Newbie Question on Enterolab testing

[jlewton]

Hi All~

First time posting but found you and have been learning here since October 2021.

Brief history:
I am 56 yo female. Have had Rheumatoid Arthritis for almost 30 years and MC for almost 10yrs now.
For RA I have taken the gambit of drugs from prednisone (15+), methotrexate (7+ yrs) Plaquenil, bextra, celebrex, several biologics Humira, Remicaid, Actemra, currently-Kevzara. (all which I am sure damaged my gut) Have remained very active despite 3 spinal fusion surgeries, ACL surgery, total hip replacement and upcoming RA foot surgery.

My MC diagnosis came in Oct 2011, and was told all the things you discuss here- like, your diet doesn't matter, it will go away on it's own, you got the good IBD out of all of them, tried all the regimens of RX most GI's prescribe, with only temporary relief. 2020/2021 started having more consistent WD although by Feb 2021 I thought it was back under control. Then I had the covid vaccine, fine with the first one, but the second one in April 2021 caused a flare up with both my RA and MC. Luckily the RA flare only lasted a couple weeks, but not the MC, just kept getting worse, (throw in a move from VA to Iowa to add a little stress) by July/August was having 30+ WD per day (sometimes 10+ during the night). At that time, I was still taking 6 Colesevelam (generic for Welchol) per day but decided to wean myself off as it was obviously not helping.

Then I stumbled upon Mark Hyman and many other Functional Medicine doctors professing Autoimmune diseases can be controlled or reversed though diet, WHAT??? Now this got my attention! And then I eventually to this group! So much great information and I would rather heal through foods than drugs if it's possible, even though it's not easy!

In August, I started my elimination diet, (everything except gluten) NO dairy, eggs, soy, spicy, raw veggies or fruit, nuts, grains, oils except olive and coconut, processed food etc, by October I accepted the fact I needed to cut out gluten too! I felt like I really didn't see any improvement, although my WD was averaging 10-15 per day, still same watery consistency though. Not the great success you hear about- give up gluten for 10-30 days and you will see great improvement. I read a lot on becoming plant based for autoimmune conditions, but that contradicts the MC diet recommendations here and felt overwhelmed and confused. Luckily my RA has remained under control during this extended MC flare, thank God!

I found a local Functional Medicine doctor and had my first appointment in November. Diagnosis, at this point anyway, Leaky Gut, now to try and heal it.

Then started the testing and supplements--AND FINALLY my question regarding ENTEROLAB. I have so many questions but let's start here.

Why do you believe that Entero Lab is the only accurate lab for MC?

Through Genova, I have had the SIBO test (negative) and fecal stool sample tests (lots of highs and lows).
Then food sensitivity testing with US BioTek.
Without going into all the details at this time regarding the test results, I am panicking after reading on the forum that the only reliable tests for MC are from Enterolab??? Have I just wasted all that money on tests that aren't accurate? Can anyone explain or help me here? Do I need to redo all the test with Enterolab?

I meant to keep this short and sweet and only ask the question about the lab, but thought I should throw in some history for reference.
Thank you to anyone who takes the time to read and may have some answers!!

~Jennifer

[Gabes-Apg]

Hi Jennifer

for some clearing residual gluten from the body after stopping can take 3-6 months.
A few questions /ponderings as to why you may be still having issues

when you went gluten free, is there still others in the household eating gluten?
did you purchase new utensils / cookware / chopping boards etc??

are you still having more than 5 watery bowel motions per day now??

what are you drinking during the day?

are you taking Vit D3 and magnesium

have you checked make-up bathroom products etc for gluten??

plant based can work for Autoimmune for some, once the gut has healed. I know a few long term members here that are following plant based eating plan but it was only after a few years of stability and gut healing

I have never personally done the Enterolab tests (and I am not a USA resident so I can not comment on the other test that you mention)
Enterolab testing is the 'short cut' way to identify food items that are major inflammation triggers.
I did elimination diet rather than testing.

the other aspect to inflammation and issues in your body - based on your age have you gone through menopause?

[jlewton]

Hi Gabes,
Thank you for your time and response.

I'll try to answer your questions, first a note on my food sensitivity testing I had done leaves me baffled, all 207 of 208 items came back in the very low or low categories with just one thing a moderate (cottage cheese- which I do not like and may have eaten just once in my life if forced to as a child, lol. Absolutely nothing came back as high or very high. Not even gluten! This is why I was really hoping someone could explain why only Enterolab is considered reliable for MC?
In addition, I have been tested 3 times for celiac and that always negative as well. Also negative for Lyme's disease.

**when you went gluten free, is there still others in the household eating gluten?
did you purchase new utensils / cookware / chopping boards etc??**

All of my kids are grown and out of house, so it's just me and my husband, he is basically just eating what I eat while he's around me, except for condiments and additional fruits and veggies. He does have bread occasionally, but we are careful where he prepares things. We did not purchase new separate utensils. In addition, I have added GF bread recently, that is also soy, dairy-free etc. But I have used the same toaster my husband uses. Didn't think this a big deal since my tests show I am not sensitive to gluten. But I have continued to eat GF.


**are you still having more than 5 watery bowel motions per day now??**

In the past 2 weeks I have actually been between 1-5 per day so making progress!

**what are you drinking during the day?**

I start with a cup or two of black coffee, (I've never been sensitive to caffeine or had issues with coffee causing stomach upset).
Then I alternate between green tea, or an herbal tea and water. May have another single cup of coffee in the afternoon, then back to water.

**are you taking Vit D3 and magnesium**
I was taking a combo vitamin ADK but in my November 2021 labs, my D was high, 120, normal is said to be btwn 25-80. So I have stopped for a few months and will be retesting soon. I am using magnesium lotion, once before bed.

**have you checked make-up bathroom products etc for gluten??** I have not, guess I should!

**based on your age have you gone through menopause?** Believe I am still peri-menopause at this time...but maybe?


I can't seem to figure things out with the elimination diet process, just been sticking to things from the recommended stage one eating.

Any thoughts or ideas?

Thank you!

[Gabes-Apg]

few observations based on your answers

Sharing toaster and eating GF breads etc could be an issue.
and depending on the ingredients of the GF bread - you could one reacting to one or some of the ingredients

that is why we encourage to avoid anything 'pre made / processed' in early stages, as it is hard to know what ingredient you might be reacting to
and definitely do not share toaster.

Check the tea's - some herbal tea bags are made from soy based products
we encourage using pure leaves rather than any products that are in bags /mass produced.

Magnesium - that is not enough. we need at least 350-400mg of elemental magnesium per day. Coffee depletes magnesium, hormone issues can deplete magnesium. For the body to use VIT d stores correctly the body needs good levels of magnesium. (the Vit D receptor in the cell relies on magnesium to know when Vit D is needed). at the moment you are not getting the full benefit of the Vit D. (it is there but not being fully used)

Food is a big part of removing inflammation triggers and tends to work for most people
for some, there are other factors/triggers that slow down(inhibit) healing:-

are you taking any medications?
sleep quality - are you getting good restful sleep each night?
environmental factors - things like mold, pollen chemicals etc at home, at the workplace
the other big trigger item for many here is stress, whether that be physical, and/or emotional, and/or mental stress. Other than Covid has there been any stressful events in the past 6 months.

8 years ago my body went into high inflammation mode, all my AI conditions were in chronic state. I had been made redundant, had to move interstate so had high levels of physical, mental and emotional stress. During that time I had to go low toxin lifestyle. my sister joked I was allergic to the world! I took my filtered water with me everywhere (drinking different water supply would cause issues) I avoided swimming in pools in summer ( to avoid chemicals) could not wear make up, had to use a natural minimal ingredient unscented soap

Once I reduced inflammation and healed I was grand. The super sensitivity went away. if you are having watery D multiple times per day you are having regular contact with some inflammation triggers

[tex]

Hi,

Gabes seems to have done a great job of answering your questions, but I noticed you mentioned confusing food sensitivity test results. With that many test results, you're obviously talking about either blood tests, or skin test results. All of those tests are totally worthless for our purposes. Our antibodies are in our intestines and our stool, not in our blood. Very rarely are they found in blood in quantities that are significant enough to be detected by normal blood tests. While skin test results theoretically should work, since the skin is somewhat similar to the lining of the intestines, in the real world, they're also worthless, probably because the skin doesn't have a mucosal surface like the intestines. Bottom line: the only food sensitivity tests that are useful for MC patients are the EnteroLab tests. All other tests are a waste of money, when searching for food sensitivities.

Tex

[jlewton]

Thank you Gabes for all the advice, lots to think over and appears I need to dig deeper!

Tex, thank you for the information on the testing, although it all still confuses me a bit, science/biology not my strong points, but I am learning!

The food sensitivity testing I had done through BioTek was through blood, finger prick to be exact. (IgG not IgA- is it IgA we need tested?)

The testing done with Genova was stool sample, GI Effects™ Comprehensive Profile - Stool, which tests for 5 different categories and ranks them from 0-10, with 10 being highest. 2-3 considered Low need for support, 7-10 High need for support
Maldigestion my score 0
Infection my score 0
Dysbiosis my score 2
Metabolic Imbalance my score 2
Inflamation my score 7

Under Inflammation my Fecal secretory IgA was very high 5008, chart says should be less than 2040.
Also noteworthy under Gut Microbiome, I think, my Akkermansia level very low- Did Not Register
As well as low Butyrate levels

Gastrointestinal Microbiome (PCR) details the Commensal Bacteria (PCR) of which I have a few of both High and Low results.

Gastrointestinal Microbiome (Culture) showed No Growth or Non-Pathogen for all Bacteria tested.

KOH Preparation for Yeast was negative for yeast

Parasitology showed no Parasites detected. HpSA - H. pylori also negative.

I have tried several supplements and still these things which seem to be helping: to include L Gutamine powder and Poly-Prebiotic powder, Akkermansia, added Ghee to my diet as well. I have tried a few others that had no impact.

Any other insight you can offer would be greatly appreciated!

Thank again~ Jennifer

[tex]

Hi Jennifer,

Yes, it's IGA antibodies that are associated with the type of Inflammation associated with MC (lymphocytic infiltration), but those IGA antibodies are in our intestines, not in our blood. The stool tests you had done strike me as sort of irrelevant, because microscopic colitis always causes poor digestion, inflammation, dysbiosis, and a distorted gut biome profile, because our gut bacteria populations depend on what we eat, and how well it is digested, or not digested. Our gut bacteria profile will change anytime our digestion gets worse, or improve, and it will change anytime we change the foods in our diet. So most of those test results just tell you what you already know, namely, that you have MC.

Incidentally, most of us who are sensitive to casein, react to ghee, because the purity of that product depends on the quality of its filtration process. Ghee is made by precipitating out the casein, and then removing it by filtration, but all of the casein is virtually never completely filtered out. Most ghee is about 98 or 99% pure, I believe. Anyway, I tried it when I was still reacting, and I couldn't tolerate it, similar to most of us here who've tried it.

I hope this helps,

Tex

[jlewton]

Thank you Tex for explaining the difference on the tests!

So, from your years of experience and expert knowledge on all matters MC, is Enterolabs the only lab that does IgA antibody testing? If so, do you know why?

Which labs are most helpful in resolving issues (WD) for those of us with MC?

I notice you usually say the "majority" of us with MC are gluten and casein sensitive, curious if you know of any in this group who are not?

I believe I've read that you have been in remission for 20 or so years, if you don't mind me asking, are you still on a super restrictive diet to stay that way or have you been able to increase your variety of food? For the last 5+ years I've really been trying to increase my veggies, you know- eat a rainbow of colorful foods to live a long healthy life, now I am wondering if I will ever get back to that?

One last question, are any oils safe for most during healing? I always try to avoid vegetable, canola and soybean oils, but wonder about olive, avocado, coconut, sunflower or safflower oils?

Your input here is so valuable to those of us just trying to figure things out! I hope you and all the moderators realize how much we appreciate your insight and sharing of your personal experiences!

Thanks again!

[tex]

So, from your years of experience and expert knowledge on all matters MC, is Enterolabs the only lab that does IgA antibody testing? If so, do you know why?

No, they're the only lab that does stool testing for food antibodies. There used to be a lab in Italy that did similar work, but I don't believe they ever offered such testing to the public. I have no idea why other labs don't offer it. Their original patent may still be in effect, but I doubt it. Their accuracy and repeatability is amazingly good, because they have the same guy with a PhD in chemistry do all the testing.

Which labs are most helpful in resolving issues (WD) for those of us with MC?

Nearly everyone orders the A1 + C1 panels. The combination of those tests is usually available at a discounted price.

I notice you usually say the "majority" of us with MC are gluten and casein sensitive, curious if you know of any in this group who are not?

Virtually all of us sensitive to gluten, but only about 70% of us are sensitive to casein. Just look at the test results that are posted in the forum that's set up specifically for that purpose. Virtually none of us have the same test results, so each one of us has to customize our diet.

I believe I've read that you have been in remission for 20 or so years, if you don't mind me asking, are you still on a super restrictive diet to stay that way or have you been able to increase your variety of food? For the last 5+ years I've really been trying to increase my veggies, you know- eat a rainbow of colorful foods to live a long healthy life, now I am wondering if I will ever get back to that?

I've tried to expand my diet, but I still have to eat a super restrictive diet. It's really restrictive now, because my histamine issues have become a major problem, probably because of my age— I'm 80 now

One last question, are any oils safe for most during healing? I always try to avoid vegetable, canola and soybean oils, but wonder about olive, avocado, coconut, sunflower or safflower oils?

All those oils you have listed would be safe for most of us. Be sure the olive oil is a certified brand, because many of the uncertified brands used to be notorious for being diluted with cheaper oils, which often means soy oil. I have to take a lot of vitamins, so I take a fish oil capsule and a flaxseed oil capsule every morning along with them. But remember, oils are a lubricant, and most of us don't need much in the way of lubricants while we're still recovering.

Tex

[jlewton]

Thank You ~ Thank You!

I am going to order the tests-I'll be back if I have questions when I get the results!

~Jennifer

[jlewton]

Please help Tex~or anybody! Results are back and feeling overwhelmed, need ideas on what to eat now? Can you eat things in the 2+ category?

When I started on the elimination diet I ate a lot of turkey bc it was close to thanksgiving they we in the stores, then I switched to more chicken and salmon when I couldn't find turkeys, am I reactive to turkey, that's not one of the things tested? Then when I read a lot of MCer's could eat grass fed beef, I added that, which explains why I am not healing. Also after about 3 months with no eggs, I added them back to my diet, which didn't make things worse, but yet, no healing, so am hopeful if I cut out the bbef and eggs, I will show progress! Still what else at this point is safe to eat? Any ideas would be greatly appreciated!

Here are my results from Enterolab:

Fecal Anti-gliadin IgA 212 Units (Normal Range is less than 10 Units)

Fecal Anti-casein (cow’s milk) IgA 76 Units (Normal Range is less than 10 Units)

Fecal Anti-ovalbumin (chicken egg) IgA 35 Units (Normal Range is less than 10 Units)

Fecal Anti-soy IgA 24 Units (Normal Range is less than 10 Units)

Mean Value 11 Antigenic Foods 39 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:

I had nothing in the no significant reactivity or the some reactivity (1+) categories.

Food to which there was moderate immunological reactivity (2+):
Corn
Rice
Chicken
Pork
Tuna
Almond
Walnut
White potato

(3+) foods
Oat
Beef
Cashew

THANK YOU~Jennifer

[jlewton]

Also...not sure if this part of results are relevant for anyone who can offer suggestions?--thanks again! Jennifer

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
Grain toward which you displayed intermediate immunologic reactivity: Corn
Grain toward which you displayed the least immunologic reactivity: Rice

Meats:
Meat toward which you displayed the most immunologic reactivity: Beef
Meat toward which you were next most immunologically reactive: Chicken
Meat toward which you displayed intermediate immunologic reactivity: Pork
Meat toward which you displayed the least immunologic reactivity: Tuna

Nuts:
Nut toward which you displayed the most immunologic reactivity: Cashew
Nut toward which you displayed intermediate immunologic reactivity: Almond
Nut toward which you displayed the least immunologic reactivity: Walnut

Nightshades:
You displayed immunologic reactivity to white potato, the member of the nightshade family usually consumed most often and in greatest quantities. While this does not necessarily mean you would react to all other nightshade foods (tomatoes, peppers, eggplant), it is possible. In the realm of elimination diets for immunologic disorders, nightshades are usually eliminated as the entire food class (i.e., all four previously mentioned foods in this class). This is especially important to the clinical setting of arthritis.

[tex]

Hi Jennifer,

With an overall score of 39 on the 11 other antigenic foods, it would be very, very risky to eat any 2+ or 3+ foods. And the reason why turkey should be safe is because EnteroLab only tests foods that are known to trigger reactions for MC patients. By doing that, they can keep their prices lower. To get started with selecting a safe diet, I'd suggest you read, or reread if you've already read it, The newsletter published by the Microscopic Colitis Foundation,that you can read or download by clicking on the following link:

https://www.microscopiccolitisfoundatio ... 479987.pdf

If you can't resist trying a 2+ food, try the one that shows the least immunologic reactivity. For example, in the grains, that would be rice.

I hope this helps,

Tex

[jlewton]

Again Tex, a huge thank you for sharing your insight and experience!

I was wondering how the foods tested were determined, that makes sense knowing they are the most reactive foods for MCer's.

I will search harder for a safe turkey and other wild options.

One additional question- Are red potatoes considered safe/unsafe as I did display immunological response to potatoes?

Thank you!

[tex]

Red potatoes might be safer because they contain a different type of starch, and consequently, colored potatoes are much easier to digest. Also, sweet potatoes belong to a different family, so they're usually safe for us.

Tex