Endoscopy deicphering

[Bigchan]

Hello, I am a young man dealing with some Thyroid issues, along with some general digestive issues.

A long time ago I was tested for Celiac disease via blood and was told I had it, but then had an endoscopy to confirm, and actually I got the results back, but I could never really decipher what they meant, so i just assumed I had it to be safe. I'm taking a much larger role in the control of my health now, and I deem it necessary to be less assumptive and to make sure I have concrete facts now.

 

Under "Clinical History"

Abdominal pain/bowel issues/Wt loss. R/O Celiac. Findings: Mild gastritis. EGD.

 

Not sure what to make of that.

 

Under "Final Pathologic Diagnosis"

A. Duodenum Biopsy; Mature benign small bowel mucosa with a normal villous architecture.

B. Stomach Biopsy; mild chronic gastritis, Helicobacter Immunoperoxidase stain is negative for Helicobacter organisms(Controls appropriate.)

c. Esophagus Biopsy, Chronic Esophagitis with Rare Eosinophils.

 

 

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If anyone can decipher and elaborate on any of this, I would appreciate it? Do I have Celiac disease? Anything else anyone notice to be relevant? Thank you!

[kareng]

That isnt really enough for me to go on....

 

but ....being negative for Celiac years ago, you could have developed it now.  But if you have been eating gluten free for all that time, than your Celiac disease should be " in remission".  So, even if you have Celiac, your current issues may be from a different cause.

[Bigchan]

  On 10/8/2017 at 10:43 PM, kareng said:

That isnt really enough for me to go on....

 

but ....being negative for Celiac years ago, you could have developed it now.  But if you have been eating gluten free for all that time, than your Celiac disease should be " in remission".  So, even if you have Celiac, your current issues may be from a different cause.

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That's all that in on my test results unfortunately. They are from early last year. (About 1.5 years ago) I was eating gluten at the time. I have been gluten free for 10 months now. (New years resolution. Complete adherence to an Autoimmune-paleo diet with no chance of flaws.)

 

I would just like to know if that test is telling me that I did or didn't at the time. Whether I do or don't now is less relevant. Thanks for your assistance friend.

[cyclinglady]

  On 10/8/2017 at 10:30 PM, Bigchan said:

Hello, I am a young man dealing with some Thyroid issues, along with some general digestive issues.

A long time ago I was tested for Celiac disease via blood and was told I had it, but then had an endoscopy to confirm, and actually I got the results back, but I could never really decipher what they meant, so i just assumed I had it to be safe. I'm taking a much larger role in the control of my health now, and I deem it necessary to be less assumptive and to make sure I have concrete facts now.

 

Under "Clinical History"

Abdominal pain/bowel issues/Wt loss. R/O Celiac. Findings: Mild gastritis. EGD.

 

Not sure what to make of that.

 

Under "Final Pathologic Diagnosis"

A. Duodenum Biopsy; Mature benign small bowel mucosa with a normal villous architecture.

B. Stomach Biopsy; mild chronic gastritis, Helicobacter Immunoperoxidase stain is negative for Helicobacter organisms(Controls appropriate.)

c. Esophagus Biopsy, Chronic Esophagitis with Rare Eosinophils.

 

 

-------

If anyone can decipher and elaborate on any of this, I would appreciate it? Do I have Celiac disease? Anything else anyone notice to be relevant? Thank you!

Expand Quote  

Item C.  What did your GI say?  

The small intestine is as large as a tennis court when spread out.  Easy to miss damaged areas.  How many biopsies were actually taken?  

I would recommend a second GI consult.  Obtain all your records, including those blood tests.  Just looking at what you posted does not tell the entire story.  

[plumbago]

 A. Duodenum Biopsy; Mature benign small bowel mucosa with a normal villous architecture.

 Abdominal pain/bowel issues/Wt loss. R/O Celiac. Findings: Mild gastritis. EGD.

___________________________

It looks like you have "normal villous architecture," in other words, no damage to your villi. It would be good to know how many samples for the biopsies they took. I do not think that means that you do not have celiac, even though the endoscopy is also known as a gold standard for Celiac diagnosis.

The second part means that they wanted to rule out celiac, but are saying you have mild gastritis.  And under C. they're also saying you have Chronic Esophagitis with Rare Eosinophils.

Plumbago

[Bigchan]

I think they were attributing the gastritis and esophagitis to food sensitivities that may not actually be Celiac in nature. So maybe Non-celiac gluten intolerance or something or other. I actually suspect Candida or some other type of infecton that I haven't explored yet, since going completely anti-inflammatory barely affected my Thyroperoxidase antibodies. Which by the way usually range from 48-60(Exceedingly low and almost to normal! :))

I figured going AIP for 6-12 months would have finished off my small amount of antibodies, but it seemed to do little to no effect. This leads me to believe I have a low-grade infection or maybe heavy metal toxicity that both needs exploring. I'm kind of leaning towards maybe not having Celiac, but of course like you all have said, there is no definitive answer at the moment, but at least I can gauge it a little better with your insight.

[Bigchan]

Okay, so as it turns out I've dug up the original bloodtests that preceded this endoscopy by about 3 weeks. I was eating substantial amounts of gluten at this time.

 

  Celiac Disease Genotyping
 Celiac (HLA-DQB1*02)        POSITIVE  AB   
 Celiac (HLA-DQ8)            Negative
 Celiac (HLA-DQA1*05)        POSITIVE  AB

 

Tissue Transglutaminase IgG Ab

Result: 3 Units

Reference Range: <20

 

 

Tissue Transglutaminase IgA Ab

Result: 9 Units

Reference Range: <20

 

Anti-Gliadin IgG Ab Deaminated

Result: 3 Units

Reference Range: <20

 

 

Anti-Gliadin IgA Ab Deaminated

Result: 5 Units

Reference Range: <20

[kareng]

  On 10/9/2017 at 1:02 AM, Bigchan said:

Okay, so as it turns out I've dug up the original bloodtests that preceded this endoscopy by about 3 weeks. I was eating substantial amounts of gluten at this time.

 

  Celiac Disease Genotyping
 Celiac (HLA-DQB1*02)        POSITIVE  AB   
 Celiac (HLA-DQ8)            Negative
 Celiac (HLA-DQA1*05)        POSITIVE  AB

 

Tissue Transglutaminase IgG Ab

Result: 3 Units

Reference Range: <20

 

 

Tissue Transglutaminase IgA Ab

Result: 9 Units

Reference Range: <20

 

Anti-Gliadin IgG Ab Deaminated

Result: 3 Units

Reference Range: <20

 

 

Anti-Gliadin IgA Ab Deaminated

Result: 5 Units

Reference Range: <20

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So your Celiac antibodies were negative?  And a negative biopsy?  Don't see that you had  Celiac back then

[Bigchan]

  On 10/9/2017 at 1:13 AM, kareng said:

So your Celiac antibodies were negative?  And a negative biopsy?  Don't see that you had  Celiac back then

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That's what I was thinking. The only reason I have really explored Celiac Disease was as part of a root cause protocol involving Hashimoto's Thyroiditis. Although upon an anti-inflammatory diet not affecting my mild Thyroid antibodies, it was making me question the proposed diagnosis. From what you guys can tell though, the endoscopy did indeed assume a negative then? I just wasn't really sure, which is why I brought it here.

Interestingly enough my C-Reactive Protein came back normal as well. So it begs to question what could possibly be fueling my Hashimoto's. Especially since I do indeed have mild digestive issues even if I am truly negative for Celiac. I'm just not really sure if its my thyroid causing my mild digestive issues, or my digestive issues causing my thyroiditis. Chicken and the egg scenario, although they both need to be expunged nonetheless. Ironically, my digestive issues seem rather underwhelming and actually don't bother me much, but it's still important to acknowledge I have them nonetheless. Noticeable bloating and mild maldigestion seem to be the the extent of it.

[RMJ]

The endoscopy was negative for celiac, but showed inflammation of the esophagus (esophagitis) and stomach (gastritis).  R/O stands for rule out.  Blood tests also negative for celiac.

[Bigchan]

  On 10/9/2017 at 3:01 AM, RMJ said:

The endoscopy was negative for celiac, but showed inflammation of the esophagus (esophagitis) and stomach (gastritis).  R/O stands for rule out.  Blood tests also negative for celiac.

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Thank you for your input. Not seeking medical advice here :), but does anyone have some likely suggestions for what could be causing both? It's obviously a double inflammation issue, since they're both of the digestive track, perhaps food sensitivities? Although I'm on the AIP protocol now, and actually am still experiencing mild digestive issues nonetheless. Maybe systematic candida or something or the sort? I do have light coating of the tongue.

[cyclinglady]

So your doctor is clueless as to what is causing item "c"?  Or are you seeing these results prior to a consult with your doctor?   I know you say you are not asking for a diagnosis.  How can we possibly give you one?    You can google the test results and take you your pick, but better to talk to your GI.  He has your complete chart.  

 

[Bigchan]

  On 10/9/2017 at 5:43 AM, cyclinglady said:

So your doctor is clueless as to what is causing item "c"?  Or are you seeing these results prior to a consult with your doctor?   I know you say you are not asking for a diagnosis.  How can we possibly give you one?    You can google the test results and take you your pick, but better to talk to your GI.  He has your complete chart.  

 

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My doctors are clueless. Most tests I get done are brought up by myself and met with resistance, let alone the capability of reviewing the results with me. My GI doctor doesn't even believe in intestinal permeability. I will be working closely with a Functional medicine practitioner in the near future when I gather a little more money, until then I'm trying to get a good idea of what's going on to cut down on time in the future. It seems like some extensive digestive testing should lead to solving my thyroid issue at this point, and if thats the case then I'd be a very, very happy fellow.

[cyclinglady]

Well, good luck on healing your thyroid.  Unlike celiac disease, the trigger is not known.  Stress, illness, whatever, can set up a Hashi's flare.  I have had my thyroid antibodies elevated for over 20 years.  My most recent test indicated that they were 300 which is down from over 2,000.  There is no cure from Hashi's.  The best you can do if to take thyroid hormone replacement if you become hypo.  Surgery if you develop a large goiter or cancer.  

I applaud your AI diet.  I have read mixed results on it.  But certainly eating good whole food can not hurt.  The less processed, the better in my non-medical opinion.  Identifying allergies and intolerances can help.  For example, I can not tolerate garlic which is considered a healthy food, but not for me.  Consider keeping a food journal.  

If you had candida (thrush) you would not be able to swallow.  It is painful.  Systemic candida is not common either.  There is a real danger of reading too much off the internet when you do not have a medical degree.  

Again, no cure for thyroiditis (autoimmune).  There is no cure for any autoimmune disease to my knowledge.    The best you can hope for is remission until the next flare-up.  That may very well include a good diet, exercise and rest.  

Keep all your medical records and still consider another GI consult when you have the funds.  

[Bigchan]

I agree with and second virtually everything you have said, however, it is well documented that a minority of those with Hashimoto's can and do reach a complete remission and are able to absolve themselves of the thyroid hormone medication. (My true and ultimate health goal.) Now, while that is certainly a slim chance, it is possible nonetheless. Now of course, this is a state that must then be maintained, particularly if the root cause was due to gluten or such, as the consumption of it again would reinstall the thyroid antibodies. There is quite a bit of findings now even represented in the most recent literature on Hashimoto's showing a complete remission at times for people who say, for instance, had a Helicobactor Pylori infection in the gut, and had it eradicated. Patients have had their thyroid antibodies drop to 0. (assuming that was their only root cause of course)

 

Right now the reference range for TPO antibodies seems to be <40 (<34 at some labs I've seen) and I am currently at 48. Seeing as I still have food sensitivities and some sort of digestive issues, it's fair to say that upon the correction of those, the final bits of my antibodies could potentially drop into normal range, albeit unlikely in relation to the percentage of the population. Especially seeing as every time I have corrected an issue thus far (Like fixing a vitamin D deficiency) my antibodies have continuously dropped. Another "drop" or two very well could land me into the safety zone.

Nonetheless, that has been my grand goal for the last two years, and I seem to be getting incredibly close, so I will shoot for it and assume I will be one of the luckier patients with it. Getting away from Thyroid hormones should especially be possible because I'm rather young and my thyroid should still be in decent condition and the possibility of healing isn't out of the question. Again, I'll hold onto the hope that I will be one of the few since I believe quite strongly in the mind-body connection, until proven otherwise I'm dedicated to the possibility of the goal.

[Jmg]

What was your response, if any, to the gluten free diet?

 

[plumbago]

"I will be working closely with a Functional medicine practitioner in the near future"

Excellent! I was going to suggest that. Do as much research on yourself and your issues as you can. Learn as much as possible before the appointment, which will make it so much more worthwhile.

Ah, now I see why you were wanting to know about hypothyroidism and possible connections to celiac disease.

"Hashimoto thyroiditis has a markedly higher clustering of other autoimmune diseases, including pernicious anemia, adrenal insufficiency, celiac disease, and type 1 diabetes mellitus"

SOURCE: Open Original Shared Link

"Consider keeping a food journal." As always, this is one of the best pieces of advice! It's so basic and yet so fundamental. Not sure about today's government, but just a few years ago, the USDA hosted a site where you'd create a login and enter in your food. It was a great at-a-glance view, of course as long as you entered in everything. I took a nutrition class and had to do that. It was very helpful.

Not so sure about the lifetime sentence of autoimmunity, either. But I won't argue over it. I have many favored authors (Weil; Taubes; Wahls) that guide me through a lot of nutrition thickets. I recommend cultivating your favorites and spending time with them and pen and paper (or keyboard and screen).

Plumbago

[squirmingitch]

  On 10/11/2017 at 12:32 AM, plumbago said:

"Consider keeping a food journal." As always, this is one of the best pieces of advice! It's so basic and yet so fundamental. Not sure about today's government, but just a few years ago, the USDA hosted a site where you'd create a login and enter in your food. It was a great at-a-glance view, of course as long as you entered in everything. I took a nutrition class and had to do that. It was very helpful.

 

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Woo Hoo! I did not know about this Plumbago and when I read this portion of your post, I Googled. Viola'!

Open Original Shared Link

[Bigchan]

  On 10/10/2017 at 7:00 AM, Jmg said:

What was your response, if any, to the gluten free diet?

 

Expand Quote  

Little to no change in my thyroid antibodies.

[Bigchan]

  On 10/11/2017 at 12:32 AM, plumbago said:

"I will be working closely with a Functional medicine practitioner in the near future"

Excellent! I was going to suggest that. Do as much research on yourself and your issues as you can. Learn as much as possible before the appointment, which will make it so much more worthwhile.

Ah, now I see why you were wanting to know about hypothyroidism and possible connections to celiac disease.

"Hashimoto thyroiditis has a markedly higher clustering of other autoimmune diseases, including pernicious anemia, adrenal insufficiency, celiac disease, and type 1 diabetes mellitus"

SOURCE: Open Original Shared Link

"Consider keeping a food journal." As always, this is one of the best pieces of advice! It's so basic and yet so fundamental. Not sure about today's government, but just a few years ago, the USDA hosted a site where you'd create a login and enter in your food. It was a great at-a-glance view, of course as long as you entered in everything. I took a nutrition class and had to do that. It was very helpful.

Not so sure about the lifetime sentence of autoimmunity, either. But I won't argue over it. I have many favored authors (Weil; Taubes; Wahls) that guide me through a lot of nutrition thickets. I recommend cultivating your favorites and spending time with them and pen and paper (or keyboard and screen).

Plumbago

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Ahh yes, I agree. Although there are still many mysteries and grey areas with autoimmunity, the root cause protocol of the functional medicine world is proving that its a battle that can be hard fault. Of course, as mysterious as autoimmunity still is, it is very unfortunate that some people as of right now are stuck in the cycle while others are reaching remission because we still don't know all the factors quite yet. I think it's amazing that we've so extensively been able to identify gut infections, heavy metal toxicity, nutrient deficiencies, and food intolerances among other things as some of the leading causes though, and showing correlation to remission through the addressing of these various areas.

 

Anyway, I closely follow Dr. Mark Hyman, Izabella Wentz, Chris Kresser, and a myriad of other leading doctors on autoimmune thyroid disease and functional medicine in general. I have a number of amalgam fillings I'm looking forward to addressing as well in addition to the gut testing I will be needing. It sucks that getting any real help isn't covered by insurance, as I dare say I would be through this battle already if it wasn't for spending over a year collecting the couple thousand dollars required to cover a good range of testing and consultations that will need to accompany them.

[Jmg]

  On 10/13/2017 at 4:46 AM, Bigchan said:

Little to no change in my thyroid antibodies.

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Did you notice any change yourself? For instance in the digestive issues you mentioned?

My thyroid levels were deemed normal but the gluten-free diet addressed several symptoms consistent with hypothyroidism. I kept a diary which helped me track any changes over time, but it wasn't easy in the case of those symptoms. The change was very gradual.

[Bigchan]

  On 10/13/2017 at 5:52 AM, Jmg said:

Did you notice any change yourself? For instance in the digestive issues you mentioned?

My thyroid levels were deemed normal but the gluten-free diet addressed several symptoms consistent with hypothyroidism. I kept a diary which helped me track any changes over time, but it wasn't easy in the case of those symptoms. The change was very gradual.

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I wanna say yes, but I went from a full-force standard-american diet directly to an AIP Whole foods diet. Going from daily pizza, ice crea, donuts, insane levels of sugar etc. to a diet full of vegetables and fish etc. It would be hard to attribute much of my feeling better to gluten-free when there were so many other possible factors at play, such as nutrient density, blood-sugar balancing, and a handful of other things. Although honestly the switch from a SAD diet to AIP made me feel noticeably better, it was nothing substantial. In fact, if I was not so die-hard as to try and fix my thyroid, I'd probably go back to eating what I want.

[Jmg]

  On 10/13/2017 at 4:01 PM, Bigchan said:

were so many other possible factors at play, such as nutrient density, blood-sugar balancing,

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If you have a gluten issue then it can affect both those and many other parameters, but I take your point. 

[Bigchan]

  On 10/13/2017 at 4:55 PM, Jmg said:

If you have a gluten issue then it can affect both those and many other parameters, but I take your point. 

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Agreed. Although I'm still not much better 10 months later, so I certainly have some more digging to do.