Symptoms that don't disappear at all

[Anonimo9719]

Hi, everyone. I am 25 years old and I have been experiencing a lot of symptoms since a long time and I am absolutely unable to get rid from any of them. My main digestive issue is pale and very soft stools, like a mild diarrhea that is happening almost everyday. I have a lot of gases as well. The diarrhea gets worse when I eat a lot of nuts but, if I don't eat them, it doesn't improve too much. I have been always skinny and it is getting worse last months. Moreover, it seems that when I eat a lot, then I get worse than when I eat less. Moreover, I usually feel very tired, irritable, angry, sleepy and I forget things constantly. Specially when I eat a lot and then I get this diarrhea, I feel very week, my hands start to tremble and, overall, I feel really sick. However, these days I was eating less and surprisingly, I don't feel that way, but a bit a better (but I don't feel even close to my 80%, anyway).

I had recently a blood test and everything looked fine. Just bilirrubine was too high, but I have Gilbert's Syndrome, so I know that's completely normal. My GP told me to go lactose free, but it didn't work at all. The only thing that made me improve was avoid eating huge amount of nuts. 

On the other hand, I need to say that I have also struggled with hair loss during a lot of time. I lose a huge amount of hair everyday and it didn't stop at all since I first realized this. However, as my GP mentioned, it's just androgenetic allopecia, so I don't have anything to do with that, just waiting to see myself going bald. Appart from that, the skin of my face is often itchy, full of pimples and very dry (and even other parts of my body). I think I should have showers less often, because it seems that I am completely damaging my skin. I also struggle with erectile dysfunction, premature eyaculation that seem to be caused by loss of libido. I am completely impotent, no erections, never! Almost no sexual desire as well.

Going back to my blood tests, I also got checked of celiac disease with IgA transglutaminase and it was negative by far (almost 5 times below the top limit). As the lactose free diet didn't work, my GP referred my to the gastroenterologist but... yeah, pretty cool... I booked a consultation on May next year, because it couldn't have been earlier! So, as you can imagine, I'm completely desperated with this right now. It looks like I'm crazy because it seems that everything I eat makes me feel bad so I am trying to avoid this and that, without results. The only thing I am achieving is loosing even more hair and lose even more weight so yeah... I am fine 😑.

My GP also told me that pale stools could be a normal thing with Gilbert's Syndrome but that doesn't explain diarrhea, I guess (despite that can be a symptom, but I think Gilbert's Syndrome shouldn't give chronic diarrhea this way). I don't want to feel like this the rest of my life, specially with no sexual desire. So, I was thinking going gluten-free for a little time and see if that makes me improve, but maybe everyone will think I'm crazy and say "I am sure that you're not celiac". I've seen that some people improve with gluten-free diet even if they aren't diagnosed as celiac (non-celiac gluten sensitivity, for example). Probably that won't be my case, but I should give a try, maybe. I have also read that some people get a negative in their celiac tests, but they are actually celiac because the test returns a certain amount of false negatives.

For some years, my symptoms haven't changed at all, so I'm desperate about this. I tried avoiding alcohol (0% since 2020), walking more, changing some things of my lifestyle and even having showers less often to avoid washing my hair too much and damaging it even more. Nothing worked at all. Some of the things that should "make me feel better" made me feeling much, much worse. Any idea of what I should do?

[trents]

Welcome to the forum, Anonimo9719!

Several things I would point out to you:

1. The tTG-IGA antibody test for celiac disease misses 20% of those who actually do have celiac disease if they are of white European decent and 80% of those who actually have celiac disease if they are of black African decent. So, you can see that it is far from a perfect test. It would have been far better had your physician order a "full celiac panel" consisting of several antibody tests instead of just ordering the one test. Here is a primer outlining the test that can and should be run: https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/

Is there any chance of getting your physician to order a full panel?

2. It is certainly possible that you have NCGS (Non Celiac Gluten Sensitivity) instead of celiac disease. NCGS and celiac disease share many of the same symptoms but there is no test for diagnosing NCGS. Celiac disease must first be ruled out. NCGS is 10x more common than celiac disease. With either one, the only way to treat the disease at this point in time is to totally abstain from gluten for a lifetime. NCGS does not damage the villi that line the small bowel as does celiac disease but can harm other body systems.

3. If you believe you will pursue more testing, either more comprehensive blood antibody testing or an endoscopy with biopsy (which is t he gold standard for diagnosing celiac disease) you must continue to eat regular amounts of gluten. Starting a gluten free diet before testing is complete will invalidate the testing.

[Anonimo9719]

40 minutes ago, trents said:

Welcome to the forum, Anonimo9719!

Several things I would point out to you:

1. The tTG-IGA antibody test for celiac disease misses 20% of those who actually do have celiac disease if they are of white European decent and 80% of those who actually have celiac disease if they are of black African decent. So, you can see that it is far from a perfect test. It would have been far better had your physician order a "full celiac panel" consisting of several antibody tests instead of just ordering the one test. Here is a primer outlining the test that can and should be run: https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/

Is there any chance of getting your physician to order a full panel?

2. It is certainly possible that you have NCGS (Non Celiac Gluten Sensitivity) instead of celiac disease. NCGS and celiac disease share many of the same symptoms but there is no test for diagnosing NCGS. Celiac disease must first be ruled out. NCGS is 10x more common than celiac disease. With either one, the only way to treat the disease at this point in time is to totally abstain from gluten for a lifetime. NCGS does not damage the villi that line the small bowel as does celiac disease but can harm other body systems.

3. If you believe you will pursue more testing, either more comprehensive blood antibody testing or an endoscopy with biopsy (which is t he gold standard for diagnosing celiac disease) you must continue to eat regular amounts of gluten. Starting a gluten free diet before testing is complete will invalidate the testing.

Hi, thank you for the quick response,

I think that I couldn't ask for a full celiac panel, because I probably need to wait for the gastroenterologist. In the end, it seems that GP's don't want to ask for tests when they don't have too much idea on how to proceed, like in this case. They prefer to ask experts to do that. I know the tTG-IGA thing, so I didn't discard that option.

I know that I should eat gluten anyway if I want to get properly tested in a biopsy, for example, but it is a bit of a shame that I have to wait 6 months to have an appointment with the gastroenterologist. Finally, it seems that I need to try these things myself. I know it's risky because I've already lost a lot of additional weight for this kind of "experiments" so, I need to be careful in this one, because it can be much more damaging than good. Probably, I can give it a try, reducing little by little the amount of gluten and see what happens.

[T burd]

41 minutes ago, Anonimo9719 said:

Hi, thank you for the quick response,

I think that I couldn't ask for a full celiac panel, because I probably need to wait for the gastroenterologist. In the end, it seems that GP's don't want to ask for tests when they don't have too much idea on how to proceed, like in this case. They prefer to ask experts to do that. I know the tTG-IGA thing, so I didn't discard that option.

I know that I should eat gluten anyway if I want to get properly tested in a biopsy, for example, but it is a bit of a shame that I have to wait 6 months to have an appointment with the gastroenterologist. Finally, it seems that I need to try these things myself. I know it's risky because I've already lost a lot of additional weight for this kind of "experiments" so, I need to be careful in this one, because it can be much more damaging than good. Probably, I can give it a try, reducing little by little the amount of gluten and see what happens.

If I were you I would insist that you be seen sooner by a gastroenterologist. Maybe you can call around and find one that has an opening. you sound like a classic celiac to me. Does take months of being off gluten to feel better, though you likely will notice right away, and a few months of eating it before your biopsy. 

[trents]

As long as you reintroduce regular amounts of gluten (the equivalent of two pieces of wheat bread daily) for two months before your appointment with the gastroenterologist you should be able to trial a gluten free diet now. These are the Mayo Clinic guidelines for a pretest gluten challenge.

[knitty kitty]

@Anonimo9719,

I found some interesting articles...

Having diarrhea for a long period of time can affect how much nutrients you absorb from your food.  Nutritional deficiencies can affect hair loss.

“Let Food be Thy Medicine”: Value of Nutritional Treatment for Hair Loss

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647708/

And...

A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236337/

And...

Your diarrhea may be caused by Gastrointestinal Beriberi....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533683/