There are three ways to test for gluten intolerance, or at least negative gluten reactions, from a lab testing standpoint. Gluten can react with the body in a variety of ways, and sometimes when we are looking to assess whether someone is intolerant to gluten, it is helpful to look at all three sets of information. Often someone will test positive only on one of the three – so as with everything in medicine, the more information we have, the better. This is especially true for kids who might not be able to report their symptoms in an objective way.
I also would add here that in my view, another way to test for gluten intolerance is to cut it strictly out of one’s diet, wait a month, then eat it again. Often by the time the immune system has had a month “off” any offending food including gluten, it’s reaction will be more noticeable, and often a person will notice feeling much worse after eating it than they ever used to. I had a patient come in last week that that happened too – he was a teenage boy, very mature and wanting to take responsibility for his health, but he had some food sensitivities and so he was on a restricted diet. He did have one gluten “cheat” however, and he felt awful afterwards. He felt like we’d “caused” the reaction by taking him off gluten, where a month ago he could have eaten it without that strong of a reaction. I had to explain to him that it’s actually a good thing, that his immune system is being reset, and it’s reaction how is healthier than the one that might have appeared as nothing a month back.
The three ways of testing for gluten intolerance I’m talking about today do involve lab tests, but I wanted to at least make a note that some people don’t need a lab to know they’re gluten intolerant. They may need a period of restriction to notice the reaction, and they may need a healthy dose of “get out of denial” to admit that they eat gluten and feel bad afterwards … simple cause and effect.
Test #1 – Auto-Immune Markers
The first test is the most obvious and the most commonly done, when looking for gluten intolerance/ Celiac disease. It is the blood test for auto-immune markers including anti-gliadin and anti-transglutaminase. Even the most allopathic MD’s will run this test. Gluten is slightly unlike other foods in that it can cause an auto-immune response within the body, leading to the destruction of cells lining the small intenstine, but also more far-reaching effects such as thyroid problems. Auto-immune gluten intolerance in it’s most severe form is Celiac disease, but there can be many cases that are not as severe as that, but will still have this auto-immune reaction to some degree.
My only problem with this test is that the large labs such as Quest and Labcorp don’t necessarily do the most sensitive testing. You might hear me say that a lot, but it’s a fact that smaller labs that really focus on one particular area often do offer superior testing, that can be more sensitive. I like Enterolab for gluten intolerance testing, they offer a stool test, and I have found it to be pretty accurate.
Test #2 – Food Sensitivity Test
The second test is a general food sensitivity test. This measures IgG responses to a range of different foods – the lab we use tests 96. Those foods include fruits, vegetables, nuts, grains, dairy, eggs etc, so it’s not specifically a gluten test, but there are approximately 10 markers in there that involve gluten – wheat, whole wheat, gluten, gliadin, barley, rye, etc etc. One can see if all of those markers are elevated, that the person is intolerant to gluten.
Interestingly, that does not necessarily mean the person’s reaction is auto-immune. If the IgG markers are high, but the auto-immune markers are negative, it would simply mean that they have an intolerance to gluten, but it’s not triggering an auto-immune response. That can definitely happen – the end results is the same, though, the person would be best to take gluten out of their diet. The food sensitivity test is more commonly performed in integrative and functional medical circles. More allopathic MD’s question it’s validity, but I’ve run hundreds of them can honestly say they’re a great source of useful information.
Test #3 – Urinary Peptides
I do this test more on kiddos than adults, although it could be applicable to adults too, especially when evaluating issues around cognition or mental health. This test is the urinary peptide test. It is based on the premise that gluten, dairy and soy have specific sequences of amino acids (in strings called peptides), that can cross the blood-brain barrier, and bind with opioid receptors in the brain. Therefore these foods have a morphiene-like effect on the person, and can impact behaviors, cognition and emotions. We do this test frequently in the autism community, since kids on the spectrum seem to have such trouble with gluten and dairy, and taking them off these foods can have such profound benefits for their brain. One of the reasons is this peptide response – it’s like they get high from their bread and milk, which can appear as trance-like states too, and I’ve seen full-blown reactions when those foods were taken away from them, much like a drug addict going through withdrawal.
For adults with general health issues I’d recommend going tests 1 and 2. For kids or adults with more neurological/ behavioral/ cognitive/ mental health concerns I would be trying to get all three tests done. The first test I do through Enterolab, the second and third are available from The Great Plains Lab.
I love functional medicine and the testing it provides to help people hone in on variables relating to their health. Gluten intolerance is so common, and so many health issues are tied to it, so this one is definitely worth pursuing.