In July I had a scope of my stomach that ruled out celiac or as it is written in the report - neg. for sprue.

I just got back some new blood work and the Gliadin IGG AB was 68.2 ref. range <45. The only other thing out of range wasReticulocytes CGr 35.0 ref. range 25-30. The doctor suggested I try a gluten free diet. But as I understand this it does not indicate celiac. She said give the diet a try and see how I felt.

Is the IGG or the IGA a better marker for celiac?

Hi cat265,

I'm glad your doctor suggested you try a gluten free diet. Although your biopsy was negative, there are many many many cases of people who improve miraculously on a gluten free despite lack of a celiac diagnosis.

This comes down to the difference between gluten sensitivity and celiac disease. Celiac disease, by definition, requires villous atrophy. But, you can be gluten sensitive and have other related disease, such a dermatitis herpetiformis (skin manifestations) or gluten ataxia, or many other wide ranging symptoms, without showing villous atrophy. Gluten sensitivity that doesn't show as celiac disease (villous atrophy) has been a somewhat controversial subject for years, but science is finally beginning to back up what patients have known for decades... gluten causes problems for many who don't meet the diagnostic criteria of celiac disease. And, it may be relative in other autoimmune disease, as well.
http://jccglutenfree.googlepages.com...sceliacdisease
http://jccglutenfree.googlepages.com/zonulin

A positive antigliadin IgG does suggest you are gluten sensitive and will likely benefit from a gluten free diet. Left untreated, you may eventually progress to show villous atrophy. But, there are also those who will never show villous atrophy, but are symptomatic, and do respond to a gluten free diet.

The antigliadin IgA antibodies are more associated with a damaged gut, whereas antigliadin IgG may be more suggestive of non-gut manifestations..... but that is just a generality. My daughter had only a mildly positive antigliadin IgG, yet she had major gut symptoms, neurological symptoms and skin symptoms... and they all resolved on a gluten free diet.

I'm not sure what all of your symptoms are, but gluten sensitivity can cause wide ranging neurological symptoms (neuropathy, ataxia, white matter lesions, seizures, myopathy, and more), gastrointestinal symptoms, skin symptoms, can affect essentially any organ/tissue in the body, and is associated with several autoimmune diseases. If you have any symptoms at all, I'd definitely recommend a gluten free diet. About half of those with gluten sensitivity also have sensitivity to casein (cow's milk protein).


I'm not sure what this means~
Reticulocytes CGr 35.0 ref. range 25-30.
but here is the labtestsonline link for it:
http://www.labtestsonline.org/unders...te/glance.html

Thanks jccgf,

I have had not your typical symptoms; extreme muscle fatigue after exerction (eg. sometimes I can barely make it up a flight of stairs, if I do I have to sit for a few moments until the strength come back into my legs) though the weird thing about this is it comes and goes I could do the same activity the next day and not have the same reaction. Iam always tired. I did have an MRI that showed multipule lesions, I never got an answer as to what casued them. Brain fog/word recall has been a big issue. I did have a low b12 but Iam takeing care of that, my last blood test was 650 (or right around there) I guess my memory (right now I can't think of my symptom, its like I go to use my brain to think and its empty) and muscle fatigue are my worst symptoms

--which is not very high, by the way--one wonders what it was before you started "taking care of it" (which I assume means you are supplementing).

Gluten Sensitivity/celiac can certainly result in malabsorption of many nutrients (not just B-vitamins), and that may help to explain some of the fatigue, and it is possible to get central nervous system "plaquing" from B12 deficiency that superficially resembles that of CNS autoimmune diseases like MS.

Can you tell us, in more detail, what tests you're had, and what the results were?

Someone else mentioned cns/csf deficiency and I tried to google it but it was a little over my head. I didn't really understand it. About 2 years ago I was found to be b12 deficient, my level was 209. Because of blurred vison in spots, the dr. ordered an MRI. I came back showing multiple non-enhancing subcortical and deep white matter punctate hyperintensities in both hemisphers. I than had a lumbar puncture to rule out MS (no MS). I had an ANA test show positive 1:80 homogeneous pattern (ref range <1:40) Gliadin IGG AB slightly high at 68.2 (ref range <45) and Anti pareital cell pos. intrinsic factor neg. Alot of other antibody test where done, all were neg. Lyme come up 2 titers pos. so that test was considered negative as well.

I think my symptoms are probabley all from malabsorbtion issue as you mentioned. That makes the most sense.

cat... keep up with the B12 with a goal to get to the top quarter of range or over the top. The brain fog/ word recall problems may be related to the low B12. 9 years after initially correcting my B12 deficiency, I still struggle some with word recall, memory, and concentration problems... but this has greatly improved from its worst. However, these symptoms are also associated with gluten sensitivity.

Cognitive Impairment and Celiac Disease
http://archneur.ama-assn.org/cgi/con...ull/63/10/1440

Most everything that applies to "celiac disease" applies to gluten sensitivity. In gluten sensitivity that presents as celiac disease, the gut is the target organ, but gluten sensitivity can target the nerve, brain, and other organs without targeting the gut.

B12 deficiency and gluten sensitivity have many overlapping symptoms... and often occur together in the same person. You have symptoms and clinical evidence of both. (Low B12 level with parietal cell antibody, antigliadin IgG antibodies).

Gluten sensitivity is associated with neuromuscular problems, and they can be sporadic. There are a few articles in particular that come to mind by Dr. Marios Hadjivassiliou, the leader in gluten related neurological disease. Gluten ataxia itself can cause wide ranging symptoms, some of which fit what you describe.


Here is an accounting of Dr. Hadjivassilou's articles, with a couple excerpts that highlight the importance of a positive antigliadin IgG:
http://jccglutenfree.googlepages.com/halloffame

Of particular interest might be these articles:

You may have to register to get the full text of a couple of these, but if you send me your email addy via pm, I have most of them as pdf files that I could forward to you. The full text articles explain more in terms of patients individual symptoms than you find in the abstracts.

Neuromuscular disorder as a presenting feature of coeliac disease. Dec 1997
Free on Pubmed: http://www.ncbi.nlm.nih.gov/pmc/arti...v063p00770.pdf

Headache and CNS white matter abnormalities associated with gluten sensitivity. Feb 2001

Myopathy associated with gluten sensitivity, Dec 2006

Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics. Mar 2003
Free full text: http://brain.oxfordjournals.org/cgi/...full/126/3/685


Absolutely give a gluten free diet a trial. It must be a strictly gluten free diet, and it could take months to a year to see improvement...although my daughters neurological symptoms (including leg weakness, leg drag, limp body fatigue, drooping eyelids) all resolved within a couple of months. In the beginning she had fleeting episodes occuring months apart, eventually as often as several times a week, but they would last only for short periods of time... anywhere from 3-30 minutes. Near the end I could see very subtle symptoms always... in her gait... with bigger episodes coming and going.



Cara

Have they checked your potassium level when you are most symptomatic?

I do not know what it was when I was at my worst. I will try to look and see if I have a record of it. I do get muscle cramps fairly easily in my feet and calves when I to extend my foot, particualry in the morning.