More & more people are learning about the potential detrimental effects of gluten & are trying gluten-free diets. Due to research, non-celiac wheat sensitivity is finally being recognized by the medical community as a legitimate condition. (see: Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity.)
WHEN TO TEST
Most experts in the medical field recommend getting tested before starting a gluten-free diet. The main advantage of testing before trying an elimination diet is that you can get an accurate picture of how your body typically reacts. If you alter your diet first before you test, then you & your doctors will always wonder what your results would have been if you had tested first.
I had been on a gluten-free diet almost exclusively for about a year when I decided to pay for stool testing thru Entero Lab. I waffled about whether or not to reintroduce gluten into my diet for the test. Their website encouraged patients who were already on a gluten-free diet to not add the gluten back into the diet simply for the test. Understandably, they're concerned that someone might have a dangerous reaction if they choose to do so. I don’t necessarily recommend following my footsteps in this instance, but since the testing was so expensive, I didn't want to chance getting a skewed result.
So, on Thanksgiving 2012, I splurged & ate traditional dressing (stuffing) with my turkey & then took the test a few days later. (If doing it this way, wait at least 3 days after reintroducing the gluten to collect the stool. It can take up to 3 days or so for your body to produce antibodies if they've been out of your system for some time.)
Thankfully I survived my symptoms resulting from reintroducing gluten, but they were uncomfortable enough to convince me to continue on my gluten-free lifestyle.
WHICH TYPE OF TESTING IS BEST?
Stool testing is definitely the way to go to adequately determine if your body is overreacting from gluten or other foods. As explained on the home page of EnteroLab.com,
“Our method utilizes stool rather than blood as the testing substrate; the rationale of using stool rather than blood for testing for food sensitivity is that immunologic reactions to proteins in the diet that cause these reactions are centered within the intestinal tract and not in the blood. “
When diagnosing food intolerances, false negative results are more common with serum (blood) testing than with stool testing. Entero Lab has research to support this assertion:
“Here’s the first set of data that we found showing the superior sensitivity of stool testing versus blood tests for antigliadin IgA antibodies. In untreated celiac disease patients, we found a 100% positivity in the stool versus only 76% in blood.”
The above excerpt is from a transcript of a presentation by Kenneth Fine, M.D.:
“Early Diagnosis of Gluten Sensitivity: Before the Villi are Gone”
Topics Discussed in Dr. Fine's Presentation:
- The History of Celiac Disease in the Medical Field
- The Reasoning for the Importance of Diagnosing Non-Celiac Gluten Sensitivity
- Why Stool Testing is More Effective than Blood Testing for Gluten Intolerance
The transcript is long, but the education is worth the time!
I highly recommend reading it or at least letting your smart phone read it to you.
(On an iphone, go to Settings>>General>>Accessibility>>Speak Selection)
WHY WE CHOSE ENTERO LAB
Despite it being expensive & out-of-network, we chose Entero Lab because we believe it to be the most thorough & reliable testing available. If you have good health insurance & your blood work & doctor’s visits are well-covered, then you could start with a blood test. The great danger of relying on a blood test for celiac or gluten sensitivity is the chance of having a false negative result. If your blood work comes back negative, you'll have to question the results. A stool test is more reliable, plus Entero Lab offers gene testing.
THE VALIDITY OF ENTERO LAB
Is Entero Lab reliable & legitimate?
Be prepared that you may receive an undesirable reaction from your doctor if you decide to discuss this testing with them. No doctor’s orders are needed for the Entero Lab testing. Some physicians may perceive it to be illegitimate since a doctor is not required in the process. Also, people question the legitimacy of Entero Lab because it's not one of the primary labs used in the medical field, like Quest or Lab Corp. Physicians can also feel threatened when presented with test results that they're not familiar with interpreting.
I was so glad we tested my daughter & I at the same time. If I would have read her report without mine there beside it, I would have wondered if Entero Lab gave positive results to everyone. She tested positive for everything they tested her for! But, I only tested positive for 4 foods. This alone helps me feel more confident in the testing.
Also, I’m very glad we paid the extra money for the gene testing. It’s hard to argue with the results of gene testing. Thankfully our genes don’t completely determine our destiny, but they're helpful in showing us what diseases we might have or can potentially develop. With that information, we can make more informed decisions about our lifestyles.
BTW, gene testing is NOT done via poop but is actually done by simply swabbing the inside of the mouth to obtain a saliva cell…i.e the "SPIT" in the title of this article.
3 months after my testing with Entero Lab, I had another stool test done through Genova Diagnostics/Metametrix, ordered by a Family Nurse Practioner. This was to help diagnose a separate issue, but gluten testing was included in the lab work. It was only about $100. Genova Diagnostics/Metametrix confirmed the results I received from Entero Lab. Both revealed elevated anti-gliadin sIgA, indicating gluten sensitivity. Genova Diagnostics also confirmed the elevated levels of fecal fat that Entero Lab reported.
Having 2 separate reports with the same positive results signifies validity of each company & their testing methods.
A BRIEF REVIEW OF ENTERO LAB
I’ve appreciated the helpful customer support from Entero Lab. I’ve talked with them multiple times, asking many questions before & after the testing. I thought there might be a limit to the number of times I could call or email questions, but nope. They’ve endured my repeated inquiries. Phyllis Zermeno is the nurse on staff who is very knowledgeable of this field of food sensitivities. She has adequately answered my numerous questions & explained a lot of details to me. Be prepared with a pen & paper in hand & don’t be afraid to ask her to repeat herself as she quickly rattles-off a lot of unfamiliar medical terms.
Despite the great expense, I’m pleased with our decision to order testing thru EnteroLab.com. I highly recommend them & my only complaint is the cost. But, if you had to smell & examine poop all day, you would charge a lot too!
*FYI, I have no affiliation with Entero Lab.
THE TESTS WE CHOSE TO ORDER
- Comprehensive Gluten/Antigenic Food Sensitivity Stool Panel
- Fat Malabsorption Stool Test (Fecal Fat)
- Gluten Sensitivity Gene Test (Saliva)
SUMMARY OF MY RESULTS
- Significant levels of Anti-gliadin & Anti-casein IgA antibodies were found
(i.e. Gluten & Dairy)
- Significant immunologic reactivity to Rice & Tuna
- Insignificant IgA levels for Chicken, Oats, Pork, Walnuts, Beef, Corn, Potatoes, Cashews, Almonds, Egg, or Soy
- Fecal Fat=848 (Normal=<300)
- My malabsorption was categorized as “Moderate”
- 1 Gene for Celiac Sprue
- 1 Gene for Gluten Sensitivity
At the time I was tested, I had been on the Paleo diet for most meals for about a year. I assume I tested positive for less foods than I would have a year earlier, before restricting my diet.
SUMMARY OF MY DAUGHTER'S RESULTS
- Significant levels of Anti-gliadin & Anti-casein IgA antibodies were found
(i.e. Gluten & Dairy)
- Significant levels of IgA antibodies for Egg & Soy
- Significant immunologic reactivity to Oats, Rice, Beef, Tuna, Corn, Cashews, Chicken, Almonds, Walnuts, Potatoes & Pork (in the approximate order of severity)
- Fecal Fat=1,007 (Normal=<300)
- Her malabsorption was categorized as “Severe”
- No Genes for Celiac Sprue
- 2 Genes for Gluten Sensitivity
When our daughter’s test results revealed that HER BODY WAS OVER-REACTING TO ALL 15 FOODS TESTED, we were overwhelmed trying to figure-out what to do. After discussing the options with her healthcare professionals & with the nurse at Entero Lab, we chose to strictly eliminate gluten, dairy (except for butter) & oats & put her on a 4 Day Rotation Diet for the remaining 12 antigenic foods. The goal is to avoid having antibodies build-up in the system due to eating the same foods every day. For example, if she eats beef on Monday evening, we try not to give her beef until Friday evening.
1 day on & 3 days off.
When trying to rotate about 12 different antigenic foods, it's tricky, to say the least! We do the best we can & continue to believe for supernatural healing along the way.
For helpful resources on rotation diets:
THE EASIEST WAY TO KEEP A FOOD LOG (Coming Soon)
WHY WE HAVE BOTH OF OUR CHILDREN ON A GLUTEN-FREE DIET EVEN THOUGH ONLY ONE WAS TESTED
Considering our financial situation, with my husband not having a permanent job for over 2 years, we haven’t had our youngest child officially tested yet for food intolerances. Experimenting with an elimination diet has been proof enough for us. Like her sister, since eliminating gluten & casein, her tummy aches are significantly less frequent, less intense & shorter in duration.
In addition to the obvious benefits of the diet, my gene testing proves that all of our children have at least one copy of a gluten sensitive gene from me, not including genes possibly inherited from their daddy. Since our youngest one complained of stomach aches almost daily & since she also has the gene predisposing her to gluten intolerance, she's gluten & dairy-free too.
HOW MY TEST RESULTS AFFECTED
MY EXTENDED FAMILY
After learning of my genetic testing, my dad was tested as well & he discovered that he has 2 copies of the main gene that predisposes to gluten sensitivity & celiac sprue. Since then, he's removed gluten from his diet & has experienced a noticeable difference. Like many others, he never considered that he might have a gluten intolerance. He just assumed that his symptoms of joint pain, muscle discomfort & stomach aches were a normal part of life & aging that he just had to endure. His wife also went gluten-free & her frequent migraine headaches & diarrhea disappeared!
Read These Articles to Learn More About Gluten-Free Living:
WHAT IS GLUTEN ANYWAY & WHO’S EVER HEARD OF CASEIN?
GLUTEN-FREE LIVING…IS IT WORTH IT?
MY FAMILY'S JOURNEY TOWARDS GLUTEN-FREE DAIRY-FREE LIVING
WHAT MY DOCTORS NEVER TOLD ME!