Is There a Test for Gluten Sensitivity or Gluten Intolerance?

Celiac.com 04/25/2024 - Gluten sensitivity, also known as gluten intolerance or non-celiac gluten sensitivity, shares symptoms with celiac disease, but it's not an autoimmune disorder like celiac disease. Instead, it's a condition where the body reacts negatively to gluten without involving autoimmune proteins. Despite its prevalence, there isn't a straightforward test for gluten sensitivity or intolerance.

Current testing methods primarily focus on ruling out other potential causes of symptoms, such as celiac disease, wheat allergy, irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD). If celiac disease is suspected, healthcare providers typically start with blood tests to detect specific markers associated with the condition, such as anti-endomysial antibodies (EMA) or tissue transglutaminase IgA (TG-IgA). If these tests suggest celiac disease, further procedures like endoscopy and biopsy may be conducted to examine the intestines for damage.

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However, when celiac disease and other known conditions are ruled out, diagnosing gluten intolerance becomes more challenging. Healthcare providers may recommend starting a gluten-free diet for a period, typically around six weeks, to observe any improvements in symptoms. If symptoms alleviate during this time, it may suggest gluten intolerance as the cause.

Despite the lack of definitive tests, some at-home kits claim to diagnose gluten sensitivity through stool or blood samples. Brands like EverlyWell and EnteroLab offer such tests, but their accuracy remains questionable, and the cost is usually not covered by health insurance.

Understanding the distinction between celiac disease and gluten intolerance is crucial. While celiac disease requires specific diagnostic procedures and can lead to severe complications if left untreated, gluten intolerance may cause discomfort but doesn't involve autoimmune reactions.

EverlyWell's Food Sensitivity Test

EverlyWell offers a test called the "Food Sensitivity Test" that includes a panel for gluten sensitivity among other food sensitivities. Here are some key points about EverlyWell's test for gluten sensitivity:

1. At-Home Test: Like other EverlyWell tests, the Food Sensitivity Test is designed for at-home use. It involves collecting a small blood sample using a finger prick and sending it to EverlyWell's partner lab for analysis.
2. Panel for Gluten Sensitivity: The test panel includes various food items, including gluten-containing grains like wheat, barley, and rye. It tests for IgG antibodies specific to these foods, which can indicate a potential sensitivity or immune response.
3. Detection of IgG Antibodies: IgG antibodies are part of the immune system's response and can be elevated in certain conditions, including food sensitivities. The test measures IgG antibody levels to specific foods to assess potential reactivity.
4. Comprehensive Report: EverlyWell provides a comprehensive report based on the test results. The report typically categorizes foods into different levels of reactivity based on IgG antibody levels, ranging from low to high reactivity.
5. Guidance and Recommendations: The test report may include guidance on dietary modifications based on the identified food sensitivities. It may recommend eliminating or reducing the consumption of foods with elevated IgG levels to see if symptoms improve.
6. Limitations: It's important to note that the Food Sensitivity Test from EverlyWell detects IgG antibodies, which are different from the antibodies associated with celiac disease (such as anti-tissue transglutaminase antibodies). Celiac disease diagnosis typically requires specific blood tests and sometimes a biopsy of the small intestine.

EnteroLab's Intestinal Antigenic Permeability Screen

EnteroLab offers a stool test called the "Intestinal Antigenic Permeability Screen" that is designed to detect gluten sensitivity and other gastrointestinal issues. The test focuses on identifying antibodies to gluten and other proteins that may indicate a sensitivity or immune response. 

Here are some key points about EnteroLab's stool test for gluten sensitivity:

1. Non-Invasive: The test is non-invasive and can be performed at home. It involves collecting a small stool sample and sending it to EnteroLab for analysis.
2. Detection of Antibodies: The test looks for antibodies to gluten, as well as antibodies to other proteins like casein (found in dairy) and soy. Elevated levels of these antibodies may suggest a sensitivity or immune reaction to these proteins.
3. Gluten Sensitivity vs. Celiac Disease: While the test can detect antibodies related to gluten sensitivity, it's important to note that it is not specifically designed to diagnose celiac disease. Celiac disease diagnosis typically involves additional tests such as blood tests for specific antibodies (e.g., anti-tissue transglutaminase antibodies) and sometimes a biopsy of the small intestine.
4. Comprehensive Report: EnteroLab provides a comprehensive report based on the test results. This report may include interpretations of the antibody levels and recommendations regarding dietary changes if gluten sensitivity is suspected.
5. Controversy and Criticism: It's worth mentioning that EnteroLab's testing methods and the validity of their results have been a topic of debate and controversy within the medical and scientific communities. Some experts have questioned the accuracy and clinical relevance of the stool tests offered by EnteroLab for diagnosing gluten-related disorders.

In conclusion, diagnosing gluten intolerance involves a process of elimination and observation of symptom response to a gluten-free diet. Individuals experiencing symptoms should consult healthcare providers to rule out other potential causes and determine the best course of action for managing their condition.