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Learn more about gluten-related health problems from a leading medical authority.
Date published: 4/25/2011
Q: Can you tell me a little bit about that?
A: Sure, the history of celiac disease that we’ve experienced in the past 30 years is a history of milestones that came about over time. Among others, there were milestones in terms of the diagnostic tools that we have developed to make the diagnosis of celiac disease.
So with gluten sensitivity, we are now where we were with celiac disease 30 years ago. Thirty years ago, we had very unspecific tests for celiac disease. In the 80’s, we used to test [for] celiac disease with the antibodies that are now, in the original form, obsolete because they are not very good. And in the 90’s, there were another form of antibodies that were much better.
The major caveat of those antibodies is that the test was operator dependent, so that it was not a machine that scored the test. So, there was somebody who had to look through the microscope and make the call, and so the call was very subjective.
So in the late nineties, we were able to target or to clone the human form of of tTg (antibodies) and we were able to develop the human form that we are now able to use for diagnosis.
Q: So this is the test [the tTg test] that you would obviously recommend?
A: This is the test, not used by me but used by everybody.
Q: If you find if you are gluten sensitive with no evidence of celiac disease, is it necessary to be on a strict gluten free diet?
A: That’s also a very good question. ... The threshold of sensitivity can change from one individual to another. If one has celiac disease, everybody needs to be totally gluten free—even a crumb can make these people sick. We don’t know with gluten sensitivity if that is always the case.
Some people may have the same level of sensitivity, and they have to be absolutely gluten free. Other people may have a threshold that is lower and therefore a little bit more flexible in terms of compliance with diet. So the stringency of the diet needs to be adjusted from one person to another.
Q: What is the average amount it takes to trigger a reaction?