Need some clarification on Enterolab Results

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Kimelizabeth
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Need some clarification on Enterolab Results

Post by Kimelizabeth »

Below are the results of my Enterolab testing.
I have been GF since January 2015 and Dairy, Egg, Soy, Oat, and Corn Free since mid February 2015. I take no medications for the MC.
While my symptoms have improved somewhat, I'm not even close to any type of remission.
Based on my lab results, is it safe to assume that I could reintroduce some of these foods back into my diet, or did my results come back this way due to the elimination of these foods?
Due to Hashimotos Thyroiditis, I will remain GF for life but would enjoy an occasional egg, piece of cheese, soy or corn product. Is this ill-advised?
I am very happy with my results but felt that they would equate to better quality of life...



Specialized Laboratory Analysis for Optimum Intestinal and Overall Health
Kenneth D. Fine, M.D.
Medical Director
13657 Jupiter Road, Suite 106 Dallas, Texas 75238
Laboratory Report
Date: 6/29/2015
Name: Schall, Kim
DOB: 6/8/1960
Comprehensive Gluten/Antigenic Food Sensitivity Stool Panel

Fecal Anti-gliadin IgA 20 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 4 Units (Normal Range is less than 10 Units)

Fecal Anti-soy IgA 3 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

Food to which there was some immunological reactivity (1+): None
Food to which there was moderate immunological reactivity (2+): None
Food to which there was significant and/or the most immunological reactivity (3+): None
Kim
GF, DF, Egg Free, Soy Free
Hashimotos Tyroiditis
MC with mixed features of CC and LC
MTHFR gene mutation
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tex
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Post by tex »

Hi Kim,

The answer to your question kind of depends on how high your antibody levels were before you stopped eating those foods. If the antibody levels were not extremely high, then it's certainly possible that after 4 months they could have declined to the point where those foods would no longer show a positive result to the EnteroLab tests.

Gluten antibodies are very persistent, because anti-gliadin antibodies have a 120-day half-life. By contrast, most other foods that cause reactions are associated with the production of antibodies that have a half-life of approximately 6 days. So obviously those antibody levels decay much more rapidly than anti-gliadin antibodies after we stop eating those foods.

After 4 months of eating a restricted diet, you should be showing signs of improvement (though it does take many of us longer than that).

The problem is, if you are already reacting, then how would you be able to tell (reliably) whether a test food causes a reaction? If you feel that you can reliably tell a difference, then sure, it's not extremely risky to try some of those foods, one at a time of course, so that you can keep track of what you are doing. Never experiment with gluten though, because it causes long-term damage, and that could undo all the good that your diet changes have done in the past months.

Also, even if we are not casein-sensitive, whenever we have enteritis (intestinal inflammation), we are temporarily lactose intolerant, because our small intestine stops producing lactase enzyme when it is inflamed.

While there is certainly a possibility that you are not sensitive to those foods, I'm concerned because obviously you are reacting to something.

Are you by any chance taking any of the medications that are known to cause MC? Medication reactions can trump diet changes.

Would you mind posting what you are eating. Maybe someone can spot a possible problem.

Also, have you by any chance been tested for selective IgA deficiency? It's possible that you might be producing very low levels of Immunglobulin A (one in about 500 people in the general population have that issue), and if that were the case, then your test results on any tests based on IgA antibodies (including the tests at EnteroLab) would probably show false negative results (or low positive results, such as your anti-gliadin result). The test for selective IgA deficiency is a simple blood test that any doctor can order. A surprising number of members here have selective IgA deficiency. Statistics show that among people who are sensitive to gluten, approximately 1 in 300 have selective IgA deficiency.

Tex
:cowboy:

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.
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Kimelizabeth
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Post by Kimelizabeth »

Hi Tex,
I have not been tested for an IgA deficiency but will request one.

I typically eat gf Chex with almond milk for breakfast. Lunch is typically leftovers from dinner. Dinner is typically beef, pork or chicken with rice or potatoes. I occasionally will try some well cooked veggies. I also occasionally indulge in enjoy life chocolate chips which are free of the top eight food allergens. I have one cup of decaf tea for breakfast and water the rest of the time. If I'm having a bad MC day I do drink Gatorade.

I do take an 81 mg aspirin each evening and Bystolic (beta blocker). Have never taken nsaids or ppi's.

Things have improved since my diet changes but still going two to four times a day and have not had anything resembling normal since June 2014.
Kim
GF, DF, Egg Free, Soy Free
Hashimotos Tyroiditis
MC with mixed features of CC and LC
MTHFR gene mutation
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tex
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Post by tex »

Kim,

Your diet appears to be reasonably safe. A few of us react to beef, pork, or chicken. You could test that out by avoiding them and eating turkey and/or lamb for few days or so, because virtually no one else here reacts to either turkey or lamb. Rabbit or venison (or any other wild game other than bison) would also be safe.

A few of us do react to chocolate, but if you do not react to the chocolate itself, the type you are using is one of the safest.

Gatorade of course has sugar problems (and possibly other issues such as dyes or other ingredients), but if you sometimes skip it for a few days in a row and can't tell any difference, then it may not be a problem for you.

NSAIDs are not a problem for everyone, but if you happen to be one who is affected by them, then the baby aspirin might be enough to cause problems, especially since you take it every day. I take plavix as a blood thinner (to reduce stroke risk), but you would need to discuss that with your doctor before considering a change, since you might be taking it for a different reason.

It's not impossible that the beta blocker might be a problem, but it's not a high probability risk. ACE inhibitors are also known to trigger MC for some people, but I take a small dose of lisinopril each night, and so far I haven't noticed that it is causing any problems (and I've been taking it for over 5 years now).

If you are not using Entocort (IOW, if you're trying to control your symptoms by diet changes alone, as many of us do), then it's also possible that you might just need more time to reach remission. For some of us, it can take a long time for the damage to the gut to begin healing. Many of us take 6 months or more (some take up to a year, and it took me a year and a half). The fact that you have seen some improvement, is a sign that you are definitely on the right track.

The result of the IgA blood test should shed some light on the situation, one way or the other. It should tell us whether or not the EnteroLab test results are likely to be valid, and that's important for future decisions about your diet.

Tex
:cowboy:

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.
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Kimelizabeth
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Post by Kimelizabeth »

Thanks for all the great info Tex. I see my GI next week and will request the lab work and I am trying to heal through diet alone and will hang in there a little while longer.
Kim
GF, DF, Egg Free, Soy Free
Hashimotos Tyroiditis
MC with mixed features of CC and LC
MTHFR gene mutation
BearcatRx
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Post by BearcatRx »

Out of curiosity, how long did it take to get results back? I won't be able to send my sample in until next Monday.
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Kimelizabeth
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Post by Kimelizabeth »

I got my results back in less than one week. I sent my sample out on a Monday, they received it Tuesday and I then received an email about 8:45 the following Monday evening that my results were ready.
Kim
GF, DF, Egg Free, Soy Free
Hashimotos Tyroiditis
MC with mixed features of CC and LC
MTHFR gene mutation
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Kimelizabeth
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Enterolab Results

Post by Kimelizabeth »

Hi Tex,
Just wanted to let you know that I finally received the results from the IgA test I had done back on July 7th. I have NO circulating IgG or IgA autoantibodies. GI is thinking CVID (common variable immunodeficiency) and has referred me to an immunologist.
That means that basically my results are invalid, correct?

In your experience working this site, is this diagnosis unusual?

It just keeps coming...
Kim
GF, DF, Egg Free, Soy Free
Hashimotos Tyroiditis
MC with mixed features of CC and LC
MTHFR gene mutation
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tex
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Post by tex »

Bummer. Well, the positive result for gluten is certainly accurate, but the rest of them (which were all negative) stand a very good chance of being false negative results.

You must really be sensitive to gluten to show a positive stool test result, with no detectible IgA from that blood test. Of course, this also highlights how much more sensitive the stool tests are when compared with the blood tests. The antibodies are produced in the intestines, and you apparently don't produce enough of them for them to be picked up by the blood (but there were still enough to show a positive result on the stool test).

That's a somewhat rare condition, but we have at least a couple of other members who have the same condition, as I recall. One lives in Australia, and you can read her introductory post at the link below, but I don't recall who the other one might be.

Lyn hasn't logged on in over a year, but if you would like to try to correspond with her about that condition, I feel sure that she would be open to discussing what she knows about it with you. Just click on the "email" button at the bottom of her post to open an email composing window.

Introducing myself

Tex
:cowboy:

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.
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Kimelizabeth
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Post by Kimelizabeth »

As always Tex, thanks for taking the time to respond and inform!!
Kim
GF, DF, Egg Free, Soy Free
Hashimotos Tyroiditis
MC with mixed features of CC and LC
MTHFR gene mutation
User avatar
tex
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Joined: Tue May 24, 2005 9:00 am
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Post by tex »

Kim,

You're more than welcome.

If you try to email Lyn, and you are not successful in receiving a response, it's possible that she may be using a new email address by now. If that should be the case, I believe that Gabes might be able to confirm whether or not the address is current.

Tex
:cowboy:

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.
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