Paging Tex and All Again

[hoosier1]

All:

I posted my Enterolab results last week, but I am still unclear as to whether or not, per the results, I am OK to consume dairy.

My results from the testing follow:

Fecal Anti-casein (cow’s milk) IgA 9 Units (Normal Range is less than 10 Units)

I am going to have the IgA deficiency test performed when I see my doctor in a couple weeks. But based on the Enterolab results alone, what is your opinion on my eating dairy?

Thanks

Rich

[Joefnh]

Rich have you had a celiac panel run yet?? if so do you know your AGA levels?

--Joe

[tex]

Rich,

IMO, theoretically, you are not sensitive to the casein fraction tested for in that test, (provided that you are not IgA deficient), but Dr. Fine himself points out that if you react to casein, you should try avoiding it anyway, to see if it helps. Here's why:

The tests used by Enterolab are extremely specific. Most allergens contain multiple forms of protein that we react to, one of which is the worst. With gluten, for example, there is the alpha gliadin fraction, and beta, gamma, and delta gliadin fractions, etc. Additionally, there are glutenin fractions in gluten, to which we react. The worst offender is the alpha gliadin protein, so that is the one that the test is designed to detect. Consequently, there is always a possibility that someone might not be sensitive to the alpha gliadin component, but might be sensitive to one or more of the others. I'm not familiar with the way that casein breaks down, but I would assume that it also has multiple components, and only antibodies to the major one are tested for. The point is, the tests are extremely specific, and it is not possible to test for every protein fraction to which we might be sensitive, so they only test for the most common one to which we are most likely to be sensitive, in order to keep the cost of the tests down to a reasonable level.

My response to one of your other posts today, explains why I suspect that you are casein-sensitive. The good news is, unlike gluten antibodies, casein antibodies have a very short half-life, so if you are sensitive to casein, you should respond to eliminating it from your diet in only a few days, (with any luck at all). Likewise for antibodies to soy - they have a very short half-life, so eliminating soy from the diet usually brings a relatively prompt response, (assuming that gluten has been removed from the diet long enough for the antibody production to die down to a level below the threshold above which a reaction is triggered). IOW, if someone is still reacting to gluten, then any other sensitivities will be a moot issue, because the reaction to gluten will dominate.

Tex

[Joefnh]

Rich I have found that in order to fine tune the correct diet, that I need to really apply the engineering discipline, and work only one variable at a time.

Our diets can be so complex, going back to a lab notebook really helps. Change one variable at a time and note the results.

Good luck Rich, this really is a process and it can try our patience.

--Joe

[hoosier1]

Joe,

Not sure what AGA is? But the following is what I had tested. So what test, by Enterolab name, did I miss?

Thanks,

Rich

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value
Fecal Anti-gliadin IgA 10 Units (Normal Range is less than 10 Units)

Fecal Anti-tissue Transglutaminase IgA 6 Units (Normal Range is less than 10 Units)

Quantitative Microscopic Fecal Fat Score Less than 300 Units (Normal Range is less than 300 Units)

Fecal Anti-casein (cow’s milk) IgA 9 Units (Normal Range is less than 10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0301

HLA-DQB1 Molecular analysis, Allele 2 0602

Serologic equivalent: HLA-DQ 3,1 (Subtype 7,6).

And I hear you about one change at a time. Only problem is, I need to do things that make me stable by Monday... Very tough. But I will try harder.

[tex]

AGA is sometimes used to refer to "Anti-Gliadin Antibody", so I'm guessing that's what Joe is referring to. Your test is positive, with a result of 10. Some people refer to the anti-Tissue TransGlutaminase antibody test as a TTG test. Your result was negative.

Rich, you stabilize your condition by removing from your diet, all possible foods to which you might be sensitive. The "one change at a time" part refers to adding suspect foods back into your diet, after you are no longer reacting with D. You can't tell that you react to a test food, if you are already reacting to begin with. You can only accurately discover sensitivities, if you are in a relatively stable condition to begin with, with relatively normal BMs, or at least something with a much better composition than liquid D every day.

Tex

[hoosier1]

Tex,

See my post (today) about stool types. I am not normally liquid D. In fact, that is very, very rare for me. I am usually a Type 6, with frequent BM's in the AM that seem to settle down through the day. And normally, lower left quadrant pain. Now the Type 6's that I have can and do feel urgent, like a Type 7.

I hear you about total elimination of all food triggers. Working harder to ensure that will happen. Just having trouble gripping with the reality the my job may not facilitate this? Even though, for example, I eat correctly. Last night, had salmon, salad (no gluten products, etc.), steamed asparagus. This was at a restaurant that had no gluten free menu.

Which brings up another good subject. Has anyone changed careers because of this condition?

Regards,

Rich

[Joefnh]

Hi Rich great posts. Yeah traveling frequently with MC could be quite tough. I noticed that you mentioned salad. I know for me that was one of the first foods that started giving me issues. Many of us have a problem with raw fruits and veggies. I used to have a salad everyday at work for lunch, but that was the first indicator about a year ago that something was wrong.

Certainly eating at a restaurant that's not actively GF can be risky business. The sauces so freely used in the kitchen are usually commercially prepared and quite often contain gluten and soy. That stuff is in everything.

A good example with my vitamin D being low my doc prescribed a large dose of D 50k IU once a week I noticed after taking the third weeks dose that I would have D on that day. In checking with Teva pharmaceuticals the capsule is filled with soybean oil...

When I took the trip to Australia this past summer, one of my carry on bags was just for safe foods for the trip (32 hours total travel time) When in Oz I stayed in a hotel with a kitchen in the room etc.. I can see with your job with weekly travel avoiding trigger foods would be hard to do.

Take care Rich

-Joe



Ok so avoiding trigger foods can be tough, here's one I gave to an undergrad Calc II student to solve... (Classic brain teaser)

The point here is solving this problem is a breeze in comparison to dealing with he variables of MC


Let f be the function given by f(x)= e^(-2x^2) (read as e raised to the negative 2 x squared)


Find the first four nonzero terms and the general term of the power seriews for f(x) about x=0.

Find the interval of convergence of the power series for f(x) about x = 0. Show the analysis that leads to your conclusion.

Let g be the function given by the sum of the first four nonzero terms of the power seriews for f(x) about x=0. Show that l f(x) - g(x) l < 0.02 for -0.6 less than or equal to x less than or equal to 0.6.

[tex]

Rich,

I agree with Joe, of course. That salad would have done me in every time. For someone with active MC, eating lettuce is like pouring gasoline on a fire. Also, you may be reacting to casein from the butter that was probably on the asparagus, and possibly on the salmon.

No, it's not easy to stay free of our food sensitivities when traveling - it's an extremely difficult project. If we are truly motivated, though, we can do virtually anything.

In engineering, solutions to problems in the real world, typically do not have to be mathematically exact. The answers only have to be close enough for all practical purposes. Right? That's true of our diet, also, when we are trying to control our symptoms, we don't have to follow a perfect diet - it only has to be close enough for all practical purposes. However, if we exceed the boundary conditions, when "calculating" our diet, we are doomed from the start, because we can't resolve the problem, if we make the wrong assumptions right out of the chute. The allowable upper limits in our diet, for the foods that we are sensitive to, are certainly not infinitesimally small. Unfortunately, though, for all practical purposes, those limits are damn close to infinitesimally small, so we have to make a dedicated effort to keeping them out of our diet, because if we ingest any amount at all, it amounts to playing Russian roulette with our diet. Once the "loaded chamber" comes up, the game is over, at least for a day or two, (or three).

We have to be constantly vigilant, because with every setback, the healing process in our gut is also set back, and healing takes a long time to begin with. If we keep having to start over, we may never get there. It's like designing a bridge. It does no good if every section of the design is flawless, except for one. The bridge is worse than useless, with any weak link, because it is an accident waiting to happen. For someone with MC, eating out, in most restaurants, is an accident waiting to happen - all it takes is one improper ingredient. Whether the ingredient is there intentionally, or accidentally, it makes no difference to our gut - the result is the same. Eating safe most of the time definitely helps, but it cannot end the reaction cycle. To end the reaction cycle, we have to eat safe all the time, at least until our gut has sufficient time to heal, because until it heals, it is hypersensitive to irritating foods such as salads.

Tex

[hoosier1]

Joe and Tex,

Thanks for the responses.

I have my Daytimer (Engineering Notebook) at my side. Am tracking everything I eat and how I feel following the next day. Have defined my new, more conservative boundary conditions which will include instructions to those who cook for me as to how to prepare my meals. I just hope that the variables that I cannot seem to control do not overwhelm my progress.

Joe, here's an answer for you.

(a) Since e^x = 1 + x + x^2/2 + x^3/3! + ... + x^n/n! + ...
replacing x with -2x^2 yields

e^(-2x^2) = 1 + (-2x^2) + (-2x^2)^2/2 + (-2x^2)^3/3! + ... + (-2x^2)^n/n! + ...
= 1 - 2x^2 + 2x^4 - 4x^6/3 + ... + (-2)^n x^(2n) / n! + ...

(b) Use the ratio test.
r = lim(n-->infinity) |a(n+1) / a(n)|
= lim(n-->infinity) |[(-2)^(n+1) x^(2n+2) / (n+1)!] / [(-2)^n x^(2n) / n!]|
= x^2 * lim(n-->infinity) 2/(n+1)
= 0.

Since |r| = 0 <1> The interval of convergence is (-infinity, infinity).

(c) Since this series is alternating, the error after 4 terms is bounded by the fifth term.
i.e., Error <= |(-2)^5 x^10 / 5!| = 32 |x|^10 / 120.

Since, we're estimating the error for |x| <= 0.6,
Error <= 32 |x|^10 / 120 <= 32 (0.6)^10 / 120 = .00161... < 0.02.

Actually googled the results :) Haven't looked at it myself yet.

[Joefnh]

That's great you have adopted a notebook, I have had to do the same thing and more to the point I have kept my diet very simple with just about 14 ingredients at least for now. I will work on challenging my diet with new ingredients in the future.

As far as the answer it is only partially correct; the fundamental construct of the proofs is presented but the answers are not all listed. Try alternating the expressive powers when looking at the first 4 expressions in section 'a'.

I had to put that here, I was writing an email to an undergrad student I have helping out with some research and he 'needed' a challenge.. It struck me that solving this problem is far easier than solving the MC equation

Best of luck Rich on your diet and managing your career path


--Joe