Six Causes of Heartburn #6: Gluten Sensitivity by Dr. Lynne August
The antibody to gluten in your stool test is 11 while the normal range is less than 10. You ask, “Does that mean I am only slightly sensitive?” Unfortunately, and paradoxically, the answer is no. You are probably quite, if not highly, sensitive to gluten.
Your stool test shows that you have two different genes that predispose you to gluten sensitivity, also known as celiac disease. It takes just one of these genes for your body to make the antibody against gluten. The fact that you have two genes strongly increases the likelihood that you have gluten sensitivity (hereafter GS).
The antibody to gluten (known as the “anti-gliadin IgA” antibody) is not higher in your stool because your IgA antibody production is suppressed. Simply put, your immune system is ‘worn out’ from 54 years of ‘fighting’ gluten. This is confirmed by your extremely low total saliva IgA antibody level. And, the low total IgA antibody in turn explains why the antibody to gluten is an unlikely “negative” in your saliva.
Here is very good news: GLUTEN SENSITIVITY AS A REVERSIBLE CAUSE OF GASTROESOPAGEAL REFLUX. There is a strong possibility a gluten-free diet (G-FD) will eliminate your need for stomach acid suppressors. Any acid suppressor, while absolutely necessary at times, exacerbates the severe malabsorption resulting from GS.
More good news! A G-FD will correct your chronically low iron and ferritin (an iron storage protein), as well as your fatigue and lack of stamina. The same holds true for your recurring upper respiratory infections, a result of immune suppression. And, a G-FD will undoubtedly relieve your recent abdominal cramping and bloating as well as your “weight gain and bloating in the stomach.”
Since you took an antidepressant 13 years ago, and again for the last year and a half, you will find this link invaluable :: The Celiac Disease – Depression Connection ::
You have been taking prescriptions of various thyroid medications the last six years. Although these medications normalize your thyroid tests, symptoms persist. The tip-off to discovering your GS is an elevated anti-thyroid antibody, your anti-TPO antibody. This elevated antibody confirms that your low thyroid is due to an autoimmune disease, Hashimoto’s. :: Celiac Disease is Linked to Autoimmune Thyroid Disease ::
The blood test your doctor ordered for celiac is negative. Blood testing for GS is often falsely negative because 80% of IgA is in the intestines. Therefore stool and saliva testing is much more sensitive than blood. In your case, the low total saliva IgA antibodies and the positive stool genetic testing for GS – combined with heartburn/GERD, Hashimoto’s, depression and a chronically low ferritin – give us compelling evidence that a G-FD is necessary. I say “necessary” rather than “recommended” because I anticipate your symptoms will only compound without a G-FD, eventually spiraling out-of-control.
For clarity, although the terms “gluten sensitivity” and “celiac disease” are interchangeable, a diagnosis of celiac disease can only be made by a licensed physician. AND, the prevailing standard for a physician to diagnose celiac is either an elevated blood gluten antibody (yes, the very test that is often falsely negative) OR an intestinal biopsy demonstrating very specific abnormalities.
Let me refer you to The Gluten Connection by Shari Lieberman, PhD. This book will answer many questions and give you a sample two-week G-FD.
“Can you also explain the difference between the gluten-free diet and the specific carbohydrate diet? Which should I follow and why?” First try the G-FD. If the results are unsatisfactory or limited I recommend you try the :: Specific Carbohydrate Diet :: (SCD). The SCD eliminates all foods which contain disaccharides, which includes all foods with gluten as well as other foods. Exposure to gluten in a gluten-sensitive individual can damage the intestinal lining resulting in an inability to digest disaccharides. Therefore benefits from eliminating gluten alone may be limited.
Please repeat the stool testing at enterolab after three to six months of improvements on the G-FD or SCD. I expect your gluten antibody to increase upon repeat. Once there is an increase I encourage you to test your stool for other food antibodies as well. You will not need to repeat your genetic testing. I am certain you are already planning on testing your twins before they leave for college.
Please be certain to monitor your bone density. You are peri-menopausal, a good time to get a baseline DXA. GS is too frequently overlooked as the cause of osteoporosis. You now know from two plus years with GERD, even the best diet and supplement choices are to little avail if you are exposed to gluten. The same holds true for osteoporosis.
Dr. Lynne August, of Greenfield NH, is the founder and director of Health Equations. She received her Medical Degree from Washington University School of Medicine in 1973. She combined conventional and holistic medicines in private practice for ten years and soon after, founded Health Equations. For almost thirty years, Dr. August has been researching significant influences on health… diet, soil, water, agriculture, food processing and environmental exposures. The inspiration in Lynne’s clinical practice and research comes largely from her experience as a Clinical Researcher at the Institute of Applied Biology in New York. There, Dr. August assisted Scientific Director Emanuel Revici M.D. in research on non-toxic therapeutic lipids. She also draws upon her training and practice in Ayurveda. Prior to her work at the Institute of Applied Biology, Lynne served on the board of the American Holistic Medical Association, researched hyperinsulinism and diabetes and served as the staff physician at a multi-disciplinary research center for children with developmental needs. Dr. August has been widely published. She lectures at physician seminars throughout North America and Europe and hosts seminars for clinical health professionals.