The Science of Celiac

The number of cases of celiac disease is on the rise. Is celiac disease the new black, or is something else going on? Everyday Einstein explains.

Lee Falin, PhD,
July 27, 2013
Episode #063

Page 2 of 3

Sometimes however the disease can go unnoticed because people don't get these symptoms, or don't notice them. Since celiac disease damages your intestinal tract, it can lead to malabsorption of other nutrients, which can lead people to think they have other illnesses. For example, anemia is a common side effect of celiac disease, because iron is no longer being absorbed properly. Osteoporosis is a potential complication because your body stops absorbing calcium and vitamin D correctly.

One of the other problems is that sometimes the damage caused by celiac disease doesn't manifest itself until later in life. Scientists are now realising that many children that were historically diagnosed with growth failure, failure to thrive, and infantilism where likely suffering celiac disease. Sometimes you might not have any of the other symptoms but have really low vitamin D levels because of your intestines not absorbing things correctly. Frequent miscarriages, infertility,  lactose intolerance, and other autoimmune conditions such as vitiligo and occasionally hypothyroidism can also be a result of the damage caused by celiac disease.

Diagnosing Celiac

Up until recently, diagnosing celiac disease was difficult because of its wacky symptoms. However, in the last couple of years, several blood tests have been developed that do a very good job of diagnosing celiac disease. Scientists have given these handy names to help you easily remember them:

  1. tTG-IgA - This is a blood test that measures how many tTG antibodies you have in your blood. You shouldn't have very many because your body shouldn't be attacking itself. If this number is really high, there is a 90-95% chance you have celiac disease.

  2. EMA - Another blood test that screens for antibodies, but is less sensitive than the tTG-IgA and is no longer recommended. 

  3. DGP - A new test that is supposed to be even better than the tTG-IgA, especially in children, but isn't widely used yet. 

  4. HLA - A genetic test done by submitting a swab of cheek cells. There are certain gene variations that make you more likely to have celiac disease. 

  5. igG-giladin - A test that can be useful to see if you have an adverse reaction to gluten that is not celiac disease (more on that later).

In the UK, the current standard is to use test number 1 to see if you have high levels of antibodies. If you do, you're referred to a gastroenterologist who does a endoscopic biopsy where pictures and samples of your intestines are taken for analysis. This analysis serves two purposes. First it confirms with full certainty if you have celiac or not (rather than only being 90-95% certain). Second, it provides a measurement for how damaged your intestines currently are.

Other Gluteny Things

Some people have problems with gluten, but don't have celiac disease. Problems with gluten can be broken up into two categories: allergic reactions and immune system reactions. 

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