Patient Perspectives on Gluten Grain Sensitivities,

Gluten Grain Intolerances,  Celiac Disease,

and Gluten Challenges for Diagnostic Purposes






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1) There are several medical viewpoints of understanding of gluten grain reactivity versus celiac disease. These important differences were not obvious to us as new inquirers, but understanding them is vital.


2) Some professionals and many patients believe there may be other subsets or types of gluten grain reactivity besides celiac disease  (this also includes wheat allergy) defined by today's standard tests.


3) Other health conditions may appear confusingly similar to gluten grain reactivities.  Gluten and other food intolerances may be only part of the picture.  Research shows that stress, infections and toxins (dietary, environmental, drugs, etc) trigger food intolerances .

    . More 2 Other subsets

                                     .Psychiatric consequences top

4) A "gluten challenge" often may not provide the celiac diagnosis that the patient very confidently expects, even if he has previously experienced dramatic improvement on the gluten free diet.  Some patients have experienced serious side effects from gluten challenges.




New developments



NEW!  May, 2007



Medical Diagrams with audio presentation


"Dietary Proteins and Peptides from Gastrointestinal to Neuroautoimmune Disorders"


 Presented March , 2007, Pan American Allergy Society


Dr. Aristo Vojdani Ph.D., M.T.- Immunosciences Laboratories, Beverly Hills, CA


Dr. Vojdani explains his diagrams of celiac disease, gluten intolerance and gluten sensitivity and compares them to the normal healthy gut.  He also discusses his highly detailed Celiac Neuroautoimmune Test panel, which includes the additional antibodies discussed below in the next link.  This is the same panel mentioned in the DVD "Unlocking the Mystery of Wheat and Gluten Intolerance".  These diagrams and audio presentation may be downloaded for use at Dr. visits and other educational purposes.



Posted June, 2006


Some researchers identify more antibodies and more genes than standard conservative test panels currently include.




.Back to Inadequate Testin



6. Seronegative celiac disease: increased prevalence with lesser degrees of villous atrophy. Dig Dis Sci. 2004 Apr;49(4):546-50 Abrams JA, Diamond B, Rotterdam H, Green PH. Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA

115157.pdf (scroll down)

7. Antibody to Tissue Transglutaminase May Fall Short for Accurate Triage of Celiac Disease Peggy Peck Medscape Medical News 2004. © 2004 Medscape ACG 69th Annual Scientific Meeting: Abstract 4. Presented Nov. 1, 2004. Reviewed by Gary D. Vogin, MD


          Back to Inadequate Testing .References


30. Research - Mortality in patients with celiac disease and their relatives: a cohort study.  Giovanni Corrao et al,  The Lancet, Vol 358 p. 356 August 4, 2001


.30 Mortality research      Return to discussion of cheating and mortality rates

.11-14 reference

11. including Early Diagnosis, Before the Villi are Gone, Transcript of a talk given by Kenneth Fine, M.D. to the Greater Louisville Celiac Sprue Support Group, June 2003.   FAQ’s, Result Interpretation Curriculum Vitae

12. Gluten Sensitivity as a Neurological Illness;  From Gut to Brain Journal of Neurology Neurosurgery and Psychiatry 2002;72:560-563  M Hadjivassiliou, A Grünewald and G A B Davies-Jones Department of Neurology, The Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK  Correspondence to:   Dr M Hadjivassiliou, Department of Neurology, The Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK;

13.   Dangerous Grains  James Braly, MD, and Ron Hoggan, MA  Introduction page 5.   Also one day challenge pages 72-74.

14.  Gluten Sensitivity a Many Headed Hydra  M Hadjivassiliou, R A Grünewald and G A B Davies-Jones BMJ  1999;  318; 17 112. Gluten Sensitivity as a Neurological Illness;  From Gut to Brain Journal of Neurology Neurosurgery and Psychiatry 2002;72:560-563  M Hadjivassiliou, R 0-1711

Marsh's "modern" definition of gluten sensitivity is to be recommended: "a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals."10 Such responsiveness may find expression in organs other than the gut. Gastroenterologists, dermatologists, neurologists, and other physicians need to be aware of these developments if the diagnosis and treatment of the diverse manifestations of gluten sensitivity are advanced. The aetiology of such diverse manifestations presents the next challenge.

       (10) Marsh MN. The natural history of gluten sensitivity: defining, refining and re-defining. Q J Med 1995; 85: 9-13.)

.References for 11-14Back to  "There may be other subsets of gluten intolerance


3.  Prevalence of Celiac Disease in At-Risk and Not-at-Risk Groups in the United States Archives of Internal Medicine, Feb, 2003 st_uids=12578508&dopt=Citation

Alessio Fasano, MD; Irene Berti, MD; Tania Gerarduzzi, MD; Tarcisio Not, MD; Richard B. Colletti, MD; Sandro Drago, MS; Yoram Elitsur, MD; Peter H. R. Green, MD; Stefano Guandalini, MD; Ivor D. Hill, MD; Michelle Pietzak, MD; Alessandro Ventura, MD; Mary Thorpe, MS; Debbie Kryszak, BS; Fabiola Fornaroli, MD; Steven S. Wasserman, PhD, Joseph A. Murray, MD, Karoly Horvath, MD, PhD

.Specialists' comments on gluten challenges bottom

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Celiac Specialist comments on gluten challenges


Note:  These doctors' comments are all over 2 years old.  We invite professionals from various medical viewpoints to comment on their current opinions of gluten challenges for celiac disease/gluten grain intolerance diagnosis purposes.  As more patients are tested, new information may surface.


1.  Several comments by Dr. Cynthia Rudert, Atlanta, GA on the site > Celiac Disease > Ask the Experts > Ask the Doctor > Tests and their results


2.  Celiac Disease:  The Great Mimic  Robert Dahl, MD


3.   Source of the following quote,  Dr. Kenneth Fine, MD >frequently asked questions> If I am already on a gluten-free diet, do I have to return to eating gluten to be accurately tested for gluten sensitivity using the stool test?  Here is the actual link


"Thus, it is better to test on the current diet before adding the unreliable variable of a one to two week gluten challenge. It varies in different people how they or their immune system will react to gluten, and how long it would be required to eat gluten to make tests positive (as they once may have been before starting the diet). There are no guarantees that a truly gluten sensitive person will have positive tests after a short 1-2 week gluten challenge anyway, even if they get symptoms from it...Alternatively, if you choose to do a gluten challenge at the outset (again which we do not recommend) and the test is negative, it may be so because damage and antibody production has not yet been initiated. And you do not get the benefit of a comparison of what your antibody levels were when gluten was out of the diet. The comparison itself before and after gluten can be helpful, and is definitely more meaningful than testing after a short time on gluten after being gluten-free for an extended period.

Thus, I recommend testing in the stable gluten-free condition first then in the variable gluten-challenge condition only if necessary.

.test first     

One final note. Sometimes people experience dramatic improvement of symptoms and feeling of well-being after beginning a gluten-free diet. If the improvement to health was dramatic following removal of gluten from the diet, then this in and of itself is a positive diagnostic test (and perhaps the ultimate test). "  (Emphasis added)


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