TPV Episode 22 Show Notes: Autoimmune Part 3

January 18, 2013 in Categories: by

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Our twenty-second show!
Ep. 22: Autoimmune Part 3

In this episode, Stacy and Sarah return to answer your questions about autoimmunity and how to combat it! First, Sarah talks about whether it is okay to cut out an entire “food group”. Then we try to track down your how far you must take the autoimmune protocol and how to deal with symptoms that remain.

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The Paleo View (TPV), Episode 22: Autoimmune Part 3

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Comments

Just an FYI regarding celiac testing. Dr. Rodney Ford has a pretty detailed explanation of the different types of tests (see: http://drrodneyford.com/faq/bloods-tests/gluten-blood-tests.html).

The typical blood test given in the U.S. is looking for intestinal tissue damage via tTG (tissue TransGlutaminase) – IgA and IgG, DGP-IgG (Diamidated Gliadin Peptide IgA and IgG), and EMA (Endomesial Antibodies) – IgA. The problem is that if you’re in the early stages of celiac disease, these tests are often negative. Which, unfortunately leads doctors to telling patients that they don’t have celiac disease and can go ahead and continue eating it.

The second type of test (which is often NOT given by GPs but is more commonly given by secondary doctors, especially chiropractors — at least that has been my experience) is the Anti gliadin antibody IgG (Also called IgG-gliadin antibody) or Anti gliadin antibody IgA (Also called IgA-gliadin antibody). This is the kind of test I had (given by a chiropractor). It is good for determining some sort of gluten sensitivity but can’t distinguish between celiac disease and non-celiac gluten sensitivity (NCGS).

The third type of test is the gene test. Enterolab provides a relatively low cost gene test that can look for either celiac disease or NCGS. Individuals can go there and order the test themselves (you don’t need a doctor to do it for you–but it also may not be covered by insurance). People with the HLA DQ2 or DQ8 genes are at risk for developing celiac disease. However, there are other genes that are associated with NCGS. I’m one of those people. I was told that I don’t have either of the genes associated with celiac disease but I have two copies of the genes for gluten sensitivity (I have both DQ7 and DQ5). Though, since Enterolab only tests the beta markers, there’s a chance I could also have the 05 alpha chain of DQ2. The gene test, again, isn’t a determining factor that you have either celiac disease or NSGS, it is just a marker that you are susceptible.

Lastly, there is the small intestine biopsy. This test has a high failure rate because a) damage in early stages can be hard to detect, b) damage isn’t universal in the intestine so some areas will be damaged while other areas will look fine c) doctors may not take enough samples to get one of the damaged areas of the intestine and d) doctors may not correctly read the results (based on the MARSH scores for the stages of damage to the villi–see: http://celiacdisease.about.com/od/diagnosingceliacdisease/ss/MarshScore.htm).

Whether or not you develop celiac disease or NSGS typically requires three things: a) a gene to make you predisposed, b) a leaky gut that allows the gluten protein to cross the enterocyte layer, and c) exposure to gluten (which can trigger an increase in zonulin production that results in a leaky gut but there are many other things that can also cause a leaky gut).

The biggest problem for most doctors in coming to a conclusion of celiac disease as a diagnosis is that they want concrete evidence of villus atrophy, which is the singular element that distinguishes celiac disease from all other forms of gluten sensitivity. In the early stages of the disease, the tests we currently have are often negative. As Dr. Ford explains, telling someone in the early stages of celiac disease to continue eating gluten until they get a positive test is like telling someone to continue smoking cigarettes until you get lung cancer.

I did not have either the biopsy or the blood tests for intestinal damage. After getting the IgA-gliadin antibody test (the cut off for a positive test for gluten sensitivity was 15 and mine was 50), I immediately went gluten free. I didn’t know about the other tests until much later. By then, the chances of any of them (other than the gene test) being positive were extremely low. The gene test is the only one that does not require you to be actively eating gluten.

HTH

Hi Sarah,
Another great podcast, thank you! I ordered some teecino coffee, without the barley. But the website says that it has inulin fiber from chicory root and dandelion. Your post about AI Paleo says to avoid inulin fiber because it is a gut irritant. Thoughts? Thanks!

Hi Sarah & Stacy,
I am not able to get this show to play (as I can the others). This one doesn’t have the green bar/play button. Please help, I’d love to hear it.
Thanks,
Devona

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