Celiac Disease is a serious condition affecting about 1 in 100 people worldwide, but with proper management and care, its impact on your lifespan and well-being can be greatly mitigated. Don't let the statistics concern you too much - they simply remind us to remain diligent in managing this disease.

You might find it interesting to learn that despite following a gluten-free diet, about 70% of individuals with Celiac Disease might still have unintentional exposure to gluten. That's not a cause for alarm - it merely highlights the hidden sources of gluten we might not be aware of in our daily lives.

This is where regular testing can be an ally. Think of it as a tool for empowering you in managing your Celiac Disease. Functional labs are excellent at providing these regular health snapshots, and they can help ensure you're on the right path with your gluten-free diet. These tests can highlight any accidental gluten intake, enabling you to adjust and improve your diet where needed.

So, while Celiac Disease does need to be taken seriously, remember that with careful monitoring and diet adjustments, it can be managed very effectively. Regular testing isn't a cause for concern but rather a powerful tool in your health management toolkit.

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What is Celiac Disease?

Celiac disease is an autoimmune condition where people with this condition cannot eat gluten. If gluten is consumed, the body's immune system will start attacking the gluten and, as a result, will damage the villi of the intestines in the process. This damage can lead to absorption issues and malnourishment. Some common symptoms include diarrhea, fatigue, headaches, and skin rashes. Some causes and triggers include gluten or gliadin proteins from various grains that activate an autoimmune reaction, HLA-DQ2, HLA-DQ8, non-HLA gene variants, zonulin, and other environmental factors.

How Can Celiac Disease Affect Patients' Quality of Life?

Celiac disease has life-long implications which can significantly impact the patient's quality of life. When newly diagnosed, patients will have to be gluten-free for life to prevent symptoms and decrease the risk of further damage to their intestines. Many people with Celiac risk unintentional exposure to gluten when they dine out or purchase processed foods, as there are many unknown and hidden sources of gluten. Even with effective management of this condition through a gluten-free diet, unknowingly consuming it can lead to fatigue, malabsorption, digestive issues such as cramping and diarrhea, neurological problems, and continued damage to the digestive tract. 

Sometimes, a psychologist referral may be made for coping mechanisms as managing this condition can be difficult for Celiac patients. Another consideration that can impact patients' lives and disease progression is that not everyone may present with digestive symptoms. However, even small amounts consumed can lead to intestinal damage stressing the importance of regular testing. It is important to note that although there may be an adjustment period that can impact a person's life after diagnosis, once the adjustments are made along with proper treatment and management, people with Celiac can still have thriving lives.

Importance Of Regular Laboratory Testing For Patients With Celiac Disease

Regular laboratory testing is essential for patients with Celiac to manage this condition effectively. Consistent testing can reduce the risk of damaging their villi, and nutrient deficiencies, assess autoimmunity reactions, and improve symptom management. Celiac can damage the villi in the small intestine, which are responsible for nutrient absorption causing nutrient deficiencies. Some of the most common vitamins shown to be deficient in Celiac patients include iron, folic acid, zinc, and vitamins B6, B12, and D leading to neurological issues, bone alterations, and other health complications. 

When needed, a follow-up biopsy may be done or an endoscopy to assess damage to the villi with worsening symptoms following disease management with a gluten-free diet. However, if the symptoms are controlled, bi-annual testing can help patients assess their autoimmune response, screen deficiencies, exposure to gluten or gliadin, intestinal healing, and if they are getting healthier. Patients with Celiac can use these tests as guides as part of their lifelong management of this condition.

Top Labs to Run Bi-Annually On Your Patients Experiencing Celiac Disease

The gold standard for diagnosing Celiac duodenum biopsy. However, after a diagnosis has been established, functional labs can be helpful in comprehensive care for Celiac patients. Here are some commonly used functional medicine labs that are used to assess, monitor, and adjust treatment protocols on a bi-annual basis for Celiac Disease:

Celiac Panel

The Celiac panel is a blood test that provides an analysis to identify untreated celiac disease, and it also monitors gluten consumption, whether intentional or unintentional. This panel measures antibody serum tissue transglutaminase (tTG) IgA & IgG levels to screen for celiac disease and IgA and IgG antibodies specific for deamidated gliadin peptide (DGP) that screens for adherence to the gluten-free diet. Regularly measuring these levels can help patients assess if antibody reactions are improving and if treatment protocols need to be adjusted.

Celiac & Nutrition

This lab test is an excellent overall panel for assessing Celiac disease progression through a blood sample. The Celiac and nutrition panel measures markers associated with Celiac, including Anti-tTG IgA, Anti-DGP IgA, Anti-Gliadin IgG, and the genetic markers HLA-DQ2 and HLA-DQ8. Keep in mind that positive genetic markers are not a diagnosis and do not mean that you will get Celiac - you are just at a higher risk. However, the antibody levels are associated with Celiac. This panel also assesses the most common nutrient deficiencies associated with Celiac such as Vitamins B12, D, and iron. It also shows reactions to gluten, making this test highly considered for bi-annual testing.

Micronutrient Panel

This comprehensive nutritional panel assesses extracellular and intracellular levels of vitamins, antioxidants, fatty acids, and amino acids. This test is completed through a blood sample. It can provide nutritional insights as to which nutrients may be insufficient, as many nutrients such as iron, folate, vitamin B12, and D are often contributed to Celiac disease leading to various health issues. This test can be completed regularly to provide patients with the nutritional requirements to improve their overall health.

Food Sensitivity Panel

Suppose a patient with Celiac is suspected of having intestinal permeability. In that case, a food sensitivity panel may be appropriate to test regularly due to the cross-reactivity of gluten with other foods leading to more symptoms. Intestinal permeability has been indicated in food sensitivities and cross-reactivity. This blood test can assess the various foods that may cross-react to gluten, providing patients with a helpful analysis in creating personalized nutrition plans specific to these results.

Gut Zoomer

Evidence shows that microbiome dysfunctions occur in people with Celiac disease. The health of the microbiome can also determine which symptoms patients will have, resulting in varying symptoms between individuals. Symptoms have also been shown to persist in Celiac patients even though they are following a gluten-free diet if they don't have a diverse and healthy microbiome. This stool test provides a comprehensive look into the diversity and health of the microbiome, which can help address Celiac symptoms. Our microbiomes are constantly changing. Therefore, this test should be completed regularly for Celiac patients with persistent symptoms.

Zonulin

Zonulin is the only known modulator of tight junctions in the gut lining. It regulates the intestinal barrier via the tight junctions indicated in intestinal permeability when triggered. This protein is associated with chronic inflammation and contributes to autoimmune conditions such as Celiac Disease. Monitoring levels of zonulin through this stool test can help assess the health of the intestinal lining, thus providing practitioners with valuable insights into treatments to address the associated symptoms.

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Summary

Managing Celiac disease is a life-long process and can involve a team of practitioners, potentially including a psychologist and family support. According to the ACG (American College of Gastroenterology) guidelines, consistent care and regular testing are needed for Celiac patients for improved outcomes. However, one out of four patients does not have regular follow-up visits and tests, increasing their risk for further health complications. Damage to the intestines can still occur even without signs or symptoms in patients with Celiac. Therefore, it is imperative for these patients to work with a qualified professional and complete regular testing. Functional medicine providers can offer comprehensive approaches that include functional labs for continued care and management of Celiac disease.