IgG Food Sensitivity Testing

There is a fair amount of debate as to the usefulness of food sensitivity testing.  Those in favor tend to cite the fact that eliminating the foods these tests suggest eliminating reduced their symptoms, and those opposed cite shaky test reliability and the considerable ongoing debate as to whether the antibodies being tested are actually important.  Of undisputed importance, however, is nutrition, which can very easily fall by the wayside when making radical changes to diet.

One study found results from a particular lab to vary by 73% on average numerically, with the eat/don't eat recommendation varying by 59% -- ie if you took the test twice it would give you a different recommendation for 59% of the foods on the list.  Not encouraging to say the least.  But that was only one lab of the three that they tested, and that was also seven years ago now.  It's likely that things have improved dramatically since then.

Another study provides some evidence in favor of IgG testing.  Patients were given the test, and some were put on a diet excluding their actual indicated sensitivities and others were put on a diet excluding other foods.  After twelve weeks, among those fully adherent to the diet, those on the true diet reported a 26% greater reduction in symptoms than those on the sham diet. 

I was given an IgG food sensitivity panel at the same time as my Celiac panel.  My results were as follows (there were 96 foods total; the ones below the .200 threshold aren't shown):

The results weren't that surprising; all of the familiar Celiac enemies are at the top, along with their frequent accomplice, dairy.  Eggs were something of a surprise, though looking back it does explain some things.  

The question was what to do with these results.  Going gluten-free is hard enough, but gluten and corn together is nigh impossible, not to mention all of the others.  But continuing to eat things that there's at least some evidence I shouldn't could hinder the healing process.  So in the pursuit of science and relief after thirty years of symptoms, I opted to attempt excluding all of the above for a time and slowly reintroduce things as I improved.  I'd heard that other sensitivities tend to calm down as the damage caused by Celiac begins to heal.  

Suffice it to say that I lost some weight in the effort, and learned that the first thing that Americans tend to do when they modify a piece of food is add some wheat or corn to it.  But I ate my bananas and unseasoned meat for a while, and eventually got brave and healthy enough to start reintroductions.

The tough part about reintroducing foods when you have a sheet of paper that says it doesn't like you is that you become hyper-aware of that.  This is one of the reasons a lot of doctors don't like doing this kind of testing in the first place.  So in the interest of curbing some of that anxiety I instead eventually instituted a "don't ask, don't tell" policy for non-gluten ingredients.  I won't down a glass of eggs Rocky-style, but I won't ask if the gluten-free cookies have eggs in them.  If I feel suboptimal afterwards, though, I know more or less what to blame.  Through trial and error, I'm hoping to figure out what of the above I still need to be concerned about.  

My Celiac Blood Panel Results

According to the classical definition of Celiac disease my bloodwork falls somewhere in limbo. Recent thinking on the subject more strongly suggests that I'm positive, but as I understand it there's still a good amount of debate.  What isn't up for debate is that in the six months since I started a gluten-free diet I've seen both subjective and objective improvements in pretty much all aspects of my health.

So without further ado, here are the numbers:

Gliadin IgA 0.9; where <5 is negative

Gliadin IgG 12.9; where <10 is negative

TTG IgA 0.6; <4 is negative, 4-10 is weak positive; >10 is positive

TTG IgG 21.4; >9 positive.  Whoah!

Total IgA:  253; where 69-382 is the normal range

A lot of doctors would consider this a negative test.  IgA is considered the primary indicator of Celiac disease in blood tests, and while both IgA tests came out negative, my overall level of IgA was normal, ruling out the selective deficiency that some Celiacs suffer from.  Typically the IgG tests are only used in those cases.  

But clearly something is going on with those IgG antibodies.  TTG IgG shows up in a number of other conditions,  but none of those match my symptoms very well.  Furthermore, the use of IgA antibodies as a primary indicator is predicated on the idea that Celiac is only confirmed by a positive intestinal biopsy, not "this person's symptoms improve on a gluten-free diet."  Call it Celiac or call it non-Celiac gluten-sensitivity; it's got the same symptoms and the same treatment if not the same pathology. But from what I've seen lately, many people, my doctor included, are considering it to be slightly different manifestations of the same disease.  Not every symptom shows up in every person.  

A biopsy in my case would have been interesting, but even if it was negative it seemed a gluten-free diet was my next step, so I didn't push for it, opting instead to see how the diet treated me.  Since I've responded so well, I feel like I have my answer.