Unlocking the Diagnosis: Why Consuming Gluten is Vital for Accurate Celiac Disease Testing
And why your doctor is not trying to harm you!
Welcome to a special edition of the Celiac Scientist. This article is in response to some concerning comments I read today on a Facebook Celiac Community Group. Someone had posted a comment regarding their doctor’s instruction to consume gluten-based products for several weeks, ahead of being formally tested for Celiac Disease. A constant stream of misinformation followed which certainly would not have helped the individual understand why her doctor had given her this instruction. Many commenters even went as far as to say the doctor was wrong and that they should continue to avoid gluten at all costs.
With the inherent dangers associated with misdiagnosis, I thought I would share my understanding and hopefully provide some clarity on the subject. When it comes to diagnosing Celiac disease accurately, there are specific reasons why patients are advised to consume gluten-based products before undergoing testing. Here's why.
Why Consume Gluten for Celiac Disease Diagnosis
Activation of Immune Response: Celiac disease is an autoimmune condition characterised by an immune response triggered by gluten consumption. To detect this immune response accurately, gluten must be present in the patient's diet.
Detection of Antibodies: When gluten interacts with the immune system of individuals with Celiac disease, it leads to the production of specific antibodies, such as tissue transglutaminase (tTG) antibodies and endomysial antibodies (EMA). These antibodies play a crucial role in the diagnostic process.
Intestinal Changes: Prolonged exposure to gluten in individuals with Celiac disease can cause characteristic changes in the small intestine, such as villous atrophy and inflammation. These changes are key indicators of Celiac disease but may take time to develop, necessitating gluten consumption over a period before testing.
Accurate Test Results: Blood tests and intestinal biopsies are commonly used to diagnose Celiac disease. For these tests to yield reliable and accurate results, the patient's immune system needs to be actively responding to gluten ingestion.
Summary
So, to recap (because getting the tests right is important), consuming gluten-based products before testing for Celiac disease is essential for several reasons:
It activates the immune response, leading to the production of specific antibodies crucial for diagnosis.
Prolonged exposure to gluten allows for the development of characteristic intestinal changes indicative of Celiac disease.
Accurate test results rely on the presence of gluten in the patient's diet, ensuring the detection of immune system reactions and intestinal abnormalities associated with the condition.
In essence, while it may seem counterintuitive for individuals experiencing gluten-related symptoms to consume gluten, doing so is necessary to facilitate an accurate diagnosis of Celiac disease through blood tests and intestinal biopsies. Consulting healthcare professionals for guidance and testing is crucial in navigating the diagnostic process effectively. It is also vital that one follows their doctor’s advice and not be guided by potentially ill-informed comments on social media.
As ever, if you have view on this topic, let me know in the comments and maybe consider following my blog or even subscribing.
It’s so awful when people have yo go back on gluten for testing- hopefully this will spread awareness to test before going off gluten!!!