it just means they tested for it.

Many thanks

James


RESULTS

Fecal Anti-gliadin IgA 13 Units (Normal Range is less than 10 Units)

Fecal Anti-casein (cow’s milk) IgA 7 Units (Normal Range is less than 10 Units)

Fecal Anti-ovalbumin (chicken egg) IgA 4 Units (Normal Range is less than 10 Units)

Fecal Anti-soy IgA 5 Units (Normal Range is less than 10 Units)

Mean Value 11 Antigenic Foods 4 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
Oat
Rice
Beef
Chicken
Pork
Tuna
Almond
Walnut
Cashew
White potato
None None None


Gluten Sensitivity Gene Test

HLA-DQB1 Molecular analysis, Allele 1 0301

HLA-DQB1 Molecular analysis, Allele 2 0402

Serologic equivalent: HLA-DQ 3,4 (Subtype 7,4)



TEST INTERPRETATION(S):


Interpretation of Fecal Anti-gliadin IgA: The level of intestinal anti-gliadin IgA antibody was elevated, indicative of active dietary gluten sensitivity. For optimal health; resolution or improvement of gluten-induced syndromes (mainly falling into six categories abbreviated as NAAAGS – neuropsychiatric, autoimmune, asthma, abdominal, glandular deficiencies/hyperactivity or skin diseases); resolution of symptoms known to be associated with gluten sensitivity (such as abdominal symptoms - pain, cramping, bloating, gas, diarrhea and/or constipation, chronic headaches, chronic sinus congestion, depression, arthritis, chronic skin problems/rashes, fibromyalgia, and/or chronic fatigue); and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.

For additional information on result interpretation, as well as educational information on the subject of gluten sensitivity, please see the "FAQ Result Interpretation," "FAQ Gluten/Food Sensitivity," and "Research & Education" links on our EnteroLab.com website.

Interpretation of Fecal Anti-casein (cow’s milk) IgA: A value less than 10 Units indicates that there currently is minimal or no immunologic reaction to milk, and hence no direct evidence of food sensitivity to this specific food. However, some immunocompetent people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, such as chronic headaches, abdominal symptoms (pain, cramping, bloating, gas, diarrhea and/or constipation), chronic sinus congestion, arthritis, chronic skin problems/rashes, fibromyalgia, and/or chronic fatigue, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test. If you have been on a diet reduced or devoid of the suspect food for many months or years (usually but not always requires two or more years), this can also (but will not always) reduce your fecal antibody level to that food into the normal range despite underlying ongoing sensitivity to that food.

Interpretation of Fecal Anti-ovalbumin (chicken egg) IgA: A value less than 10 Units indicates that there currently is minimal or no immunologic reaction to egg, and hence no direct evidence of food sensitivity to this specific food. However, some immunocompetent people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, such as chronic headaches, abdominal symptoms (pain, cramping, bloating, gas, diarrhea and/or constipation), chronic sinus congestion, arthritis, chronic skin problems/rashes, fibromyalgia, and/or chronic fatigue, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test. If you have been on a diet reduced or devoid of the suspect food for many months or years (usually but not always requires two or more years), this can also (but will not always) reduce your fecal antibody level to that food into the normal range despite underlying ongoing sensitivity to that food.

Interpretation of Fecal Anti-soy IgA: A value less than 10 Units indicates that there currently is minimal or no immunologic reaction to soy, and hence no direct evidence of food sensitivity to this specific food. However, some immunocompetent people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, such as chronic headaches, abdominal symptoms (pain, cramping, bloating, gas, diarrhea and/or constipation), chronic sinus congestion, arthritis, chronic skin problems/rashes, fibromyalgia, and/or chronic fatigue, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test. If you have been on a diet reduced or devoid of the suspect food for many months or years (usually but not always requires two or more years), this can also (but will not always) reduce your fecal antibody level to that food into the normal range despite underlying ongoing sensitivity to that food.

Interpretation of Mean Value 11 Antigenic Foods: With respect to the 11 foods tested, a mean value of 4 Units indicates that overall, there was no significant detectable evidence of immunological reactivity to these antigenic foods in terms of fecal IgA production.

Many foods besides gluten, milk, egg, and soy are antigenic in their own right; the main classes of which include other grains, meats, nuts, and nightshades (potatoes being the primary food eaten from this latter class). Minimizing exposure to antigenic foods is an important component of an anti-inflammatory lifestyle to optimize immune system health. This is especially important for those with chronic abdominal symptoms and/or chronic immune/autoimmune syndromes, or for those who want to prevent them.

For immunologic food sensitivity testing, the actual numeric value (in Units) for any given food or for the overall average of a group of foods is important mainly for determining: 1) if the immune reaction is present or absent, and 2) the immune reaction in relative terms to different foods tested in a given individual at a given point in time. It is not a score, per se, to be interpreted as a measure of clinical or immunological severity for that individual or between individuals. This is because the amount of IgA antibody made by a given person is particular for the immune function of that person. Furthermore, sometimes a person can display what can be viewed as immunological and nutritional “exhaustion,” whereby a more significant and symptomatic immunologic food sensitivity is accompanied by a lower positive measured anti-food antibody value (rather than a higher positive). In such an instance, following clinical improvement and improved nutritional status (while the suspect antigenic foods are withdrawn), values can actually be higher for a time before finally falling into the negative range after several years.

Thus, the overall average food sensitivity antibody value for this panel is an assessment of your overall humoral immunologic food reactivity, which can help determine if dietary elimination trials may help you. If the mean value is less than 10 Units, the humoral immune reactions can be considered clinically insignificant (negative); if greater than or equal to 10 Units, they can be considered clinically significant (positive). Rather than reporting the absolute value of a positive result for each individual food, since it cannot be considered as an assessment of severity, the results are reported in semi-quantitative terms between the foods tested (1+, 2+, or 3+). This provides you with the knowledge of which foods are stimulating the most immune response which, in turn, is indeed the most practically applied information to dietary elimination trials.

Dietary Recommendation Based on Test Results to Individual Foods:

Although there was no detectable evidence of immunologic sensitivity to these antigenic foods, if you have an autoimmune or chronic inflammatory syndrome, or just want to pursue an optimally healthy diet and lifestyle, avoiding all grains, meats, and nightshades can optimize an anti-inflammatory diet despite a negative result on food testing. As nuts and seeds are a very healthful source of vegetarian protein and heart-protective oils and minerals, rather than avoiding all nuts and seeds, you can render nuts and seeds less antigenic, more digestible, and more easily tolerated by choosing the few that you seem to best tolerate overall, soaking a one-day supply in a glass jar filled with clean water for 4-8 hours (or for ease, overnight), and pouring off the water and rinsing before eating. The resultant soaked nuts or seeds can be eaten as is (alone or with fresh or dried fruit), blended into nut butters (by adding some water), or added to “smoothies.”

If you do decide to undertake dietary elimination trials, we discourage dietary changes that involve removing too many foods at once. This can lead you to feel too hungry too often, especially if adequate healthful replacement foods are not readily available. Dietary elimination (beyond gluten-free, dairy-free, and soy-free) is best approached over a period of weeks to months and sometimes years, removing one or two additional foods at a time, rather than removing many foods at once.

Finally, since 1 in 500 people cannot make IgA at all, and rarely, some immunocompetent people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have a syndrome or symptoms known to be associated with food sensitivity, such as chronic headaches, abdominal symptoms (pain, cramping, bloating, gas, diarrhea and/or constipation), chronic sinus congestion, arthritis, chronic skin problems/rashes, fibromyalgia, and/or chronic fatigue, avoiding antigenic foods may help you despite a negative test. If you have been on a diet reduced or devoid of the suspect food for many months or years (usually but not always requires two or more years), this can also (but not always) reduce your fecal antibody level to that food into the normal range despite underlying ongoing sensitivity to that food. If you have no syndrome or symptoms associated with food sensitivity, and have been eating any or all of these suspect foods, you can continue to follow your normal diet and retest in 3-5 years.

Interpretation of HLA-DQ Testing: Although you do not possess one of the HLA-DQB1 genes predisposing to celiac disease (HLA-DQ2 or HLA-DQ8), HLA gene analysis reveals that you have one copy of a gene that predisposes to gluten sensitivity, in your case HLA-DQB1*0301. Having one of these genes means that each of your offspring has a 50% chance of receiving this gene from you, and at least one of your parents passed it to you. This test was developed and its performance characteristics determined by the American Red Cross - Northeast Division. It has not been cleared or approved by the U.S. Food and Drug Administration.

[tex]

Hi James,

Since even your anti-gliadin antibody level is surprisingly low, I wonder if you might possibly be IgA-deficient. Selective IgA deficiency can be ruled out by a simple blood test. Do you happen to know if by any chance you have ever had that test? As the discussion section of the results mentions, 1 in 500 people are not capable of producing normal amounts of Immunoglobulin A, and for those individuals, any lab tests based on IgA antibodies (including the classic celiac blood tests) will typically result in false negative results.

If you do not have selective IgA deficiency though, then you are one of the very few here who only have a sensitivity to gluten. And you are also one of the very few who only have a single gene that predisposes to gluten sensitivity (the type commonly associated with MC).

So it appears that either you have selective IgA deficiency, or something else is wrong (other than food sensitivities), causing your symptoms.

Do you mind if I add your results to our list here?

Thanks,
Tex

[JamesEcuador]

Hi Tex

I don´t have the results to hand right now but I believe I did have IGA blood tests 2 years ago as part of my testing for celiac disease (negative).

Could the low anti-gliadin antibody level be explained by me being on a very strict gluten free diet for a year?

Please feel free to post my results on your list.

[tex]

Could the low anti-gliadin antibody level be explained by me being on a very strict gluten free diet for a year?

Yes, and it could also be the reason why the results are negative for all the other foods. IOW, your antibody levels may not have been extremely high to begin with, and you have done a very good job of avoiding all those foods.

Thanks, I'll add your results.

Incidentally, your second gene allele is rather uncommon, and the subtype 4 alleles are the only ones known that are not associated with non-celiac gluten sensitivity.

Tex

[JamesEcuador]

Thanks Tex, much appreciated.

Perhaps my environmental conditions (namely consuming parasite infested water for the last 3 years), which have been impossible to avoid, have made me into a non typical case. On top of that, my LC does appear to be a lighter form than what many people suffer with. I´ve never had the crippling diarrhea or constipation (neither C o D permanently anyway) that so many people on this site suffer from and in the last few months I have started to see improvement on the nausea, body aches and brain fog that had been my worse symptoms . I just can´t shake off the abdominal pain and cramps....hopefully after 6 months of living with clean water and reduced stress I may see some improvement and get closer to remission.

[JamesEcuador]

Incidentally, your second gene allele is rather uncommon, and the subtype 4 alleles are the only ones known that are not associated with non-celiac gluten sensitivity.

Tex

Sorry Tex I´m not sure what you mean there. Are you saying that the subtype 4 alleles contradict with the gluten sensitivity gene that has been identified? I clearly have a lot to learn on genetics!

[tex]

No, I was trying to say that most of us have 2 genes that predispose us to gluten sensitivity. You only have 1, which has to be a good thing.

And yes, it's certainly possible that the parasites might be a perpetual problem causing those nagging symptoms. Your moving back to the UK may provide us with some new insight into a possible aspect of the disease.

Tex

[JamesEcuador]

And yes, it's certainly possible that the parasites might be a perpetual problem causing those nagging symptoms. Your moving back to the UK may provide us with some new insight into a possible aspect of the disease.

Tex

I certainly don't mind being a guinea pig!