Enterolab Results -- No Surprise Except the IgA

MBombardier · Post by **MBombardier** » Thu Mar 10, 2011 3:40 pm

Tex, you can do whatever magick you do to post these results wherever. I understand the explanation, but I need an interpretation, especially of the gene results and their impact on my children, my father, and my brother.

Also, do the low IgA values mean that I could be casein-intolerant but not showing it? Or is the anti-gliadin and anti-tissue transglutaminase IgA different from the anti-casein IgA?

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value
Fecal Anti-gliadin IgA 5 Units (Normal Range is less than 10 Units)

Fecal Anti-tissue Transglutaminase IgA 1 Units (Normal Range is less than 10 Units)

Quantitative Microscopic Fecal Fat Score 1446 Units (Normal Range is less than 300 Units)

Fecal Anti-casein (cow’s milk) IgA 1 Units (Normal Range is less than 10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0201

HLA-DQB1 Molecular analysis, Allele 2 0501

Serologic equivalent: HLA-DQ 2,1 (Subtype 2,5)

Interpretation of Fecal Anti-gliadin IgA: Intestinal antigliadin IgA antibody was below the upper limit of normal, and hence there is no direct evidence of active gluten sensitivity from this test. However, because 1 in 500 people cannot make IgA at all, and rarely, and some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have a syndrome or symptoms known to be associated with gluten sensitivity, a gluten-free diet may help you despite a negative test. If you have no syndrome or symptoms associated with gluten sensitivity, you can follow a gluten-containing healthy diet and retest in 3-5 years; or you may opt to go gluten-free as a purely preventive measure.

Interpretation of Fecal Anti-tissue Transglutaminase IgA: The level of intestinal IgA antibodies to the human enzyme tissue transglutaminase was below the upper limit of normal, and hence, there is no evidence of a gluten-induced autoimmune reaction.

Interpretation of Quantitative Microscopic Fecal Fat Score: A fecal fat score greater than or equal to 300 Units indicates there is an increased amount of dietary fat in the stool which usually is due to gluten-induced small intestinal malabsorption/damage when associated with gluten sensitivity. Values between 300-600 Units are mild elevations, 600-1000 Units moderate elevations, and values greater than 1000 Units are severe elevations. Any elevated fecal fat value should be rechecked in one year after treatment to ensure that it does not persist because chronic fat malabsorption is associated with osteoporosis among other nutritional deficiency syndromes.

Interpretation of Fecal Anti-casein (cow’s milk) IgA: Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic “sensitivity” to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation Of HLA-DQ Testing: HLA-DQB1 gene analysis reveals that you have one of the main genes that predisposes to gluten sensitivity and celiac sprue, HLA-DQB1*0201 or HLA-DQB1*0302. Each of your offspring has a 50% chance of receiving this gene from you, and at least one of your parents passed it to you. You also have a non-celiac gene predisposing to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having one celiac gene and one gluten sensitive gene, means that each of your parents, and all of your children (if you have them) will possess at least one copy of a gluten sensitive gene. Having two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity or celiac disease may be more severe.

Gloria · Post by **Gloria** » Thu Mar 10, 2011 9:19 pm

Marliss,

I'm sure Tex will be along to analyze your Enterolab test results. They look inconsistent to me because you seem to have tested OK on gluten and casein, but your fecal fat score is one of the highest I've seen here. That usually indicates that you have malabsorption, but I don't recall you saying that you've lost a lot of weight.

I'll be interested in Tex's opinion.

Gloria

Deb · Post by **Deb** » Fri Mar 11, 2011 6:16 am

My fecal fat score was 1433 and I haven't lost weight either. However, I failed to stop my fish oil supplement
before the test so am planning to retest that after a year, as per their recommendation.

Zizzle · Post by **Zizzle** » Fri Mar 11, 2011 8:24 am

Seems to me you need total IGA blood testing to determine if these results are accurate or if you are IGA deficient.

MBombardier · Post by **MBombardier** » Fri Mar 11, 2011 10:29 am

Here are my egg/yeast/soy results:

C) Egg, Yeast, and Soy Food Sensitivity Stool Panel
Fecal Anti-ovalbumin (chicken egg) IgA 1 Units (Normal Range is less than 10 Units)
Fecal Anti-saccharomyces cerevisiae (dietary yeast) IgA 1 Units (Normal Range is less than 10 Units)
Fecal Anti-soy IgA 1 Units (Normal Range is less than 10 Units)

Because I seem to be IgA deficient, this was a @#$$%^& waste of money. I know perfectly well that I am sensitive to soy.

I will talk to my doctor about testing my IgA. I was just reading about it, and it is apparently an inherited condition. A couple of the diseases associated with it are rheumatoid arthritis, and immune thrombocytopenic plupura. My mother had rheumatoid arthritis, and idiopathic thrombocytopenic plupura to the point that she had her spleen removed in 1990. I see on Wikipedia that "idiopathic" is also known as "immune" now.

It says that allergies like asthma (my whole family) and food allergies are associated with the condition, so I strongly suspect I am IgA deficient, and that I inherited it as well as my looks and one of my gluten sensitivity genes from my mother.

I am going through the whole grieving process again. I was okay with getting rid of gluten and soy. But the rest of this really sucks, especially having to tell my kids that they have this time bomb ticking in their immune systems. My oldest, who is intolerant of corn, is expecting this, but my 23yo son will react, especially since his baby girl now has celiac possibilities from both sides of the family. My 12yo has already started going gluten-free for ADD issues, but my 16yo will likely react badly, just like her brother.

And if I am IgA deficient, and if they inherited that... Right now it's hard to be thankful that we are finding out about all this now so that we can take steps to verify it and to do our best to ensure the best health possible for all of us.

TooManyHats · Post by **TooManyHats** » Fri Mar 11, 2011 11:12 am

Oh, Marliss, I'm so sorry you weren't able to get any answers from your testing. I don't know much about that deficiency, but I wonder if there's anything that can be done to correct it? Does this skew all test results?

btw, idiopathic means of unknown origin.

MBombardier · Post by **MBombardier** » Fri Mar 11, 2011 12:41 pm

Yes, it skews all the results. If there is little IgA then the reaction of intestinal IgA antibodies is small or non-existent. If I am deficient, all my IgA may be reacting, but it doesn't show the true picture because there is not a normal amount to react. There is apparently nothing to be done about an IgA deficiency. From what I've read, some people start producing it on their own, others don't. The main thing to watch for is accompanying deficiencies in IgG2 and IgG4, and to make sure that there is good patient-doctor communication in case of infection, or when other suspected autoimmune illnesses pop up.

Yes, I know what idiopathic means.

Technically it means pertaining to disease of unknown origin. As a homeschooler, I have three kids who have done or are doing Latin. I was interested to see that in the last 20 years the description of ITP has changed from idiopathic to immune, though the change is evidently still new enough that it merits mentioning.

After the uber-mayhem of my life settles down to its regular hectic pace after this weekend, I am going to write a letter to my doctor. There are several tests I want him to run now besides checking my IgA. Up until recently I have been quite healthy and rarely went to the doctor. I am planning on giving my Gi a heads-up, too. I don't have time for this crap...

Can you tell I'm angry? Grief stage #2, full bore.

TooManyHats · Post by **TooManyHats** » Fri Mar 11, 2011 12:45 pm

You're definitely entitled to your anger. I most certainly would be. It's good to get all your ducks in a row and get what you want on paper. Good idea.

Post by **tex** » Fri Mar 11, 2011 2:44 pm

Hi Marliss,

Sorry to be so late to respond - work is a bear these days.

I'm sorry, but my best guess is that you do indeed have selective IgA deficiency.

I agree that you should certainly ask your doctor to do the test, to verify that, but I think that based on your test scores, IgA deficiency is a foregone conclusion, unfortunately.

With such obvious small intestinal damage, (as per the fecal fat score), there has to be a cause, and that cause is almost surely food sensitivities, which the tests failed to pick up, (presumably due to IgA deficiency).

Incidentally, your gene test results match mine, exactly, (FWIW). So, at least one of your parents has a celiac gene, and half your children will probably have a copy. Of course, the "0501" gene also predisposes to gluten sensitivity, but not celiac disease, and half your kids will have that one, also. And, of course, you inherited that one from one of your parents, also.

The celiac gene is further evidence of a false negative result to the anti-gliadin test, and it also suggests that gluten-sensitivity is almost surely the cause of the damage to your small intestine, (as indicated by your fecal fat score).

I wish the data were better.

Tex

Gabes-Apg · Post by **Gabes-Apg** » Sat Mar 12, 2011 3:32 pm

Marliss
sorry that the results did not give you the answers you wanted.

If MC was black and white with very defined parameters, none of us would be part of this family.
MC is unique for all of us with what triggers issues, what treatments work and dont work, what shows up in tests.

every step of our mc journey is learning, there are no mistakes.
i see the example of your test results as the reason why listening to your body is where the answers are. Yep this takes time and energy but it gives you the answers.

I couldnt afford the enterlab testing, so i figured out my eating plan with elimination process, and like Linda, i am finding that some ingredients that worked well 6 months ago are not working now, it changes, by using the diary and tracking reactions you can figure out what is working and what isnt.
Given all the grief our bodies give us during the chronic symptom phase of MC it is sometimes hard to 'trust it' or trust our minds, as we are tired and overwhelmed by MC and the changes it has bought to our lives. Using the baby food system, and ants motto softee softlee catchee monkey, i re-engineered the relationship wth my body and mind regarding my digestion, and it is working fantastic.

MBombardier · Post by **MBombardier** » Sun Mar 13, 2011 1:19 pm

Thank you, Gabes.

Your posts are always so bracing and encouraging!! Onwards, and upwards!!

MBombardier · Post by **MBombardier** » Wed Mar 16, 2011 7:10 pm

I am feeling soooooooo overwhelmed, and like such a weenie. Thanks again for your post, Gabes. I am going to go eat some baby food, and give myself a pep talk before leaving for my meeting this evening.