Hi Kat,
That's a very good question, and I don't believe that I'm qualified to answer it, but since you asked for an opinion, I guess I'll give it a shot. From everything that I have seen, I get the impression that in most cases, (possibly all cases), those genes are all altered at about the same time, IOW, early on, just before the chronic symptoms begin. It's possible that in some cases, though, some of those genes may not actually be "triggered", until later.
Kat wrote:and they all (so far) have said that discontinuing "should" reverse the MC, and that biopsies after remission showed no signs of MC
I see that all over the literature on the internet, also - not only about this issue, but most medication-associated chronic reactions. That outcome may well be true, but for some reason, virtually all of the people who have been fortunate enough to experience that resolution of symptoms, never register for membership on this discussion board. At least, I'm not aware of any members of this board, (with one exception), who have experienced that. Katy's MC was triggered, (in her opinion), by the long-term use of NSAIDs, and she didn't seem to have significant gluten issues for several years. She did, though, have minor symptoms, (stiffness, aches and pains, etc.). After a few years, those symptoms have grown progressively worse, to the point where she definitely has to cut all gluten, (and possibly other foods), from her diet, in order to resolve her symptoms. To me, that still appears as though her gluten intolerance was triggered initially, but it took a while for her sensitivity to develop to the point where her reactions to gluten included D. We are all aware that sensitivities to allergens tend to become worse, with increasing exposure, and food sensitivities are probably no different, regarding this rule.
I have also noticed that there is increasing evidence that the 5-ASA meds, (such as Asacol), can cause chronic pancreatitis, in some cases, and if you review the literature, virtually all medical authorities claim that the pancreatitis issues will resolve completely, upon discontinuation of the med. However, the more I search, the more evidence I find, that many of those patients later suffer from recurring bouts of pancreatitis, for no apparent reason. IOW, my point is - I get the impression that many medical authorities are too quick to pronounce a patient cured, when in fact, they are only in a state of temporary remission. Doctors used to believe that MC could be cured, for example, but they are slowly beginning to realize that they are unable to cure the disease, and the best they can hope for, at this point, is to control the symptoms.
Please don't beat yourself up over the bad weekend reactions. We all tend to make errors of judgment once in a while, with this disease. It's still possible that your issues may resolve without permanent diet changes, once your gut has time to heal, but I agree, the recent reaction episode does not help the odds any.
I've never heard of a Thyroid Uptake test triggering MC, but that certainly doesn't mean that it might not be an undocumented trigger for MC, for certain individuals, under certain conditions. Did you take the capsule a day before the scan? If so, then obviously, it would take several days, (or more), to purge the radioactive material from your body. Considering the wide range of "events" that are known to trigger MC, (from meds, to parasites, viruses, food sensitivities, and even stopping smoking), it certainly wouldn't be much of a stretch of the imagination to suspect that swallowing a readioactive capsule might also be a possible trigger. After all, one of the ways that genes are commonly altered, is by the use of radioactivity. Normally, that requires much higher doses than what you were exposed to, of course, but who knows? Under certain conditions, some of us might be hypersensitive to such a risk, even though the odds against that are almost astronomical. Actually, odds are somewhat meaningless, when you consider that all of us have been unfortunate enough to develop a disease that only affects a handful of people per hundred thousand, in the general population. Those are pretty long odds, and yet it happened.
Tex