The Gluten Syndrome.net.top
Patient Perspectives on Gluten Grain Sensitivities,
Gluten Grain Intolerances, Celiac Disease,
and the risks of Gluten Challenges for Diagnostic Purposes
(Formerly GlutenSensitivity.net, www.GlutenReactivity.net)
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Most likely tests to find positives
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Last Updated January 12, 2011
Gluten Syndrome Laboratory Test Panels
Test Panels which Target Villi Damage only (Celiac disease)
Panels are in alphabetical order by Laboratory or Celiac center name.
This website has no financial interest in any products or services mentioned here
NOTE: Evidence of the gluten syndrome can be hard to find. It hides very well often!
Some researchers believe no one test panel covers all possibilities. Gluten can break down into pieces for which there are no tests at this time. Patients who wish to "leave no known stone unturned" must be prepared to run several types of tests, methodically checking all markers, systems and mediums until they exhaust all known possibilities. There are several known toxic gluten fractions for which no tests are available at this time. Research on these markers.
Some researchers also believe that disturbances*** may block the markers for which these tests are looking. They also believe the body may be too exhausted to even properly process the proteins needed to make very many antibodies. Therefore, if a negatively tested patient still suspects a gluten related reaction, the patient is wise to seriously respect his body's message.
Panels on this page test for various combinations of the following known markers, in the following body systems, in the following mediums:
Gluten Syndrome Antibody Markers Body Immune Systems* Mediums
*Gliadin (a "piece" of gluten) AGA - Anti Gliadin Antibodies IgA, IgG, IgM, ALCAT Blood (serum), Stool, Saliva
8 more forms of gliadin antibodies are now available for testing by Cyrex Labs
Gluten (Whole gluten molecule - rarely tested - WHY NOT!!) IgA, IgG, IgM Blood
UPDATE: Gluten(in) now available by Cyrex Labs IgA, IgG Blood
Gluteomorphin (a toxic opiate like piece of improperly digested gluten) IgA, IgG, IgM, ALCAT Blood
UPDATE: Gluteomorphin antibody tests available by Cyrex Labs
tTG (tissue transglutaminase - elevation indicates gut damage) IgA, IgG, IgM, ALCAT Blood, Stool, Saliva
EMA (anti endomysial antibodies - replaced by tTG) IgA, IgG, Blood
Wheat (whole kernel, to test unknown factors) IgA, IgG Blood
UPDATE: Wheat and wheat germ antibody tests available by Cyrex Labs IgA, IgG Blood
Overall Intestinal Function (fat malabsorption) Molecule size, Stool
Genes - HLA DQ 2, 8 only - reported positive/negative Blood or cheek swab
OR your HLA DQ type is reported
Some researchers also recognize HLA DQ 1 and 3 and others.
Some believe genes are not needed in all cases, and blame toxins, stress and infections as underlying causes due to leaky gut or breached mucosal membranes. membranes)
Non Antibody markers
Urine tests for gluteomorphin peptides (not the antibodies to gluteomorphins, but the peptides/pieces of gluten themselves) are available from Genova Diagnostics (Urinary Polypeptides panel), and Great Plains Laboratories (Gluten and Casein Peptides)
Some blood test panels do not look for antibodies. Instead they react the blood with various substances (antigens), in this case gluten related antigens and look for changes in the white cells or specific white cells called lymphocytes that may indicate an immune response. These changes may be swelling, granulation, apoptosis, halos, etc. These tests are controversial. Some professionals believe they pick up foods the person eats frequently, not necessarily ones to which they have an immune response. Some patients believe the test help them identify problem foods.
* Most labs now run "deamidated gliadin" which is considered more likely to be positive if an immune response is present.
Cross reactive foods
Additionally, some labs test for known cross reactive foods and other potentially problematic substances, gluten grain substitutes/foods and organs/tissues most prone to gluten damage due to their similar protein structure. Cross reactive food include
Milk, (casomorphins, butyrophilins) - the peptides themselves and IgA, IgG, IgM antibodies
Egg - IgA, IgG, IgM
Corn - IgA, IgG, IgM,
Soy - IgA, IgG, IgM,
Barley, and Rye are considered gluten grains.
Spelt, Durum wheat, Polish wheat, Kamut, Fu, are forms of wheat.
Buckwheat, Sorghum, Amaranth, Tapioca, Potato, Rice, Hemp, are considered gluten free, but may also cross react in some people.
Oats are considered gluten free if produced in a gluten free environment and marked as such. Many folks react to GF oats.
Sometimes coffee, chocolate, and sesame may also cross react.
Note: Quinoa, buckwheat, millet, sorghum, and other non gluten grains are now suspected to be problematic for some patients**. It may be helpful to test gluten substitutes also. Some researchers believe that if the gut is still "leaky" (meaning it allows substances to cross the gut wall before they are sufficiently broken down), the body may become reactive to more substances including gluten substitutes.
Tissue damage tests and biopsies
Villi focused celiac specialists use villi and skin biopsies as gold standards to diagnose an immune reaction to gluten and only then to prescribe the gluten free diet.
Gluten syndrome specialists do NOT use the villi biopsy for gold standard gluten syndrome diagnosis but may utilize the endoscopy if there are other reasons to examine the gut. Often, since they are already there, they take a biopsy to check, but ignore a negative biopsy diagnostic since the villi may be healthy but other tissues in other places may be the targets of damage instead. To look for tissue damage in other places that are not easily biopsied, gluten syndrome specialists rely instead on organ/tissue function tests and soon predictive organ/tissue antibody tests to check for possible organ or tissue damage, coupled with gluten antibody tests. If the patient has gluten antibodies, a gluten free diet and other treatments are prescribed and the tissue antibodies are rechecked later for possible improvement.
Here are common tissue antibody tests that indicate organ damage is ongoing.
Brain and nervous system - Myelin basic protein (MBP), cerebellar tissue and neurofilaments - IgA, IgG, IgM
Thyroid - Thyroid peroxidase, Thyroglobulin - IgA, IgG, IgM
Pancreas - Glutamic Acid Decarboxylase - IgA, IgG, IgM
Stomach - Parietal cells (B 12 function) - IgA, IgG, IgM
Heat Shock Proteins
DPP IV - Digestive enzyme that breaks down gluten and milk
The "celiac only" perspective on genes
According to most researchers, gene tests are not proof that the immune system presently reacts. They do indicate a predisposition for gluten reaction. Celiac focused specialists recognize HLA DQ 2, and 8 for celiac predisposition. Other genes in other locations are under investigation.
The most complete gene tests are run in 2 parts.
Most celiac focused gene tests do not report the patient's actual HLA DQ genes. They only report positive or negative for HLA DQ 2 or 8. If they are positive some labs will provide the specific 2 or 8 gene subtype upon request. These tests can run from $400 - $500 and may be much higher if they are ordered through a hospital or celiac center.
The "gluten syndrome" perspective on genes
Dr. Ken Fine, MD, Enterolab, Dallas, Tx, recognizes HLA DQ 1, 2, 3, and 8 as gluten syndrome associated genes. He states that HLA DQ 4 is the only HLA gene that does not appear to be related to gluten reaction. According to Dr. Fine this translates to about 83% of the Caucasian population as gluten syndrome gene carriers. https://www.enterolab.com/StaticPages/Faq_Result_Interpretation.htm
Enterolab reports the actual HLA DQ genes the patient possesses, not just positive or negative for HLA DQ 2 or 8. Enterolab only runs a 1 part gene test , not the second part for certain few DQ 2 subtypes. Why? Here is an explanation. This gluten syndrome related gene test is $169.
Dr. Fine believes that if gluten is presented to the immune system, meaning if it slips, improperly digested, beyond a mucosal barrier such as the gut wall, the immune system will always react if a gluten syndrome gene is present.
Dr. Fine's work is highly respected for it's clinical accuracy, but to date is unpublished. (Jan, 2011)
Dr. Aristo Vojdani, Los Angeles, CA, does not believe a gene is necessary for immune response to gluten, but if it is present it does predispose. He believes TOXINS, in particular, (and stress and infections) are sufficient to trigger immune response without a gluten related gene. He considered HLA DQ 2 and 8 only when he came to this conclusion.
Additional factors and comments
The more markers tested in the most places in the body, in the most mediums, the higher the chance of finding evidence somewhere in the body of an adverse reaction to gluten. There is no guaranteed order of testing priority.
Patients who test extensively and become convinced that they are not gluten reactive may develop gluten reactivity in the future, often triggered by stressors, toxins, or infections. According to some researchers, genes are not needed but can predispose to adverse reaction.**
Some patients go gluten free simply because they believe gluten is not good for anyone due to changes in gluten grains and other health issues today. Without test confirmation, it is more difficult to establish and maintain a lifelong strict gluten free diet.
Some patients will not find confirmation with the incomplete tests available today.
FYI !! Seesawing on and off a gluten free diet may trigger painful and/or atypical reactions in some people, including neurological symptoms.
For a few patients, going gluten free may trigger a temporary withdrawal reaction, similar to a drug withdrawal, with a variety of symptoms.
The hypersensitive immune system
Some professionals believe the immune system may still be too hypersensitive (runs in "high gear") even on the gluten free diet. They believe it needs to be "shifted back into neutral" to avoid continued overreaction and autoimmune damage. Many doctors believe this may involve other lifestyle changes beside going gluten free. Many patients also choose to reduce or avoid toxins, sugars, grains in general, processed fats and food, electromagnetic radiations. They switch to more nutrient dense organic, pastured animal foods and sometimes some raw foods, and simplify their lives to avoid stress.
For a specific protocol to intended to calm down the immune system, see www.thedr.com
* IgA, IgG, IgM are different parts of the immune system
ALCAT tests the white blood cell reaction to various substances. It is not an antibody test.
ELISA ACT panels test the B cells within which the antibodies are made. This is not an antibody test.
** Dr. Aristo Vojdani PhD, MT, Immunosciences Laboratories, (researcher)
*** Dr. Dietrich Klinghardt, MD, PhD Disturbances may include emotions and body electric issues in some investigators opinions
Click to go directly to a specific lab
Immunosciences Laboratories - see Cyrex Labs
ALCAT Worldwide Cell Science Systems
www.alcat.com email: firstname.lastname@example.org
1239 East Newport Center Drive, Suite 101
Deerfield Beach, FL 33442
Phone: (800) US AL CAT (872-5228) (954) 426 - 2304 Fax: (954)428-8676
Chicago, University of - The University of Chicago Celiac Disease Program
Founder/Medical Director - Dr. Stefano Guandalini
Program Director - Carol McCarthy Shilson
5839 S. Maryland Avenue, MC 4069, Room C-491
Chicago, IL 60637
Phone - 773-702-7593 Website www.celiacdisease.net
This panel focuses on celiac villi damage only.
Celiac Disease Screener tTG-IgA (specific to villi damage) Gene test Additional options EMA -IgA, and/or Total IgA
This is a panel recommended by University of Chicago Celiac Disease Program. This is not a commercial lab.
Columbia, University of - Celiac Disease Center at Columbia University
Dr. Peter H. R. Green MD - Director
For general education and information contact Hal Winfield Phone 212-342-0251
Website - www.celiacdiseasecenter.columbia.edu
This is a short non comprehensive antibody panel.
Celiac Disease Panel Gene test Intestinal duodenal biopsy Skin Biopsy
This panel is recommended by the Columbia Celiac Disease Center. This is not a commercial lab
Can't get a doctor to listen or prescribe testing?
This lab provides direct testing services through local Patient Service Centers.
An on staff DLS physician provides the script.
These are not comprehensive panels.
Direct Lab Services offers 3 gluten related panels without a prescription from the patient's doctor.
A staff physician provides the script. The specimen is drawn at a local LabCorp location.
Celiac panels are found under the "testing" link in the alphabetical list
Celiac Disease Ab Profile Price: $192
Celiac Disease AB Comprehensive Profile Price: $220
Immuno Labs tests available through Direct Lab Services are found under the Tests > Specialty Labs > Immuno Labs link on the Direct Labs website
Immuno Labs AGA - IgA, IgG Price: $152 Includes Comprehensive Metabolic Profile*
Immuno Labs tTG - IgA Price: $149
A milk and egg antibody profile Price: $179 Includes Comprehensive Metabolic Profile*
* This is a free test that is offered when other tests are ordered. - Comprehensive Metabolic Profile -14 includes liver, kidney, glucose, and electrolytes. The CMP is a frequently ordered group of 14 laboratory tests that gives important information about the current status of your kidneys, liver and electrolyte and acid/base balance as well as your blood sugar and blood proteins. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed. Glucose (diabetes testing Kidney(renal panel) Liver panel (Hepatic) Electrolytes (*fasting required)
You must first order through DIRECT LABS and receive the necessary requisition prior to visiting a Patient Service Center (PSC). The PSC will not draw your blood without the DLS paperwork and/or you could get billed the much-higher "Patient Price" without it.
These are short non comprehensive antibody panels.
Enterolab - Director, Dr. Kenneth Fine
10875 Plano Rd. Suite 123, Dallas , Texas 75238
Phone 972 -686-6869
Website: www.enterolab.com Email: email@example.com
This is a home stool test.
This is not a comprehensive antibody panel.
However, due to it's high sensitivity for gliadin and tTG, and its' intestinal function test it finds antibodies much more often than typical celiac panels.
No dr. script required.
Gluten Sensitivity Panel (GS) $249 Gene test alone $149 Egg, Soy and Yeast test $199
Gluten Sensitivity Panel with Milk and Gene test $369 Colitis test $49 (GS Panel also recommended)
Test kits available at www.enterolab.com This is a home test. Results emailed to patient. Email support available.
This stool panel is part of ongoing announced but unpublished research, is claimed to be more sensitive than blood, and includes an intestinal function test.
Even though this test panel checks only 2 of many possible antibodies, it has a MUCH higher positivity rate than identical "celiac only" blood tests.
The sensitivity of this test is presumed to be due to earlier presence of antibodies in stool versus blood.
However, since only 2 of many possible gluten related antibodies are checked, a negative test result does not rule out the presence of other possible gluten related antibodies or necessarily indicate that the patient can safely consume gluten. In other words, a positive is conclusive of an immune reaction, a negative is inconclusive.
Intestinal villi biopsy is not recommended by this lab unless there are other reasons to examine the digestive tract and duodenum. These researchers believe damage may occur in many places in the body including but not limited to the villi, and this invalidates villi biopsy as a diagnostic gold standard.
This test is controversial, but patient and even overall professional confidence appears to have risen significantly over the past 8 years, despite lack of formal validation. Many many patients find the test results match their experience.
See www.enterolab.com for essays which explain this research project.
* The gene test is a 1 part test meaning it is not as detailed for a few patients for the HLA DQ 2 gene. See this page (bottom) for explanation.
The specific HLA DQ alleles of the patient are reported whether or not the patient possesses a gluten syndrome gene.
Genova Diagnostics (formerly Great Smokies Laboratories)
63 Zillicoa St.
Asheville, NC, 28801
Telephone: (800)522-4762 Fax: (828)252-9303
8 am - 6:30 pm EST, Monday - Friday,
This lab offers gluteomorphin and casomorphin testing in addition to tTG/gliadin antibodies.
Urinary Polypeptides panel - Gliadomorphins or Gliadorphins, (another term for gluteomorphins)
Support guide here
Celiac Profile - Tissue Transglutaminase IgA and IgG,
Adrenocortex Stress Profile
When IgA-tTG is positive, testing for IgA-Anti-endomysial Antibodies (IgA-EMA) is routinely performed.
Clinicians also have the
option of testing two additional analytes;
Dr. script required. See physician for pricing
The Great Plains Laboratory, Inc.
West 77th Street
Director: Dr. William Shaw Ph.D. Board certified Chemistry and Toxicology
Phone: 1-800-288-0383 Local: 1-913-341-8949 Fax: 1-913-341-6207
Informacion en Espanol: sfeliciano@GPL4U.com
Check website for customer service in other languages.
This lab offers gluteomorphin and casomorphin testing.
Gluten/Casein Peptides Test - Gliadomorphins or Gliadorphins, (another term for gluteomorphins)
Casomorphins (milk peptides similar to gluteomorphins)
Explanatory brochure here
Dr. script required.
Immco Diagnostics, Inc.
Vijay Kumar, PH.D. - President and CEO
60 Pineview Drive, Buffalo, NY 14228 USA
USA Phone: 800-537-8378 International phone: 716-691-0091 Fax: 716-691-0046
Website: www.immco.net email: firstname.lastname@example.org
This is a short, non comprehensive antibody panel.
Gluten Sensitive Enteropathy (Celiac Disease) Panel - $275 Gene test only - $350 Dr. script required
Cyrex Labs now offers comprehensive gluten syndrome testing
formerly performed by Immunosciences Laboratories.
Immunosciences Laboratories is currently a specialty retail and research lab.
Medical Director - Dr. Dhiren Joshipura, M.D.
Chief Scientific Advisor - Dr. Aristo Vojdani, Ph.D., M.Sc., C.L.S. of Immunosciences Laboratories
Clinical Advisor Functional Medicine - Dr. Thomas O’Bryan, D.C., C.C.N., D.A.C.B.N. www.thedr.com
Video clips of Dr. Vojdani
5040 N. 15th Ave. Suite 107
Phoenix, AZ, 85015
Phone: (602)-759-1245 Fax (602) 7597-8331
Research articles available at www.thedr.com
NEW! Gluten Sensitivity Screen Array 1 - Saliva Home Collection Test
Tests deamidated gliadin - IgA, IgM,
tTG - IgA, IgM
Price: $150.00 if ordered from www.thedr.com
Patients may order test with script here
Many patients start with the economical, and fairly sensitive saliva screener, Array 1, first. If the patient makes these particular antibodies, this test is claimed to have a 96% sensitivity to find them. This means out of 100 samples it will accurately pick up 96 of them if they are present in the sample.
If the saliva screener is negative, the patient has the option to order the more comprehensive antibody blood panel, array 3. Or they may order both panels to begin with to "cover the most possible bases" since the two tests check mostly different antibodies in different mediums.
NOTE: While the saliva test is quite sensitive for the antibodies it checks, it will be negative if patient has different gluten related antibodies besides the ones this saliva test checks. Furthermore, research indicates that tTG is not elevated in all cases of the gluten syndrome. Research shows that tTG is only consistently elevated in cases of severe tissue damage to intestinal villi damage. Note that elevated tTG does not appear in the gluten intolerance diagram on the Medical Diagrams page and The Immunology of Immediate and Delayed Hypersensitivity to Gluten article. Full text here
Antigenic Permeability Screen
Actomyosin - IgG,
The gluten antibodies in this recommended blood panel are the most
complete list offered for tests developed and available at this time.
IgM antibodies for these same peptides may be added at a later date.
IgM Antibodies may be necessary to check if "Activation Induced Cytidine Deaminase" (AID),
an enzyme, is not functioning properly.
(Note: the saliva screener, Array 1, below, checks 2 IgM antibodies.)
NEW! This array checks the following antibodies as shown in the chart above
Glutenin (Gluten) - IgA and IgG
Gluteomorphins - IgA and IgG
Alpha Gliadin 17 MER - IgA and IgG
Alpha Gliadin33 MER - IgA and IgG
Gamma Gliadin 15 MER - IgA and IgG
Omega Gliadin - IgA and IgG
Gliadin-Transglutaminase - IgA and IgG
tTG - Tissue Transglutaminase - IgA and IgG
Glutamic Acid Decarboxylase - IgA and IgG
Prodynorphin - IgA and IgG
Wheat - IgA and IgG
Wheat Germ Agglutinin - IgA and IgG
This panel checks: Foods that most often cross react with gluten
Food most often used as gluten free substitutes.
These are the most comprehensive Gluten Syndrome
and Cross Reactive/Substitute Foods Panels available
Coming: Predictive antibody tissue damage tests
to find targeted areas of autoimmune damage.
A gluten (or other food) containing diet is required for the any of the food antibody tests.
Dr. Script required.
See www.thedr.com if you do not have a practitioner to write the script and interpret the results.
1. Section of Immunology, Department of Pathology, Universtiy of Verona, Verona, Italy,
2. Section of Internal Medicine, Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
3. Section of Histology, Departmant of Experimental Medicine, University of Genova, Genova, Italy
4. Immunology Unit, Institute G. Gaslini, Genova, Italy,
5. Department of Pediatrics, University Hospital of Verona, Verona, Italy
101 University Blvd., Suite 350, Denver, CO 80206
Tel. (800)-320-1807 (303)-320-1807 Fax (303)-388-9220
Hours 8:30 AM - 5:00 PM M-F
This is a genetics lab that also offers a celiac gene test
and a short non comprehensive gluten antibody panel.
Celiac Disease DNA (gene) test - $395 (cash $355.50) Additional family members $316.00
Celiac Disease Antibody Panel Celiac Disease DNA and Antibody Panel
Reports positive/negative meaning "yes" or "no" for HLA DQ 2/8
Full HLA - DQ2/8 genotype (specific alleles) available upon request by patient's physician
Kimball Genetics counselors are very informative and helpful.
* Gene test is a 2 part test, meaning the alpha and beta portions are performed. This means it is more detailed for the HLA DQ 2 gene for a few patients.
This panel is unfinished
Maryland, University of - University of Maryland Center for Celiac Research
Medical Director: Dr. Alesio Fasano M.D. Co Medical Director: Carlo Catassi M.P.H.
Director: Pamela King Dietitian: Pamela Cureton
20 Penn Street, Room S303B, Baltimore, Maryland 21201
Celiac Appointment Line (410)-328-6749 (800)-492-5538
This is a short, non comprehensive antibody panel.
Celiac Disease Panel Gene test Intestinal duodenal biopsy Skin Biopsy
This is a "villi damaged celiac disease" panel, recommended by University of Maryland Center for Celiac Research. This is not a commercial lab.
National Digestive Diseases Information Clearinghouse
2 Information Way, Bethesda, Maryland, 20892-3570
Tel: (800) 891-5389 Fax: (703) 738-4929
This panel focuses on villi (celiac) damage only.
Celiac Disease Panel Gene test Intestinal duodenal biopsy Skin Biopsy
This is a panel recommended specifically for "villi damaged celiac disease" by NDDIC. NDDIC is not a lab.
The NDDIC website does not address the genetics of gluten reactivity. The NDDIC is a service of
the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is a part of the National
Institutes of Health (NIH) under the U. S. Department of Health and Human Services.
Optimum Health Resource Laboratories (formerly York Nutritional Laboratories)
2900 North 29th Avenue, Suite #205, Hollywood, Fla, 33020 USA
Toll free Tel: (888) 751-3388 Local (954) 920-3728 Fax: (954) 920-3729
This lab offers tests for gliadin, wheat AND gluten. Most labs do not check gluten.
Optimum Research Lab tests all four IgG subsets - IgG-1, IgG-2, IgG-3, IgG-4
Validation related research is posted on the website. No dr. script required. These are finger stick home tests. Results shipped to patients with
guidebook and 1 year of unlimited telephone and email support.
9410 Carroll Park Drive, San Diego, CA 92121
Tel: (888) 423-5227 (858) 824-0895 Fax: (858) 824-0896
This is a short, non comprehensive antibody panel.
Celiac Disease Panel $290 tTG-IgA Screener only - $45 PRO-Genologix Celiac Genetics* testing $509
Individual tests available as follows: AGA - IgA or IgG $35 Total IgA $25.00 EMA $150
Dr. script required. Will send transport kit to doctor or patient, no doctor account required.
35% discount for
cash (30 day) payment. Results sent to doctor.
* Gene test is a 2 part test, meaning the alpha and beta portions are both run. This gives more detail regarding the HLA DQ 2 gene.
If the test is positive for HLA DQ 2 or 8 it reports the specific alleles. If negative for HLA DQ 2 or 8 it reports "yes" or "no" .
Disclaimer Text Ó2006 - Gluten Sensitivity