How to Test for Gluten Intolerance and Celiac Disease
March 7th, 2019
Do you experience bloating, diarrhea, abdominal pain, or headaches after eating bread and other products containing wheat, barley, or rye? You could have gluten intolerance, also known as non-celiac gluten sensitivity.
How to Test for Gluten Intolerance
I have found the single best way to determine if you have an issue with gluten is with an elimination diet. This means you remove gluten from your diet for at least 30 days and then reintroduce it. Please note that gluten is a very large protein and it can take months or even years to completely 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 eliminate 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 want 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. Cyrex also offers an array 4 test to check for gluten cross-reactivity with other grains.
The key with these tests is you MUST be eating gluten (or other grains you are concerned about) for roughly 4 weeks prior to testing in order to detect gluten antibodies. That being said, if you know you don’t tolerate gluten I do not recommend adding it back into your diet just to see what happens on a test. If you are certain that gluten is to blame for your symptoms, I would avoid it no matter what any test says because in my experience, testing does not always have the most valid responses compared to the gold standard of an elimination diet.
At the end of the day, I tell my patients that your body knows better than any test. If your symptoms disappear when you take gluten out of your diet and return when you add it back in –even if you have a negative test result – you still have an issue with gluten so don’t eat it!
How to Test for Celiac Disease
I often get a lot of comments from readers when I write about giving gluten up for 30 days to test for gluten sensitivity. To clarify, I am not referring to testing for celiac; the gold standard to diagnose celiac disease is still an intestinal biopsy. Identifying celiac disease is important since it is an autoimmune disease and it can put you at risk for long-term complications if not properly addressed.
Symptoms of Celiac Disease
Although digestive issues are common in children with celiac disease, most adults do not experience these symptoms. Instead, the following signs are often a red flag for celiac in adults:
- Unexplained iron-deficiency anemia
- Bone or joint pain
- Osteoporosis or osteopenia
- Liver and biliary tract disorders
- Depression or anxiety
- Peripheral neuropathy (tingling, numbness, or pain in the hands and feet)
- Seizures or migraines
- Canker sores inside the mouth
- Itchy skin rash1
Whether or not you are experiencing any of these symptoms, it is crucial to get tested for celiac if you have a 1st-degree relative with the condition, as this puts you at a 1 in 10 risk of developing celiac yourself. However, if you suspect that you have gluten intolerance rather than celiac, the single best way to determine gluten intolerance 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 Intolerance 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 repaired. Leaky Gut Revive™ can be a powerful ally in repairing your gut in conjunction with functional medicine’s 4R program.
Additionally, I often find that there are other infections in the gut such as parasites, Candida, small intestinal bacterial overgrowth (SIBO), and other 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.