[lahock]

How long after being off gluten can you still get an accurate diagnosis for celiac or gluten sensitivity?
Cyn

[NancyM]

It depends on the method being used. For Enterolab, I think it is up to a year. Blood tests change very quickly after going gluten free, biopsy results do too, but not as fast as blood tests. I was just reading about it on the gluten file, but I can't find the link I was reading now.

What method of testing are you pondering? And how long have you been GF?

[jccgf]

I'll see if I can find it. I know just the study you are talking about, Nancy. I'm sure it is somewhere in the diagnostic thread. I'll post back. Nancy, I think I also went back and edited into that infamous thread when I ran across the study about dropping antibody levels. Whatever is faster to find....lol!

I think one or two weeks would be ok, but any longer and you'd be left questioning results.

I think the study showed significant drops by the third month. But, my memory is foggy.

Cara

[jccgf]

I don't know that this was the study I was thinking of, but it does mention some being seronegative at three months.

If you ran the test and got a positive, you could rely on that. However, if you get a negative there would always be the chance it was a false negative if your antibodies had dropped.

I think I have heard a couple of weeks off gluten would not affect test results. But, more than that... the test would be compromised.

How long have you been off gluten? And yes, even if celiac blood tests are negative, you might still benefit from a diet. I think it is worth doing the blood tests to see if an official diagnosis is possible.

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=10710062

Of 53 initially EmA-positive patients who completed study criteria, EmA was undetectable in 31 patients (58%) after 3 months' diet, in 40 (75%) after 6 months, and in 46 (87%) after 12 months

[NancyM]

Originally Posted by jccglutenfree

I'll see if I can find it. I know just the study you are talking about, Nancy. I'm sure it is somewhere in the diagnostic thread. I'll post back. Nancy, I think I also went back and edited into that infamous thread when I ran across the study about dropping antibody levels. Whatever is faster to find....lol!

Only thing I remember was it was a web site at the U. of Arkansas at Little Rock. Dr. Allen? He had a lot of "thoughts" all summarized and one section was about how quickly the blood results fall off.

[jccgf]

Dr. Nelson?
http://www.uams.edu/celiac/FAQs/FAQframe.htm

Quote:

Strict GF diet should result in decreases in antibody titers over time. EMA (tTG) will go down first, usually negative by 4-6 months. IgA gliadin next then IgG gliadin which may persist for a year.

Another study has shown that patients (who were ultimately diagnosed with CD) with equivocal biopsies when given large "doses" of gluten containing protein over 2 month period will develop the typical changes of villous flattening. This is also known as a "Gluten Challenge".

[lahock]

I was asking for my dd who has been gluten free for 1 week. She had an ELISA (IgG) food sensitivity test done and came back allergic to gluten, wheat, rye, barley, corn, oats, and rice (for grains) and a whole bunch of other stuff. It has been suggested to me on an allergy site, that she be tested for Celiac/gluten sensitivity...of which we know basically nothing about. She cut out all of her known allergens 1 week ago and feels 100 times better all ready. I am also considering being tested myself since I have many food issues. I am still eating gluten.
She has excellent health insurance, which Celiac tests are covered by insurance and what type of dr will do them? She really doesn't want to start eating gluten again (to get accurate results) because for the first time in a very, very long time she feels "great". She has a dr appt with her primary care on the 31st and we didn't know if she should wait that long to ask about being tested.
Thank you all for your help! Cyn

[jccgf]

THey like to send you to a GI specialist, BUT any doctor can order the blood work. The blood tests will be covered by insurance. I would call her primary care physician and explain that she changed her diet a week ago, feels better already and doesn't want to go back to eating the problem foods...and you would like to run the blood tests ASAP before the window of opportunity closes. I'd try to get those run this week if possible.

The definitive dx for "celiac disease" is based upon a biopsy, but the blood test results would tell you a lot. If positive, a biopsy may really not be necessary. If negative, they'd probably refuse a biopsy anyway....and she already has had a positive response to the diet and would likely stay on it despite a negative result.

If you think you would want biopsy proof of celiac disease, now or EVER, best to get her back on gluten until blood work and biopsy could be scheduled.

The Diagnostic testing is all explained in The Gluten File~ Diagnostic Testing page. Be sure they include the antigliadin antibody tests, often considered optional or out of date.

There is mainstream testing, alternative testing, and self testing by elimination diet. You need to decide what is important for YOU (HER) in terms of official diagnosis.

The biggest caution I give is that many people improve with dietary changes even in the absence of biopsy proven celiac disease, so if those tests results are negative...always give the dietary trial a chance. In this case, it sounds the dietary trial has already spoken. You may still want to look for an official diagnosis, however. Up to you.

Cara

[mistofviolets]

Hi Cyn! I'm so glad you made it over

When she calls the drs office, she could also say she'd like the blood work ordered so that it will be accurate, and that she and the dr will be able to discuss the results at her appt. That sounds pretty reasonable, and I don't see a good reason for them to turn that down!

Good luck!

[jccgf]

Silly me! I found the study, filed prominently at the top of page 1 of the Diagnostic page in TGF. Just bumped into it~

Antibody levels in adult patients with coeliac disease during gluten-free diet: a rapid initial decrease of clinical importance. PMID: 15554953

OBJECTIVE: Analysis of antibodies against tissue transglutaminase (tTG) has been shown valuable in the diagnosis of coeliac disease (CD) but how quickly serum titres decrease after introduction of a gluten-free diet (GFD) is not known in adults. CD is a well-recognized disorder amongst the general population and many persons try a GFD for fairly vague symptoms before they seek medical advice. Therefore, it is important to determine the time that the serologic tests remain predictive of the disease after the introduction of a GFD. METHODS: Sera were taken from 22 consecutively biopsy-proven adult patients with CD in connection with the diagnostic biopsy. The patients were followed for 1 year and sera were taken after 1, 3, 6 and 12 months after start of a GFD. Sera were stored at -20 degrees C and analysed for IgA antibodies against gliadin, endomysium and two different commercial tTG assays based on recombinant human tTG (tTGrh) and guinea-pig liver (tTGgp). RESULTS: Twenty patients could be followed during GFD and all antibody titres fell sharply within 1 month after introduction of a GFD and continued to decline during the survey interval. Thirty days after beginning the diet only 58, 84, 74 and 53% of all patients had positive antibody levels of tTGrh, tTGgp, EmA and AGA respectively. CONCLUSIONS: As the antibodies used to confirm the diagnosis of CD fall rapidly and continue to decline following the introduction of a GFD, it is important that health care providers carefully inquire about the possibility of self-prescribed diets before patients sought medical attention.

PMID: 15554953