The Nutrigenomix 45 Gene Test (see Sample Report for 45 Gene Test) includes the latest genetic test for gluten intolerance. This test indicates a person’s risk for gluten intolerance. The test covers six variation of a gene region on a common white blood cell; HLA for short.
Variations in the HLA genes are the gold standard used to classify an individual’s risk for gluten intolerance.
Depending on the specific combination of the six variations of the gene, individuals can be classified as low, medium, or high risk for celiac disease.
While the research is young, recent studies indicate that this risk classification can also apply to non-celiac gluten sensitivity.
What is Celiac Disease?
Celiac disease is a disease in which gluten, a protein found in grains such as wheat, barley and rye triggers inflammation of the gastrointestinal tract. The immune system attacks specialized structures in the small intestine called villi which are responsible for the absorption of many nutrients. When the villi are destroyed and the gut lining is inflamed, individuals are unable to adequately absorb nutrients effectively.
It’s estimated that 1 in every 80 to 100 people [1% of the population] of European ancestry have celiac disease. What’s worse, 83-90% remain undiagnosed. The likelihood of having celiac increases to 10% if a person has a first-degree relative [mother, father or sibling] with celiac.
Classic gastrointestinal symptoms include
- steatorrhea (fat malabsorption; stools can be foamy and float, oily residue in toilet bowl]
- bloating & gas
- weight loss
- abdominal pain
Non-gut symptoms include:
- joint pain
- abnormal liver function test
- bone disease
- iron and/or B12 deficiency anemia
- skin disorders [eczema, psoriasis, dermatitis herpetiformis]
Some with celiac disease may not have any of the classic symptoms at all; this may explain why those who are at a greater risk of having celiac include those with type 1 diabetes, Down syndrome, thyroid disease, osteoporosis, infertility, depression, and certain cancers. The connection between gluten intolerance and other chronic diseases are not intuitive because classic symptoms are absent.
For celiac disease is adherence to a strict gluten-free diet for life to allow the digestive tract to heal and to prevent further damage. Intestinal villi heal within 6 to 24 months on a gluten-free diet. Lactose intolerance is typically present as well so lactose avoidance is often recommended and/or a dairy free diet.
What is non-celiac gluten sensitivity (NCGS)?
Once relegated to the fringe, NCGS is now being supported by studies. NCGS, which affects an estimated 5% of the population, is defined as adverse reactions to gluten when both celiac disease & wheat allergy have been ruled out. NCGS does not result in damage to the small intestine so nutrient malabsorption doesn’t happen.
There is overlap between irritable bowel syndrome (IBS) and NCGS and recent research and here, here suggests that besides gluten, natural compounds in wheat, which offer resistance against pests, (wheat amylase trypsin inhibitors) can over-activate the immune system leading to many of the symptoms described despite testing negative for gluten intolerance. A recent study suggests that it might not be gluten at all but rather certain types of carbohydrate that are difficult to digest (FODMAPS); that once subjects were put on a low FODMAP diet and give purified gluten, NCGS symptoms didn’t occur so the researchers concluded any complaints have nothing to do with gluten, or worse, imagined by the patient.
It may be that gluten is a marker for hundreds of other proteins found in grains like wheat, barley and rye which are problematic, the above study provided purified gluten but people don’t eat that, they eat foods, in this case whole intact grains, milled grains and grain products. Non-celiac gluten sensitivity may need to be renamed to ‘non celiac wheat [barley, rye or grain] sensitivity‘ since even those who tested negative for celiac can be symptomatic when grains and grain products are eaten.
Nevertheless, a proposed NCGS diagnosis is one of exclusion criteria: it is diagnosed in cases of gluten reaction where both an allergic and autoimmune (villi damage) reaction have been ruled out.
Treatment for NCGS includes some degree of gluten avoidance however it’s not known at this time if a gluten-free diet needs to be followed for life or if a partial or near complete avoidance of gluten is OK, i.e. 30%, 50% or 80% gluten reduction etc? Lactose intolerance may be present; lactose avoidance will need to be assessed.
Consequences of undiagnosed & untreated celiac disease
A number of complications result from undiagnosed celiac disease…
- nutrient deficiencies [iron, calcium, folate, B12, zinc, iodine, magnesium etc]
- gastrointestinal symptoms [bloating, gas, cramps, diarrhea]
- infertility, miscarriages, intrauterine growth restriction
- higher risk for osteoporosis, hypothyroid disease
- certain cancers
- increased overall mortality
- skin issues like eczema, psoriasis, dermatitis herpetiformis
- possible aggravation of existing autoimmune diseases like lupus, arthritis, Sjogren’s
- early mortality
The Nutrigenomix 45 Gene Test by Nutrigenomix is an easy, non-invasion test that use a saliva sample to test for the HLA gene variation. Clients that test ‘Medium Risk’ or ‘High Risk’ should speak to their physician about celiac serological testing (gluten antibodies in the blood) if they have symptoms of celiac disease or have an affected family member.