This is a case. So a 69-year-old male, history of bad temper, uncontrolled temper, poor socialization, mood swings, yo-yo dieting. He snores, mild sleep apnea, carbohydrate cravings, currently doing about an 80/20 primal diet. Other 20 percent is conventional Standard American Diet food, including gluten. There were yellow, so antibodies in the equivocal range for gluteomorphin IgG. Cyrex also showed red for tissue transglutaminase-2, gliadin, gliadin transglutaminase complex, omega gliadin, alpha-gliadin, and native and deamidated gliadin. Highly suspicious for celiac. Should they get conventional celiac blood work and endoscopy? What if conventional testing shows negative? He also had significantly elevated or out of range antibodies to all dairy in the Cyrex. The Genova organic acids suggested folate, biotin, and amino acid deficiencies. My case also had yellow to all meat on Cyrex.

Dr. Amy Nett:  If there is any question as to whether or not he’s going to continue eating wheat, then absolutely because he needs to understand this is going to have a very serious impact on his health.

So 69 already and I don’t know what his gut symptoms are, but that’s interesting. So if you can communicate the seriousness of these findings and he says, oh, wow, I’m never going to touch wheat or gluten again, then probably not. If he’s like, whatever, these antibodies are high, I feel fine, then absolutely I would suggest you just go to a conventional gastroenterologist, do the additional testing for celiac, and have a more firm diagnosis and hopefully then he’ll take that gluten sensitivity a little bit more seriously.

Yeah then we’ve lost a little bit of ground. But then you just have to explain, “Look, this is non-celiac gluten sensitivity, which is also very, very serious.” But no, I agree, kind of a mixed bag. It could help support your case, it might backfire a little bit.

Okay, so yeah, so he should also be dairy free and then the urine organic acids test, remember that’s not the most reliable test. So I don’t normally use, I don’t play whack-a-mole with those markers. So if it suggested low folate, then I might look at the CBC homocysteine, consider functional methylation testing. And then the biotin and amino acid deficiencies, on the Genova Organix, honestly, I haven’t found those markers for “amino acid deficiency” super-reliable. So I would probably let those go unless he’s really not getting a lot of protein .

Okay, so that’s the Cyrex Array 10, and the reliability of that is a little bit tricky. So what I would do is explain to him that his immune system is probably thrown pretty far off balance if 20 percent of his diet still includes wheat gluten. And wheat gluten is triggering his immune system to that extent. So what I would probably say is try to improve the diet whether or not you do the testing for celiac. Bring the immune system into better balance and then use the testing as a guideline for a reintroduction. Because it’s unlikely that all meat is going to trigger an immune response. So what I would do is bring the immune system into better balance then you could either repeat the test or just do a very careful reintroduction. When foods are in that equivocal range, oh, and seafood was pretty much all green. Okay, so that’s good. Seafood is pretty nutrient dense anyway. But yeah, try a careful reintroduction of meat to see what can actually be tolerated.