Are you one of the many people who have had a gluten intolerance blood test that came out negative? Were you thrilled when you were told that your test results say that you can have wheat? But are you also one of the even greater number of people that remain confused about their test results being negative because you know you don’t feel well when you eat food that contains gluten?
YOU’RE NOT CRAZY!
If a blood test says you don’t have a problem with gluten then it must be right, right? Not so! You aren’t crazy, there are a variety of potential reasons that your gluten intolerance blood test results came out negative and yet you know you can’t eat gluten because it makes you feel bad when you do. I have patients who have been told…”it must be something else that you’re feeling because this test shows that it’s not gluten” or “Maybe you’re just getting swept up in the fad out there about being gluten free, because your test is negative, so you can eat it!”
Once again, you aren’t crazy. Feeling badly when you eat gluten AND a negative test result CAN coexist. Let’s look at a few reasons why.
THE PRESENCE OF GLUTEN WHEN TESTING
Hopefully, whoever ordered your gluten intolerance test made sure that you had been eating gluten for the last several weeks and that you continued to eat it right up until testing day. The presence of gluten in your bloodstream for testing purposes may seem obvious to most but I still get several people every few months who tell me that their test results were negative AND they were following a gluten free diet before and during the time of testing. These negative test results would not be reliable to rule out Celiac or Non Celiac Gluten Sensitivity. I have seen jaws drop when I clarify this for a patient.
DO YOU PRODUCE ENOUGH ANTIBODIES?
This is a key area to understand and to instruct your provider to gather information about before or at least along with your test for gluten intolerance. Testing for gluten intolerance is a test of antibody response, we call them IgA and IgG’s. There are several reasons why you could be a low producer of these antibodies. If you are a low producer of these antibodies then your IgG and IgA antibody results against gluten could also come out low and be classified as negative when you may actually have gluten intolerance.
Low IgG and IgA production can occur from stress, variations in your genetic makeup, autoimmune conditions, the presence of immunosuppressive drugs and perhaps other reasons that science has yet to clarify. Excellent studies have been done showing up to 80% drops in IgA production when an individual is experiencing stress. Remember that stress responses occur in all age groups for all kinds of reasons and that there is good stress (weddings) and bad stress (funerals).
Autoimmune conditions can contribute to variable levels of antibody production. Celiac Disease is an autoimmune condition and many Celiacs have low antibody production – the exact group that is trying to be diagnosed could come out falsely negative on blood testing!
Steroids are the most common group of medications that are immunosuppressive. Anyone on these drugs should know that their antibody production against gluten may be quite low if tested while taking this type of medication and therefore negative test results shouldn’t be trusted. These medications might be taken with conditions such as Crohn’s Disease or Ulcerative Colitis.
GET TOTAL IgG and IgA VALUES BEFORE YOU TEST FOR GLUTEN!
At the very least, get Total IgG and IgA levels tested along with your gluten intolerance test so that you and your provider know how to better interpret your results. While a traditional Celiac panel should include a total IgA level which is great, it doesn’t test for all of the different wheat proteins, subtypes of the gliadin protein or the subtypes of the enzymes against gliadin. Cyrex Labs does test for all of these different fractions but still does not include total IgG or total IgA with any of their panels. An excellent testing combination for better test accuracy and interpretation would be to use Cyrex Labs AND get total IgG and total IgA’s run at the same time – that way you are understanding your level of antibody production at the same time that you are doing a gluten intolerance blood test.