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Are there tests to determine gluten sensitivity?

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  • AAmy Jones, Nutrition & Dietetics, answered

    Currently, there is no test to determine true "gluten sensitivity." We have tests for Celiac and tests for wheat allergy, but no current test for gluten sensitivity/intolerance. The only way to determine gluten sensitivity is to exclude it from the diet for a few months to see if symptoms improve. 

  • AMark Hyman, MD, Functional Medicine, answered
    There are gluten allergy/celiac disease tests that are available through Labcorp or Quest Diagnostics. All these tests help identify various forms of allergy or sensitivity to gluten or wheat. They will look for:
    • IgA anti-gliadin antibodies
    • IgG anti-gliadin antibodies
    • IgA anti-endomysial antibodies
    • Tissue transglutaminase antibody (IgA and IgG in questionable cases)
    • Total IgA antibodies
    • HLA DQ2 and DQ8 genotyping for celiac disease (used occasionally to detect genetic susceptibility).
    • Intestinal biopsy (rarely needed if gluten antibodies are positive -- based on my interpretation of the recent study)
    When you get these tests, there are a few things to keep in mind. In light of the new research on the dangers of gluten sensitivity without full blown celiac disease, I consider any elevation of antibodies significant and worthy of a trial of gluten elimination. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be “false positives.” That means the test looks positive but really isn’t significant.

    We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems.
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