How To Test For Gluten Intolerance And Celiac Disease

July 21st, 2013

Print Friendly, PDF & Email


How to test for gluten intolerance and celiac disease

I have found the single best ways to determine if you have an issue with gluten is to take it out of your diet for at least 30 day and then reintroduce it.  Please note that gluten is a very large protein and it can take months and even years to clear from your system so the longer you can eliminate it from your diet before reintroducing it, the better.

The best advice that I share with my patients is that if they feel significantly better off of gluten or feel worse when they reintroduce it, then gluten is likely a problem for them.  In order to get accurate results from this testing method you must elimination 100% of the gluten from your diet.

Another way to determine if you are gluten sensitive is to ask your doctor to order the following tests:

  • IgA anti-gliadin antibodies (these are found in about 80% of people with Celiac disease)
  • IgG anti-gliadin antibodies
  • IgA anti-endomysial antibodies
  • Tissue Transglutaminase antibodies
  • Total IgA antibodies
  • Genetic testing (HLA DQ2 and HLA DQ8)
  • Intestinal biopsy (for celiacs)

I’d like to mention that one potential problem with testing is that gluten is made up of several hundred peptides and gliadin is made up of 12 different sub-fractions.  Most modern day testing focuses on only the alpha-gliadin (one of the twelve sub-fractions) and therefore there is considerable room for error and false negative tests.  There is a new laboratory (Cyrex Lab) that has recently opened that is testing for these sub-fractions and may help to minimize false negatives.

At the end of the day, I tell my patients that your body knows better than any test.  If you feel better when you take gluten out of your diet or feel worse when you add it back in and you have a negative test result – you still have an issue with gluten and don’t eat it!

I often get a lot of comments from readers when I write about giving gluten up for 30 days to test for gluten sensitivity.  I am not referring to testing for celiac, yes the gold standard to diagnose celiac disease is still an intestinal biopsy and identifying celiac is important since it’s an autoimmune disease.  However, for those who suspect that they have gluten intolerance rather than celiac, the single best way to determine gluten sensitivity is to remove it from your diet and see how you feel without it and how you feel when you add it back in.

How to treat gluten sensitivity and celiac disease

Eliminating gluten 100% from your diet means 100%. Even trace amounts of gluten from cross-contamination, medications or supplements can be enough to cause an immune reaction in your body. The 80/20 rule; or “we don’t eat it in our house, just when we eat out” is a complete misconception. A Lancet article published in 2001 states that for those with celiac disease or gluten sensitivity, eating gluten just once a month increased the relative risk of death by 600%.

I tell my patients that even though the outward manifestation of eating gluten may be mild bloating or headache, inside their body, their immune system is being stimulated and the effects may last for three to six months.

For many, simply removing 100% of gluten from their diet isn’t enough. The damage that has been caused to the gut lining must also be healed. Additionally, I often find that there are other infections in the gut such as parasites, Candida, bacterial overgrowth, and bacterial imbalances that need to be addressed and corrected. For some, there may be a need to go completely grain-free due to the cross reactivity of gliadin sub-fractions in non-gluten grains.

When in doubt, go without. You’re not missing any vital nutrients by not eating gluten. In fact, you may be saving your life or the life of someone you love.


Interested in learning more about gluten?


Take our Guide to Gluten eCourse! This course outlines a proven method to help you determine your own body’s reaction to gluten. Our objective is to empower you to discover how gluten affects your body and how to thrive without gluten in your diet.During the course, you will have access to a number of worksheets, shopping guides, and checklists that you can complete in the comfort of your home. The more worksheets and checklists you complete, the more helpful and effective this eCourse will be for you.The focus of this 4-hour eCourse is to provide a detailed understanding of gluten and the tools to enjoy a gluten-free lifestyle.

The Myers Way Guide to Gluten eCourse includes:

  • 4 hours of information and worksheets
  • Gluten-containing foods list
  • Signs you have a gluten sensitivity
  • How to test for gluten sensitivity
  • Gluten sensitivity risk factors
  • Symptom tracker
  • Gluten-free grocery list
  • Gluten-free travel tips

… and much much more!

You will learn about:

  • Gluten and its effect on the gut
  • Gluten sensitivity testing and treatment
  • Avoiding gluten in obvious and hidden sources
  • Enjoying abundant foods that are naturally free of gluten

Get 35 Gut Recovery Recipes for Free!

Receive 74 pages of delicious recipes and tips to repair a leaky gut PLUS a $10 gift card when you join my free weekly newsletter

Your information is secure and will never be sold or rented to a third party.

Related Articles

  • Karen Trainor

    I explain gluten sensitivity to my friends like this: even ONE crouton is enough to keep my symptoms aggravated for up to 6 months. Yes, just one crouton!

  • Pingback: Gluten and the gut | Mark's Daily Apple Health and Fitness Forum page()

  • Pingback: Gluten Sensitivity is Real()

  • Pingback: This Is Your Gut On Gluten » Amy Myers, MD Functional Medicine()

  • Pingback: Great Article on Gluten Free by Amy Myers M.D. | Gluten-free from Utah!()

  • Laura

    Hi Dr. Amy. First, thanks for all your efforts – you are making a difference in the lives of SO many people. Second, a question regarding gluten testing. I want to have my 3 kids tested for gluten problems as a result of positive gene tests for HLA-DQ (from Entero labs). The Cyrex array 3 has appeal to me; however, Entero lab offers a stool test that measures gluten antibodies. It has been explained to me that the antibodies in the stool testing would show up prior to any results appearing in the blood. Can you explain some pros/cons of these approaches? I would also consider an elimination diet for the kids; however, I was diagnosed as gluten sensitive last month. I’ve probably had it for ten years (when I was diagnosed with Hashimoto’s) and just chalked up all the symptoms to being a busy mom….. so I”m not so trusting of my symptom evaluation skills. Some science would be appreciated as I guide my family to better health. Thanks again:)

    • That’s not 100% true and no one really knows. It’s a piece of the puzzle! ask Enterolabs if they test for the fecal IgA level now — they used to not. and you need to know the igA level to see if you cna respond. but really what do you need the test for? your kids are pos for the gene so either they have a sensitivity now or they will in the future — get them off gluten ASAP and save your money

  • Sara11

    My daughter has been 100% gluten free for 6 months. She went gluten free because she has Hashimotos, and the experts are all saying that if you have Hashimotos, then you need to be gluten free. After the 6 months, we saw a SEVERE INCREASE in her TPO antibodies – numbers so high we had NEVER seen it before (over 1300, where she had been trending around 300-400). I was talking to a friend whose daughters also have Hashimotos, and she said the same thing happened to her girls – that when she took her daughters gluten free, their antibodies got much worse. Now I don’t know what to do. She says she really doesn’t feel any better off gluten, but with Hashimotos, is that really the standard – how you feel on or off gluten? Enterolabs tested her and said she had gluten sensitivity ??? I’m debating whether I should now let her have gluten and see if she feels worse.

    • I wouldn’t recommend giving her gluten again because it isn’t adding anything good to her diet–especially if you tested her and she came back positive as sensitive to gluten. It could be very dangerous to add it back into her diet.

  • Jess

    My daughter who has had chronic stomach pain since forever has been gluten free for 1 month. We had her tested (blood test for elevated IgA) but it was negative. The doctor recommended we do an elimination diet on our own. We took gluten away and her stomach pain went away (first time in forever!!!) We had already eliminated dairy/soy which helped but didn’t take a way the pain Anyway we just reintroduced it this weekend and she is home sick with me today. Is it normal to have a more heightened reaction to it after eliminating it? Also should I trust the blood test or do further testing to see if she might have celiac’s (scope)? The doctor said the blood test was 98% accurate so mb she is just be intolerant? Just wondering if I should do more to rule out celiacs or just be happy that taking it away has eliminated her stomach pain?!?! 🙂 Thanks in advance for your advice and for your informative article:)

    • YES it is possible for your reactions to be heightened after avoiding gluten. It is also possible to be gluten-sensitive and not celiac. I don’t know if you need to rule out celiac–it sounds like she is doing better without gluten, and she’s not missing anything nutrition-wise by leaving it out of her diet.

  • Heather

    My 7 yr old had chronic diarrhea and skin rashes since birth. More recently we saw behavior and personality changes. He had a huge, growing list of foods that worsened his rashes including ALL acidic foods which was nearly all fruit, all processed meat, preservatives, dyes, including some natural dyes like anatto, dairy, corn, and soy. We had removed gluten in the past (but not oats) for up to a month with no changes. Last fall we tried again but also removed oats, stopped using cast iron, wood spoons, and all forms of cross contamination. Now, 6 months later he has no rashes, no diarrhea, normal behavior, he can eat acidic foods and has corn, soy, and dairy. It is AMAZING! He can eat again and he is healthy and thriving! He had a negative blood igg and iga test which we did early in our eliminations. He also tested negative at the allergist with a skin prick. However he definitely had leaky guy with food particles getting into his blood stream and affecting his brain and skin and kidneys (bed wetting multiple times a night) and despite no pos tests and I don’t want to subject him to a biopsy, he will never eat gluten again. I am just so amazed that he can eat oranges and strawberries and so many foods that he couldn’t brfore, all because of gluten.