Comments on: A New “Silent Killer”?

By: Sarah

Sarah — Tue, 14 Jul 2009 01:42:59 +0000

It recently came up in conversation with the dietician that I work with that celiac is more common in people of certain ancestry (east-asian for one), so perhaps the study populations weren’t the same? I imagine that an air-force base 60 years ago was a fairly homogenous population…

By: Rob

Rob — Fri, 03 Jul 2009 04:19:36 +0000

There are whole panels that reference labs will do for testing for celiacs. You’re right that there is no perfect test. but there are groups of tests that can give you a pretty clear cut yes or no. The fact that that the endomysial antibody test is sensitive to low total IGA is an easy fix, you just run a total IGA, along with it, as a sort of a control. You combine it with a ttg a reticulin and a gliadin, and you can pretty well get a “positive” or negative answer. Thanks for the great post, something else to think about.

By: CardioNP

CardioNP — Fri, 03 Jul 2009 02:27:44 +0000

Gluten free diets can actually have much higher caloric content than gluten containing diets. I did try a gluten free diet for a year due to equivocal testing. It did not help my neuropathy.
To truly follow a strict gluten free diet is extremely difficult. It essentially means that you must eat only home prepared meals or special GF foods. Food starch is a ubiquitous ingredient in commercially prepared foods. I’m glad to have gone back to eating a regular diet.

By: WhiteCoat

WhiteCoat — Fri, 03 Jul 2009 02:07:22 +0000

Not sure that we know enough about celiac diagnosis to say one way or another. There’s no perfect test. Biopsy only shows the body’s reaction to the gluten, so it might not pick up subclinical cases. Tissue transglutaminase isn’t 100% sensitive – especially in IgA deficient patients and celiac disease is also associated with IgA deficiency. EMA is specific, but may be falsely negative if there isn’t much villous atrophy. Genetic testing for DQ2 or DQ8 may exclude celiac disease if they are negative, but negative genetic testing does not exclude allergy to gluten, which can cause symptoms similar to celiac disease.
Don’t know that gluten free diets have any less calories – they just switch some grains for others.
But if people feel better on the diet even if they don’t have celiac disease, more power to them.

By: MedZag

MedZag — Fri, 03 Jul 2009 00:27:32 +0000

Was just talking with the endocrine fellow about this today… weird.

She said some places are even instructing patients to go gluten-free if they’re GGT/endomysial (+) and BIOPSY (-). That seems a little overkill to me, though putting a slew of people on gluten-free diets may help drop obesity a bit.

By: EAST

EAST — Thu, 02 Jul 2009 22:03:23 +0000

Trust me, Celiac sucks. I just started my gluten free diet a few months ago. I now notice fewer problems with neuropathy, I’m less grouchy/ depressed, and don’t get lost on the freeway anymore… I’d like the distention / abd swelling to go down so I don’t have to wear maternity pants anymore (or have people ask if I’m pregnant- I want to tell them that I’m infertile), but that is more of a good day vs. bad day issue.