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Does Malabsorption+gluten-intolerance=celiac?


jshelton999

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jshelton999 Apprentice

I had a strong positive result from Enterolab for gluten sensitivity: 124 (normal <10) and I've had confirmed malabsorption with very low Vit D, and problems with absorption of my thyroid med (Synthroid).

So does this mean that there was intestinal damage even if the doc didn't see anything more than gastritis in the biopsy? BTW - I have little confidence in my gastroenterologist and suspect he didn't really look for Celiac.

I've been telling my friends and family that what I have is probably Celiac rather than just gluten-intolerance because of the malabsorption issues and frankly, 'Celiac' is better understood term to them than 'gluten-intolerance'...

So what do you think? Might I have Celiac rather than just gluten-intolerance? Can you have these malabsorption issues without Celiac?

Thanks for your feedback...I'm really anxious to get this all sorted out!


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Amyleigh0007 Enthusiast

Let me preface this by saying I am not a doctor..... Now, from my understanding, gluten intolerance doesn't produce villi damage and Celiac does (that's why biopsy is the gold standard for dxing Celiac). If you are having malabsorption issues I would think you have villi damage which means you have Celiac. If I am wrong, please, someone correct me.

Jestgar Rising Star

I think the answer is: it's not clear. And really, it doesn't matter, the treatment is the same. If you want, tell people that you caught your Celiac disease before it had done too much damage, but you were starting to have malabsorption problems.

jshelton999 Apprentice

Thanks for the quick replies! My instincts tell me there was intestinal damage and my doc just missed it. I didn't have a good feeling about him from day one. When I asked him before the endoscopy about looking for Celiac, he wouldn't discuss it, acting offended that I would suggest he look for it...

But if malabsorption can only occur when it's Celiac, then I definitely have Celiac.

BTW - One reason I need to have the exact condition dialed-in is that I'm on LTD and my insurance company needs a diagnostic code or they'll stop benefits. Ideally, I'll heal completely before too long and can go back to work - after 7yrs on disability!

rubyred Apprentice

FWIW, I used Enterolab and tested positive for malabsorption too. But, I was told by 2 doctors that I don't have celiac, even though my endoscopy showed mild blunting of villi. I think soy was causing the villi blunting?? Leaky gut?? I really don't know, never got any real answers. I also had gastritis and my stomach lining was atrophied. I've been gluten-free for a year now. Still don't know what to say to some people sometimes - do I have gluten sensitivity? Did I catch celiac early? I have the gene so I figure even if I don't have celiac, I still need to continue eating gluten-free. I can't really answer your question, but just wanted to share my experience.

CLeeB Rookie

Just like to chime in to say that I'm in the same boat with the same question. As you can read in my sig, my TtG test was within normal ranges, but i never had the full celiac panel done (stupid policy by HMO - only use the TtG test and then run the other ones if positive). But a comprehensive stool test (Metametrix) showed poor digestion and malabsorption, among other things. And Enterolab showed significantly high levels of anti-gliadin antibodies. Per naturopathic doc's orders, I've been gluten free for a little over a year.

I agree with Jestgar...it's unclear at this point. I just don't think science completely understands how gluten sensitivity/intolerance and celiac link/intereact/insert your favorite verb here. OTOH, I think it does matter for some of us what the label is. Yes, you are absolutely correct, the solution is the same. But dealing with the unknown is not something i think many human beings do very well. And there are a lot of unknowns when it comes to gluten.

FWIW, my naturopath, when i asked her to define my condition as best she could, said "severe gluten intolerance without test-proven villi damage."

Just proves how muddy the water really is.

Amyleigh0007 Enthusiast

My doctor admitted that he usually doesn't diagnose someone with Celiac unless their villi are completely smooth. Even with a positive blood test. I told him I thought that was dangerous because if someone has completely smooth villi that means they are in the critical stages of Celiac. I asked him why he wouldn't diagnose someone who had mild blunting. He said that's what he learned in med school 30 years ago. I told him times are different now. He said he knows and he is getting updated info from his daughter who is going through med school. So, I guess it all depends on your doctor and how long ago he/she went to med school!!!


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    • cristiana
      Thank you for the update.  So interesting to know how things are changing, when I was diagnosed I had very similar blood results but still had to have the endoscopy.  Glad you know where you stand.  As your father has celiac disease you probably already know a lot about it, but do contact us if we can help further.
    • trents
      But isn't it easier to just take a D3 supplement? Is the D light somehow a superior source? Links?
    • Scott Adams
      So the way it should be used is to take it before possible gluten exposure, so right before a meal at a restaurant take 1-2 capsules. Unfortunately taking it 1 hour or more after an exposure is too late.
    • Scott Adams
      Welcome to the forum, and thank you for sharing your detailed experience. It sounds like you’ve been through a lot over the past several months, and it’s understandable to feel frustrated after navigating unclear diagnoses and conflicting advice. Since you’ve found relief with a gluten- and corn-free diet, it might be worth continuing that approach for now, especially given your current commitments to culinary classes. You could consider working with a knowledgeable dietitian or a gastroenterologist who specializes in food intolerances and celiac disease to explore potential intolerances or other conditions without immediately reintroducing gluten. If confirming celiac disease is important for your long-term health management, you could plan for an endoscopy during a less busy period, ensuring you follow the gluten challenge protocol beforehand. In the meantime, prioritizing your well-being and avoiding known triggers seems like a practical step. Always advocate for yourself with doctors, and seek second opinions if needed—your health concerns are valid. Many people with celiac disease, especially those who are in the 0-2 year range of their recovery, have additional food intolerance issues which could be temporary. To figure this out you may need to keep a food diary and do an elimination diet over a few months. Some common food intolerance issues are dairy/casein, eggs, corn, oats, and soy. The good news is that after your gut heals (for most people who are 100% gluten-free this will take several months to two years) you may be able to slowly add some these items back into your diet after the damaged villi heal. This article may be helpful:    
    • trents
      Welcome to the forum, @Ryangf! If you don't have celiac disease you could still have NCGS (Non Celiac Gluten Sensitivity). They share many of the same symptoms but NCGS does not damage the lining of the small bowel as does celiac disease. Some experts feel NCGS can be a precursor to the development of celiac disease. NCGS is 10x more common than celiac disease. There is no test for it. A diagnosis of NCGS is arrived at by first ruling out celiac disease by formal testing. At the end of the day the antidote for both is the same, namely, life-long abstinence from gluten. Yes, corn is a common cross-reactor with gluten for some celiacs. So are oats, soy, eggs and dairy.  I have concern with your possible exposure to wheat flour dust during your culinary training. It gets in the air, you breathe it in, it gets trapped in the mucous of your mouth and airway and winds up in your gut. If you decide to go forward wit the "gluten challenge" for formal celiac disease testing, aim for the daily consumption of 10g of gluten (about the amount in 4-6 slices of wheat bread) for four weeks leading up to the day of either the blood draw or the endoscopy/biopsy.
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