Accurate Testing for Celiac Disease

This past week there have been several news articles that have inaccurately portrayed celiac disease, gluten intolerance and the gluten-free diet, so all of us at 2G Pharma wanted to set the record straight so our readers are getting the best and most medically sound information. 

There were two pieces out today that did particularly bad jobs explaining the disease. The first was a news article in the Florida Times-Union that discussed testing out a gluten-free diet and measuring weight loss as a diagnostic method for celiac disease. The article claimed that if you lose 7-14 pounds per week that you have a gluten sensitivity. The second was a piece on the Today Show that called celiac disease food allergy and that talked about celebrities using the gluten-free diet for weight loss.

First of all, celiac disease is a genetic autoimmune condition that affects the villi of the small intestine. Villi are the fingerlike projections in your small intestine that are responsible for absorbing nutrients from food. When a person with celiac disease eats gluten, the villi are damaged and are no longer able to absorb the important nutrients in food needed for a strong and healthy body. Celiac disease affects about 1 in 100 people in North America, however 95% of people with the disease are still waiting to be diagnosed.

As far as testing for celiac disease, trying a gluten-free diet and measuring weight loss is NOT a trusted way to diagnose the disease. There are several acceptable methods. They are the following:

Antibody Celiac Test
An antibody celiac test is measuring anti-endomysium and anti-tissue transglutaminase. The antibody test will determine the response a patient's body is having to the gluten protein. A person with celiac disease will have higher-than-normal antibody levels.

The antibody test is made up of a panel consisting of Anti-Tissue Transglutaminase (tTG-IgA), Total Serum IgA and anti-endomysial antibody (EMA-IgA). In order for the test to be accurate, patients must be eating gluten regularly. This is equivalent to about four servings per day for six weeks. If a patient has a positive antibody test, they will need a small intestine biopsy to confirm a celiac diagnosis.

Genetic Testing
The genetic test for celiac disease is used for two reasons. The first is to rule out a celiac disease diagnosis if the HLA-DQ2 and HLA-DQ8 genes are not present. If a patient does not have these genes, it is nearly impossible for them to develop celiac disease. In this case, they would not need a follow-up antibody test or small intestine biopsy

The second reason for the genetic test is to determine a possible diagnosis in patients that are already living on a gluten-free diet. Having the HLA-DQ2 and HLA-DQ8 genes does not definitely mean a person has celiac disease, however it does put them in a high-risk group that requires further testing.

Small Intestine Biopsy
If a patient receives a positive antibody or genetic test, it is strongly recommended that he or she undergo a small bowel biopsy to determine if there is damage to the villi. The biopsy is taken using an endoscope, which is a long, thin tube that the physician weaves through the mouth and stomach to reach the small intestine. The biopsy is the gold standard of diagnosis and the only definite way to determine an accurate celiac diagnosis. 

Home Celiac Test Kit
The Biocard Celiac Test Kit is an at-home test that measures (anti-tTG) IgA antibodies from a fingertip blood sample. It works by taking a small blood sample from pricking your finger, mixing the blood with a buffer and applying the mixture onto a test cartridge. The test can be administered from the comfort of your own home and you’ll get results in just 10 minutes. If the test comes out positive for celiac disease, the makers of the test recommend consulting with a doctor to confirm the diagnosis with an intestinal biopsy.

The moral of the story is that news organizations are great for raising awareness but don't always get it right. If you think you may have celiac disease or a gluten intolerance, talk to your doctor and get tested before taking matters into your own hands.

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