New Celiac Blood Test May Allow You to Skip the Biopsy


"The Unknown", photo (c) Angelica Nelson

Dr. Vikas K. Sarna and colleagues have a new blood test that does several wonderful things.  It can be used to detect Celiac Disease even if you're no longer eating gluten, so it eliminates the potentially damaging gluten challenge.  It's 90% accurate, so far.  It doesn't require a biopsy/endoscopy.  And it's much cheaper than the way we detect Celiac Disease right now.  So why isn't it already being used? 

Your guess is as good as mine.  So far the only negative I'm seeing is that the study is fairly small, with 62 participants.  And there are perfectly reasonable calls for a larger study.  However, Nexvaxx, the "Celiac vaccine" has a bit more than double that number of participants, which is still small.  And the news is all agog over that one. 
There is a currently a call to action to have a bill pass Congress that would hold drug makers to the same gluten free labeling as other FDA regulated things.  Please participate in it.  And while you're making that call, please mention that funding is needed to study a new celiac blood test, that is a cheap alternative to the old method of diagnosing Celiac Disease.  The old method is not only invasive, but expensive and time consuming. (If asked for details, give the name of the researcher.)  We need a chance to make this new blood test work.  If it's a failure, then OK, I can accept that, but it's scientists who will decide that.  Not me.  And they can't do it without funding.
The suspicious side of my mind is saying it's because it reduces the need for endoscopy and that makes a lot of money for hospitals.  But, it also leads to lack of diagnosis as insurers publish clinical practice guidelines that discourage the diagnosis of Celiac disease.   It happened in Lyme, so why wouldn't it happen in CD?  The push-pull of profit vs cost cutting is really unhealthy for everyone. It can even be deadly. I'm pretty sure that's a big reason why Medicare for All is gaining steam as an idea, on both sides of the political spectrum

So I wanted to make sure you're aware of the new blood test and I'd like to see it talked about more on the news.  I'd like to see some positive pressure going toward making that test a reality.  But what does it do?  Actually, the test is really clever.  It basically tests to see if your T cells are currently reacting to gluten or not.  There are many types of T cells, but the ones they're testing are specific to those changed when the HLA-DQ2 or 8 (genes) are activated.  I only have one of those genes, so I'm curious to see a study that shows how accurate it is for people like me.

It's been more than a year... let's get moving on this!!

In their own words:  "HLA-DQ–gluten tetramers can be used to detect gluten-specific T cells in blood of patients with celiac disease, even if they are on a GFD. We investigated whether an HLA-DQ–gluten tetramer-based assay accurately identifies patients with celiac disease."     and     "This test would allow individuals with suspected celiac disease to avoid gluten challenge and duodenal biopsy, but requires validation in a larger study."  from:  https://www.gastrojournal.org/article/S0016-5085(17)36352-7/pdf   (Note:  get the PDF asap, because the cost to keep a paper outside the paywall is very high.  It will go back to being unreadable soon enough.)


Just having a clear answer on this one aspect of why gluten drives your body crazy will help you get closer to the truth.  And that's all we can expect from science and health care.

 Another benefit to patient and doctor sanity will be an answer to the question, "OK do I have Celiac or not?" for the millions of people who for some reason or other can't tolerate gluten long enough to be tested in the usual way.  Having Celiac ruled out doesn't mean you have to eat gluten again.  It means your problem needs more definition.  Perhaps it's an allergy, or any of many sensitivities that are already identified, such as gluten neuropathy (that's me!), gluten related migraine (that's me again!), gluten ataxia, gluten related blood clotting (this needs more study, but that's me again!), gluten exacerbation of IBD, etc. The possible choices for non-Celiac effects from gluten are many. 

Limitations of the New Blood Test

Nobody should be taking this to mean that it will show who is faking or not. Nobody should tell you to eat something that makes you feel sick, or try to turn your health into a mental health issue. Science moves slowly, but it does move. This test, even if validated, can't determine for you whether or not gluten is safe for you.  It only does one thing, tells if your T cells have Celiac-specific changes or not.  That's all.

Believe in yourself, I can't emphasize that enough. Seek correct diagnosis, even if it turns your assumptions upside down.  And don't over generalize a positive or negative result.

Transglutaminase is still a real factor in Celiac Disease, and all this new test does is show whether two genes are active or not, if you have them.  The standard TTG test will still be used to tell if you're being exposed to gluten, at your one year follow up.  The new test can't do that.  And we'll probably need a new test to verify that NCGS is in remission, someday, when we understand it better.

It would be wonderful if all these issues were already worked out.  But that's the hardest thing in life, it's always evolving.  That's why faith and self trust are so important. 
So, what's your take on this?  And had you heard of the new blood test, already? 

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