August 12, 2006
Celiac
Question from Greensburg, Pennsylvania, USA:
My son has been a very tightly controlled type 1 for 15 years. He has never had an A1c over 7.4. His pediatric endocrinologist wanted a routine gluten antibody test done on him. Although he is asymptomatic, his antibody count came back at 8.0, which alarmed her. She said 10 was considered gluten intolerant. We did another test, three months later, and it came back at 4.0.
We have now switched to another endocrinologist as my son turned 18. This doctor is not at all concerned about the reading of 8.0, but he is insisting that we do another antibody test. Is it normal for this antibody to fluctuate like this? Should I put him on gluten restricted diet?
Answer:
The way you follow celiac disease is with the antibody. Treated, it goes down and patients feel better. One of the worries about testing, for some, is the potential for positive tests in people without symptoms. Or, maybe as the old saying goes, you don’t know the fire is hot until you take your foot out. Many say how much better they feel once they do the diet. They didn’t know how really badly they felt. They thought it was normal and everyone felt that way.
I don’t have an absolute answer, but might recommend six months on the diet to see if it makes him feel better.
LD