There are no tests "specific" to gluten sensitivity. Basically the same tests that are used in celiac testing... although because most doctors have reduced the celiac panel to a single test (anti-tTG)... It is important to be sure your doctor understands the need for the antigliadin antibody test.
The antigliadin antibody test is the best test there is for gluten sensitivity, but antigliadin antibodies are associated with many conditions (many of which have reports as being responsive to a gluten free diet... so in my opinion... a positive antigliadin antibody always indicates gluten sensitivity). A positive antigliadin antibody may be the ONLY positive test in someone presenting with neurological disease.
Here are some of the other conditions associated with antigliadin antibodies"
http://jccglutenfree.googlepages.com...niggantibodies
Don't miss the excerpt listed from
From: The Neurology of Gluten Sensitivity: Science vs. Conviction by
Hadjivassiliou and Grunewald
Quote:
"There is also confusion about the role of antigliadin antibodies as a screening tool. Given that gluten sensitivity can exist without enteropathy, it is inappropriate to estimate sensitivity and specificity of these antibodies against the presence of enteropathy as the 'gold standard'. To assert that antigliadin antibodies lack specificity based on the fact that 10% of the healthy population may have them is a misconception. It is entirely plausible that 10% of the healthy population with circulating antigliadin antibodies have gluten sensitivity without recognized manifestations. The prevalence of coeliac disease itself is now recognized to be 20 times higher than what it was thought to be 20 years ago because most cases are clinically silent. It is important to realize that amongst the 10% antigliadin antibody positive people lurks those with 'silent' gluten sensitive enteropathy."
"It is ill-considered to suggest that antigliadin antibodies should not be used as a screening tool because they are found in “healthy” individuals. It is also irresponsible to suggest that neurological patients should not be screened for coeliac disease unless additional factors are present such as unexplained anaemia or evidence of malabsorption."
"Neurologic manifestations of gluten sensitivity are a scientific fact, not a theological issue. Whilst the debate continues, we owe it to our patients to screen them effectively for gluten sensitivity with the simple widely available antigliadin antibody test so that we do not in the meantime deprive them of a harmless but potentially effective treatment in the form of a gluten-free diet."
|
I have seen the genetic testing used by celiac experts mostly as a means to "rule out" celiac disease in those without HLA DQ2 or HLA DQ8. It might occasionally be used to tip the scale to a positive diagnosis in someone with inconclusive other tests (say positive anti-tTG but negative biopsy). Celiac specialists may also recommend genetic testing for family members of known celiacs... because if family members have the same genetic predisposition, then they should be screened every few years. If not, they give them a 'pass'.
BUT, if there are positive celiac (anti-tTG or anti-endomysial) antibody tests... I can think of no reason at all to do the genetic testing. I did the genetic testing years after we began a gluten free diet more out of curiosity.
Dr. Hadjivassiliou has seen up to 20% of his patients with gluten sensitivity and neurological disease have a third genetic type of HLA DQ1, with the remaining having the "celiac genes" (HLA DQ2 or HLA DQ8). Most genetic testing done for celiac disease does not look for HLA DQ1, but ONLY look for the "main celiac genes - DQ2, DQ8).d
My daughter and I both have double copies of HLA DQ1 (testing done via Enterolab)...which in the end probably explains why we failed the diagnostics for celiac disease, yet had so much of the other stuff (GI symptoms, neurological symptoms, strong family history of autoimmune disease (celiac disease, pernicious anemia, diabetes). My daughter had only a positive antigliadin IgG. My blood work was all negative. I began a gluten free diet to support my daughter, but enjoyed resolution of my lifetime of nagging GI complaints.
Quote:
|
Also is a Gastroenterologist the specialist of choice when it comes to investigation of CD or gluten sensitivity? Obviously neurologists and GP's are not cognisant to the fact that these things may be a causative factor in Peripheral Neuropathy. Are Gastroenterologists generally very open to the idea that someone may be gluten intolerant even if they do not have frank CD?
|
Most GI's are only concerned about celiac disease. Most neurologists do not realize that gluten sensitivity can cause neurological disease, but I'd imagine this has changed some over the last five years as gluten ataxia is gaining recognition in mainstream medicine, being report at neurology conferences, in the neurology publications, etc.
All you really need is a doctor willing to order the blood tests. While GI's "own" celiac disease, I think it makes sense to have your regular doctor order the blood tests, and then follow up with a specialist if you have any positive results. I think you should be able to find a neurologist or GI who would appreciate gluten sensitivity w/o celiac disease~ you may just have to prescreen so as not to waste your time with a doctor who is unwilling to 'catch up' with the research. If your symptoms are primarily neurological, I'd follow up with a neurologist. If your symptoms are primarily GI, I'd follow up with Gastroenterologist (especially if you test positive for "celiac disease").
I can tell you just about any DAN! doctor/ integrative/ environmental medicine doctor will be likely to understand gluten sensitivity.
Cara