Entero Lab -- Review

Okay, this isn't a product review, it's a service review, but still the word needs to be spread about them.  Entero Lab offers tests for gluten, casein, egg, yeast and soy sensitivities, along with gene panel testing for gluten sensivity genes.  They test for antibodies in your stool, and since these antibodies are produced in the intestines, this test is more sensitive.  Also, because of this testing method, these foods (gluten, casein, etc.) do not need to be in your diet at the time of testing.  The antibodies remain present in your digestive system a lot longer than in your blood...so, you can be gluten-free and still be tested.

I ordered the Gluten Sensitivitiy Stool and Gene Panel Complete test for both of my boys.  Panel includes test for anti-gliadin IgA, anti-glutaminase IgA, fat malabsorption, anti-casein IgA, and also a swab to run a gene panel looking for gluten sensitivity alleles.  It takes three weeks from the time they receive the specimens to get the results, but it is worth the wait.

Both of my boys had the blood test to test anti-glutaminase IgA levels and both came back with normal levels...but I had a gut feeling that neither one was okay, so we did this test and it confirmed my suspicions.  I have their results below, so you can see how the results come back, basically my older son is gluten intolerant and my little one is both gluten and casein intolerant and is also producing anti-glutaminase IgA, which means it is autoimmune (so, probably Celiac).

The gene analysis showed that both boys carry an allele that predisposes them to celiac (HLA-DQB1*0302) and another allele that isn't a celiac one, but predisposes you to gluten sensitivity (HLA-DQB1*0603).  That means that both my husband and I have at least one gluten sensitivity allele, and at least one of us is carrying the gene for Celiac.

So, before we get to the results, here is an explanation of terms, so it's easier to understand what makes someone intolerant or sensitive to gluten or casien:

1) Gluten is actually general term for a group of proteins found in wheat, barley, and rye.  Each grain has a unique but very similar gluten, so each has its own name, but if you are intolerant to one, you are intolerant to them all.  Gliadin is the gluten protein found in wheat...

2) Anti-gliadin IgA is an antibody made by the body to attack gliadin (the gluten protein found in wheat), so if these levels are elevated that basically means you're body doesn't like gluten and thinks it's a harmful foreign substance and is treating it as such.

3) Tissue transgluminase (tTg) is an enzyme produced by the body to help in breaking down proteins, its functions are mainly to convert glutamine into glutamic acid and to also crosslink proteins (meaning create bonds between two proteins) so they don't degrade before the body breaks it down.  The problem with that is that the tTg is staying between these bonds and if someone already has a sensitivity to gluten...meaning they have the anti-gliadin IgG attacking the molecule, they could also start attacking the enzyme, thinking it's another foreign material leading to:

4) Anti-tissue transgluminase IgA which is an antibody made by the body to attack the tTg enzyme.  This is the autoimmune disease, your body is attacking itself because of it's gluten sensitivity and how the enzyme is situated in doing its job.  This antibody is the one tested when doctors test for Celiac.

5) Casein is a protein in milk and has a similar structure to gluten, about 50% of people who have a gluten intolerance also have a casein intolerance.

6) Anti-Casein IgA is, of course, the antibody produced by the body to attack casein because the body thinks it is a harmful foreign substance.

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value
Fecal Anti-gliadin IgA    10 Units   (Normal Range is less than 10 Units)

Fecal Anti-tissue Transglutaminase IgA    4 Units   (Normal Range is less than 10 Units)

Quantitative Microscopic Fecal Fat Score    Less than 300 Units   (Normal Range is less than 300 Units)

Fecal Anti-casein (cow’s milk) IgA    5 Units   (Normal Range is less than 10 Units)

HLA-DQB1 Molecular analysis, Allele 1    0302

HLA-DQB1 Molecular analysis, Allele 2    0603

Serologic equivalent: HLA-DQ   3,1  (Subtype 8,6)Interpretation of Fecal Anti-gliadin IgA:  Intestinal antigliadin IgA antibody was elevated, indicating that you have active dietary gluten sensitivity. For optimal health, resolution of symptoms (if you have them), and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.Interpretation of Fecal Anti-tissue Transglutaminase IgA:  The level of intestinal IgA antibodies to the human enzyme tissue transglutaminase was below the upper limit of normal, and hence, there is no evidence of a gluten-induced autoimmune reaction.Interpretation of Quantitative Microscopic Fecal Fat Score:  Provided that dietary fat is being ingested, a fecal fat score less than 300 indicates there is no malabsorbed dietary fat in stool indicating that digestion and absorption of nutrients is currently normal.Interpretation of Fecal Anti-casein (cow’s milk) IgA:  Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic “sensitivity” to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.Interpretation Of HLA-DQ Testing:  HLA-DQB1 gene analysis reveals that you have one of the main genes that predisposes to gluten sensitivity and celiac sprue, HLA-DQB1*0201 or HLA-DQB1*0302. Each of your offspring has a 50% chance of receiving this gene from you, and at least one of your parents passed it to you. You also have a non-celiac gene predisposing to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having one celiac gene and one gluten sensitive gene, means that each of your parents, and all of your children (if you have them) will possess at least one copy of a gluten sensitive gene. Having two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity or celiac disease may be more severe. This test was developed and its performance characteristics determined by the American Red Cross - Northeast Division. It has not been cleared or approved by the U.S. Food and Drug Administration.

For more information about result interpretation, please see http://www.enterolab.com/StaticPages/FaqResult.aspx Stool Analysis performed by: Frederick Ogunji, Ph.D., EnteroLabMolecular Gene Analysis performed by: American Red CrossInterpretation of all results by: Kenneth D. Fine, M.D., EnteroLab

And for my little one:

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value
Fecal Anti-gliadin IgA    95 Units   (Normal Range is less than 10 Units)

Fecal Anti-tissue Transglutaminase IgA    57 Units   (Normal Range is less than 10 Units)

Quantitative Microscopic Fecal Fat Score    Less than 300 Units   (Normal Range is less than 300 Units)

Fecal Anti-casein (cow’s milk) IgA    28 Units   (Normal Range is less than 10 Units)

HLA-DQB1 Molecular analysis, Allele 1    0302

HLA-DQB1 Molecular analysis, Allele 2    0603

Serologic equivalent: HLA-DQ   3,1  (Subtype 8,6)Interpretation of Fecal Anti-gliadin IgA:  Intestinal antigliadin IgA antibody was elevated, indicating that you have active dietary gluten sensitivity. For optimal health, resolution of symptoms (if you have them), and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.Interpretation of Fecal Anti-tissue Transglutaminase IgA:  You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.Interpretation of Quantitative Microscopic Fecal Fat Score:  Provided that dietary fat is being ingested, a fecal fat score less than 300 indicates there is no malabsorbed dietary fat in stool indicating that digestion and absorption of nutrients is currently normal.Interpretation of Fecal Anti-casein (cow’s milk) IgA:  Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic “sensitivity” to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.Interpretation Of HLA-DQ Testing:  HLA-DQB1 gene analysis reveals that you have one of the main genes that predisposes to gluten sensitivity and celiac sprue, HLA-DQB1*0201 or HLA-DQB1*0302. Each of your offspring has a 50% chance of receiving this gene from you, and at least one of your parents passed it to you. You also have a non-celiac gene predisposing to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having one celiac gene and one gluten sensitive gene, means that each of your parents, and all of your children (if you have them) will possess at least one copy of a gluten sensitive gene. Having two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity or celiac disease may be more severe. This test was developed and its performance characteristics determined by the American Red Cross - Northeast Division. It has not been cleared or approved by the U.S. Food and Drug Administration.

For more information about result interpretation, please see http://www.enterolab.com/StaticPages/FaqResult.aspx Stool Analysis performed by: Frederick Ogunji, Ph.D., EnteroLabMolecular Gene Analysis performed by: American Red CrossInterpretation of all results by: Kenneth D. Fine, M.D., EnteroLab