25: Why Your Gut Reacts to Gluten—3 Celiac Disease Myths

Could your bloating, constipation, fatigue, or stubbornly low iron be a clue to celiac disease—even if you’ve never had diarrhea? And if you’ve already gone gluten-free, can you trust a negative celiac blood test?

In this episode of Team Gut Girls, Dr. Whitney Baxter, ND and Dr. Dominique Vanier, ND unpack three common celiac disease myths that can delay diagnosis and make gluten-free living more confusing than it needs to be.

We explore why what you eat before testing matters, why celiac symptoms can extend well beyond the bathroom, and where gluten cross-contact deserves your attention. Shared toasters and crumb-filled peanut butter jars? Let’s talk. Your shampoo? A different conversation.

In this episode, you’ll learn:

• Why going gluten-free before testing can lead to a false-negative result
• How celiac disease can show up as constipation, bloating, fatigue, iron deficiency, or symptoms outside the gut
• What tTG-IgA and total IgA blood tests measure—and where an intestinal biopsy fits in
• What to discuss with your healthcare provider if you’re already gluten-free
• How family history and other autoimmune conditions can influence screening decisions
• Which kitchen habits help reduce gluten cross-contact
• Why ongoing symptoms after going gluten-free deserve another look

You’ll also leave with practical questions to bring to your next appointment, so you can move from “Could gluten be the problem?” toward a clearer plan.

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Resources

Celiac Canada: https://www.celiac.ca
More episodes and transcripts: https://www.teamgutgirls.com

If this episode helped connect a few dots, follow or subscribe to Team Gut Girls and share it with someone navigating unexplained gut symptoms. Because better gut health changes everything.

This podcast is for educational purposes only and does not replace individualized medical advice. Speak with your healthcare provider before changing your diet or starting a gluten challenge. If celiac disease is suspected, discuss testing before removing gluten.

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Transcript: Episode 25: Why Your Gut Reacts to Gluten—3 Celiac Disease Myths

Celiac Myths Intro

Why Your Gut Reacts to Gluten

Dr. Dominique Vanier, ND: Welcome back to another episode of Team Gut Girls. Today, we’re talking all about celiac disease, but not the version that you’ve heard probably 100 times. So we’re gonna bust three myths that we see trip up patients and clinicians constantly. And just for those that are not aware what celiac disease, it’s an autoimmune disease where the body attacks certain parts of the small intestine that typically, but not always, results in things like diarrhea, iron deficiency, nutritional deficiencies, and somebody feeling like crap.

So let’s talk about some stats. There’s about a hu- 1 in 100 Canadians will be diagnosed with celiac disease, so the prevalence is about 1%, and Celiac Canada estimates roughly 85% of them don’t even know it yet. The average Canadian waits six to 10 years. Six to 10 years from first symptoms to a [00:02:00] diagnosis.

and often they’re told that it’s all in their head. So, you know, the background information’s important when it comes to celiac because a lot of the time it’s genetic, so almost everyone with celiac carries a gene called HLA-DQ2 or another gene DQ8, but so do about 30% of the North American population, and only 4% of gene care- carriers ever develop celiac disease.

Dr. Whitney Baxter, ND: So we’re gonna bust three main myths today, like Dominique mentioned, so let’s dive into those right now. So myth number one is can I get the celiac blood test whenever? I’ll just book it. Turns out the timing and what you’ve been eating counts, so we’ll talk about that. Myth number two is celiac means diarrhea and weight loss.

This is typically what we think about when we think of an autoimmune disease of the gut. We’re seeing more other symptoms actually, like [00:03:00] constipation, bloating. It can be more vague, non-gut symptoms that aren’t the textbook picture that we’ve been taught Myth number three. Any trace of gluten, even in shampoo, toothpaste, a shared sponge, will set me off.

People will say they’ve gotten glutened. We’ll give you the actual numbers on how much gluten matters and where it really hides.

Dr. Dominique Vanier, ND: Mm-hmm. Mm-hmm. I’m excited to talk about each of those.

Why Diagnosis Matters

Dr. Dominique Vanier, ND: and I want us to keep asking the same question we ask about every test, as we’ve talked about in previous episodes.

Does this result change what we do next? So if I get my blood results back and they are positive, will it change the treatment plan? And for celiac, the answer is absolutely. So a confirmed diagnosis means lifelong gluten-free, but, no cross-contamination gluten-free. So we’re not talking about, going to a restaurant and saying, you know, “I’d like it to be gluten-free,” but it’s cooked on the same surface ’cause there’s a [00:04:00] high level of cross-contamination there.

You know, this also means family screening. You know, we have to talk about, do other family members have celiac as well and they don’t know it? And certainly monitoring for bone health and other autoimmune conditions because those with celiac are at a higher risk of other autoimmune conditions, including microscopic colitis and, Hashimoto’s hypothyroidism.

So we wanna get the diagnosis right the first time. All right. Let’s dive in. Whitney, take, take it away

Myth One: Testing Timing

Dr. Whitney Baxter, ND: So speaking of getting the diagnosis right, a lot of us, or a lot of people, you know, they’ve been avoiding gluten for a really long time, and they’re feeling a lot better, and they want to find out if they have celiac disease.

So they’re wondering, okay, I’ve been gluten-free for months. Can I just go do the test? This is probably the most test- common testing mistake we see, or we see patients in practice and we’re asking, “Have you been screened for celiac disease?” And they said yes. Oftentimes people kind of check that off and continue on, [00:05:00] but we really need to be clear on what they were doing prior to that test because the blood test is measuring antibodies in your immune system, which is responding to gluten.

So if there’s been no gluten for a long period of time, there’s no antibodies out and about. Still means you could have this condition. So when someone goes totally gluten-free, the tTG-IgA antibody falls, and the gut lining starts to heal, which is great. This is what we want. So this test can come back normal even in someone who has true celiac disease.

This is called a false negative. So we don’t wanna miss this. We wanna see a true test. Unfortunately, it means eating something that causes pain and more damage in the process. it’s kind of the least invasive test that we have. But think about it like this. It’s like testing for a pollen allergy in January.

So you’re not having those hay fever symptoms. There’s no pollen out and about. The trigger [00:06:00] isn’t there, so your body isn’t reacting.

Dr. Dominique Vanier, ND: Mm-hmm. Yeah, that’s a good analogy. I will say I have this conversation probably, weekly, right? I’ve, I’ve met patients where at some point along the way, you know, they’ve cut out gluten ’cause they didn’t feel good with it.

It maybe changed their bowels. It may cause bloating. Maybe they just felt really tired when they ate it. but they never got the celiac test, and so now we’re talking about, well, we still have some level of bloating. we need to go back to really put this to bed. Do, do we have celiac?

Gluten Challenge Guide

Dr. Dominique Vanier, ND: and so that conversation, then leads to, like, how much food or how much wheat should I be eating if I’ve cut it out in order to get, a true positive or true negative when we do the testing?

And so Celiac Canada actually, actually has great guidelines on this for somebody who’s already gluten-free, and they call it the gluten challenge. And so what that means is if we are wanting to test, and get an accurate test result, the person needs to eat about six to [00:07:00] 10 grams of gluten a day, so that’s roughly two slices of wheat bread, not gluten-free bread, wheat bread, for six to eight weeks.

And then whenever I have this conversation, people’s eyes light up out of fear, right? Because they know that they’re not gonna feel well. So certainly if somebody’s contemplating going gluten-free, get the test first and then make that decision after. ’cause we can have non-celiac gluten sensitivity.

That’s a thing, but it’s really important to know why somebody is sensitive to gluten. and so with that, then the person gets the TTG-IgA and total IgA test. That’s typically the first line, and that’s a blood test like Dr. Whitney mentioned. And then sometimes people will go even further and get that genetic testing done.

you know, that is, in, in somebody’s family doctor’s scope. and then especially if somebody gets their test results back positive, for the TTG that we discussed, is that gene testing may be opened up to, to other family [00:08:00] members. Okay.

Myth Two Beyond Diarrhea

Dr. Dominique Vanier, ND: Let’s talk about myth number two. This one is really interesting and also does extend to the presentation in children.

And the myth is, I can’t have celiac because I’m constipated and I’m not running to the bathroom having diarrhea or loose bowels. And I will say this one is changing fast, and the data is pretty clear on this. So I wanna reference a study here. There was a 15-year study of 770 adults diagnosed, at a referral center in Italy, and they found diarrhea in only 27% of patients.

Constipation showed up in 13%, so less, but definitely not inconsequential. And then they found alternating bowel habits, which is jumping back between diarrhea and constipation, in 15% of the study participants. Bloating was pretty high in 20%, and even patients, had reflux sometimes, in, 12% of the study participants.

[00:09:00] So, what… let’s talk about this, right? ‘Cause when patients are coming to you in practice, are you seeing presentations like bloating, kinda like that, that off-typical presentation?

Dr. Whitney Baxter, ND: Yeah. So we, we do a lot of iron infusions in our clinic, and we’re always screening for iron. And if someone… We’ve talked about this in other ep- uh, podcast episodes, but if someone has really low iron, so it’s kind of a clue, like low nutrient absorption.

Dr. Dominique Vanier, ND: Yeah.

Dr. Whitney Baxter, ND: What’s going on here? Even though their gut’s digestion seems normal to them. No one’s really asked about their digestion. That’s not why they’re coming in. So it’s something that we always think about and screen for.

Dr. Dominique Vanier, ND: Mm-hmm. Mm-hmm. Yeah.

Real World Cases Kids

Dr. Dominique Vanier, ND: I, I… This, this makes me think of an interesting case that I had with a patient where she was diagnosed with IBS, and the presentation was bloating, loose bowels, fatigue, early menopause, which was interesting.

Mm-hmm. May have been related, may not. wasn’t tested for celiac. Antibodies were sky high. Had the endoscopy ’cause it did, it confirmed on the histology that she had celiac. [00:10:00] Started to improve with a gluten-free diet, but it didn’t get 100% better. And then also had a concurrent other autoimmune condition, microscopic colitis.

So-

Dr. Whitney Baxter, ND: Ah …

Dr. Dominique Vanier, ND: it’s, it was an interesting, interesting case in that it’s not always one thing. It can be multiple things.

Dr. Whitney Baxter, ND: Right. Mm-hmm.

Dr. Dominique Vanier, ND: and so, you know, even on the topic of kids, like I mentioned earlier, like the presentation of constipation in children is pretty high. So in kids, constipation is one of the most common reasons for a pediatric GI referral.

There was a 2025 Mayo Clinic study of about 250 children with celiac found it’s often the non-classical symptom that prompts testing, and it frequently persists even after going gluten-free It’s

Dr. Whitney Baxter, ND: so interesting. And, the gastroenterology guidelines are still saying, you know, if there’s a presentation of diarrhea, then you need to rule out celiac disease and other autoimmune conditions.

So we’re not… This isn’t [00:11:00] always on our radar.

Dr. Dominique Vanier, ND: Mm-hmm.

Dr. Whitney Baxter, ND: It, it’s really good to bring up.

Dr. Dominique Vanier, ND: Mm-hmm. Mm-hmm.

Dr. Whitney Baxter, ND: Mm-hmm. okay, listeners, so just remember, if you’re constipated, if you’re bloated, if you’re feeling tired despite good sleeps and adequate nutrition, if you have low iron, if your bones are thinning, so these, questionable nutrient deficiencies, we need to be thinking about celiac.

So that’s something to talk to your doctor about Okay, so that was a good myth-busting, number two. So

Myth Three: Trace Gluten

Dr. Whitney Baxter, ND: let’s move on to number three. Okay.

Dr. Whitney Baxter, ND: I need gluten-free shampoo, separate sponges, and a totally separate set of dishes because any trace of gluten will set off my immune system. This is a really good thing to talk about because it k- kind of ties into this, it’s scary, right?

we’re thinking if we have an autoimmune condition of the gut, there’s more damage, there’s more pain. It’s, it’s scary. [00:12:00] So people want a number. How many parts per million is safe? Does it matter if my body wash has wheat protein in it? Can I leave my home? So let’s start with the science here because it answers most of this, the biology.

Celiac damage happens in the small intestine, so the gluten has to be swallowed and reach the gut. Gluten proteins are far too large to pass through intact skin, so we’re thinking anything topical on our skin, the shampoo, conditioner, body wash, lotion, deodorant, and makeup that stays on the skin cannot trigger an autoimmune reaction.

So this includes people with, dermatitis herpetiformis, the skin form of celiac disease. So let’s talk about Celiac Canada’s position statement here. The absorption through the skin has not been shown to be harmful. Okay? So that’s really good to know. Because gluten cannot get from the skin into the intestine.

The only [00:13:00] route that matters is in the mouth. So 20 parts per million, this is the number. Below is okay, above is probably not. So again, this is Celiac Canada, really good resource if you wanna look into this.

Dr. Dominique Vanier, ND: Mm-hmm. I will say I get that question a lot, right? Because, there, you know, maybe on Reddit, like on social media, there’s a lot of conversation around, you know, cross-contamination can go so far as, you have to have your own dish set, and you have to have, basically your own individual things in the kitchen, which can, can make it really restrictive for people to eat, to enjoy food with their family, to, you know, even partake in a gluten-free meal.

and so having this, this level of education I find is powerful and can put people, people at ease.

Cross Contamination Reality

Dr. Dominique Vanier, ND: So, you know, I guess that brings us to the next question of where do products actually matter? and it’s really about anything that goes in or near the mouth. So things like toothpaste, mouthwash, lip balm, lipstick are allowed in small [00:14:00] amounts every day.

But you, you know, probably wanna choose gluten-free versions if they’re available, which is a more reasonable, option for people who have celiac. and then hand lotion is more of an in-between case, right? So when you wash your hands before eating, it’s a non-issue, but if you’ve maybe washed your hands and you’re, like, touching your mouth, then there’s, there’s that level of, of exposure there And then when it comes to the kitchen, the real answer is cleaner, probably cleaner than you think, but not zero, in that shared dishes, cutlery, pots, and sponges, they should…

They, they’re fine if washed. and you know, there was a study reviewed on Celiac Canada’s site, and a knife used on a gluten-containing cupcake and then washed with soap and water, rinsed under wa- running water, or wiped with an antibacterial wipe left 93% of gluten-free samples clean, and then all methods worked equally.

So the reviewing [00:15:00] GI specialist, concluded that soap and water is very effective and separate pots and utensils are probably unnecessary. Yeah, so I think that that’s helpful for listeners, right? Because we don’t have to go to these crazy lengths of then having all your own things and then, you know, not being able to participate with, with our, y- you know, loved ones.

But it’s important to have your own, for example, peanut butter jar or your own toaster, right? those things that are, we’ll call them high, high surfaces or surfaces that can have, high levels of cross-contamination.

Dr. Whitney Baxter, ND: So you can think about it, it doesn’t… Like, how granular does it need to be. It’s measured in what you swallow, so what’s going into your system, into your gut, not what you touch or what’s going onto your skin.

So that can be really helpful. and keep your daily intake under 10 milligrams or under 20 parts per million. Is that right? PPM, parts per million.

Dr. Dominique Vanier, ND: Mm-hmm.

Dr. Whitney Baxter, ND: and put your energy and kind of be ca- more [00:16:00] careful around things with crumbs, shared jars. So Dr. Dominique mentioned the peanut butter jars and the toaster, not your shampoo

And that Celiac Canada, website does have really good, resources for people, really clear lists and templates and things that you can, that you can look at if you have more questions.

Testing Pathway Explained

Dr. Whitney Baxter, ND: Okay, so

Testing Pathway Explained

Dr. Whitney Baxter, ND: let’s walk through the actual testing pathways because there’s more to it than the celiac blood test. Dom, you wanna walk us through this?

Dr. Dominique Vanier, ND: Mm-hmm. Mm-hmm. Yeah. So this is the screening blood work. This is step one. And the first, the first, the first blood test is called tTG-IgA, which stands for tissue transglutaminase IgA. First-line test. It’s highly sensitive and specific when the person is eating gluten. So when we say sensitive and specific, it means it can accurately, or it can, it can as accurately as possible rule in or rule out when somebody has a true positive test [00:17:00] result or a true negative test result.

we also order something called total IgA alongside it, because some people are IgA deficient, and then that can make that first antibody I mentioned, the tTG-IgA, not as accurate. So you think about this total IgA like a control. So when I’m requisitioning blood work in practice, I’m starting with those two.

And then if somebody has, a borderline test result, there are other antibodies we can run as second line. the guidelines typically don’t say run all of them. There’s the step one and step two process, but those second line antibodies are EMA and DGP, and again, used for borderline results or, in young children.

And then this, the, we’ll say, step, overarching step two is more the confirmation of celiac. And so when somebody does get those positive antibodies back, they’ll typically be referred for an upper endoscopy, and then that includes a [00:18:00] small bowel biopsy, and the biopsy looks for something called villous atrophy.

And so that’s the flattening of our villi, and our villi, they… I’m using these, they’re called finger-like projections. So that’s actually, what it’s, what it’s written like in the medical text. But that is our absorptive surface. And so when somebody has celiac, there’s been damage to those villi, and then they can’t absorb their nutrients as well, and that’s where we see that show up in blood work after somebody has had celiac for some period of time.

and so right after the endoscopy of somebody, if we’re waiting for the histology results and we are suspecting that somebody does have celiac, I’m recommending that they go gluten-free right away. often the patient knows already that they don’t feel well on gluten, and then they’ve had to kind of hold out for this test, but as soon as the test is done, we’re just waiting for the results, but it’s, there’s no, there’s no harm in going gluten-free after that point

Dr. Whitney Baxter, ND: Mm-hmm.

Who Should Get Tested

Dr. Whitney Baxter, ND: Okay, so

Who Should Get Tested

Dr. Whitney Baxter, ND: is this something that [00:19:00] everybody needs to test for?

Dr. Dominique Vanier, ND: Hmm. Good question. No. You know, if we wanna correlate this with symptoms. but I will say I’ve seen cases where the only symptom was that there’s a classic celiac rash and no digestive issues, and that’s where it can be really complicated. But, you know, when it comes to w- when we’re testing anything, there’s something called this pre-test probability.

So if somebody has certain symptoms that, um, that, you know, for example, diarrhea, constipation, alternating bowel habits, bloating, nutritional deficiencies, that elevates them to have a more, accurate test when we do the testing. So, you know, a- another reason to do some testing would be if, there’s a first-degree relative with celiac.

we know the prevalence in relatives is about 7.5% versus 1% in the general population. Another reason could be if they have, another autoimmune condition, such as Type 1 diabetes, autoimmune thyroid [00:20:00] disease. the stats say that about 30% of adults with celiac have at least one other autoimmune disorder, which is really high.

That’s a third. somebody with unexplained iron deficiency anemia, low vitamin D, low B12, like unexplained early osteoporosis, right? If a woman is still cycling, has regular periods, right? Which so she’s got adequate estrogen to cycle, but we’ve got osteopenia happening or even osteoporosis that, that’s giving us some clues.

They have elevated liver enzymes, recurrent mouth ulcers, even dental enamel defects. Like I mentioned, that itchy blistering rash called dermatitis herpetiformis, and really persistent GI symptoms of any kind, including constipation. So those are all things that will just tip us off as to maybe we do need to do some celiac testing.

Dr. Whitney Baxter, ND: And I’m just Google Imaging this rash to remind myself- Yeah … what it looks like. Yeah. It looks like [00:21:00] eczema.

Dr. Dominique Vanier, ND: It does.

Dr. Whitney Baxter, ND: And rashes are so tricky. anything derm, skin related is so tricky. There’s so much overlap. So yeah, think about this in kiddos if they’ve got eczema, weird digestion symptoms, tummy aches.

Constipation can show up as bedwetting- Yes … or, yeah, leaky bladders all of a sudden if they’re potty-trained. So putting all these pieces together.

Dr. Dominique Vanier, ND: And also- We also

Dr. Whitney Baxter, ND: talked about-

Dr. Dominique Vanier, ND: That’s a really good point, ’cause we wanna think about especially in kids, right? They can’t, they can’t always communicate, what’s going on with their stomach, right, depending on their age.

But we can see concurrent things happen, and this is where it can be tricky, and this is really where you have to have a good practitioner because, because of what’s going on in the small intestine with, with absorption with celiac, we may see things like a lactose sensitivity happen at, at the same time.

And so we may go down that angle thinking like, oh, this is just milk and dairy, but totally miss the crux of the issue, which is actually an autoimmune condition. So something to- Yeah … to be aware of. And when we connect the [00:22:00] dots, every person can look different under this umbrella. we see, like I’ve mentioned, like maybe possibly a lactose issue.

We can see the microbiome shift with celiac disease. you know, bloating, which is such a nonspecific specific symptom. So you know, it’s important, it’s important to do the testing and try to get it done as early as possible rather than waiting those, six to 10 years like I quoted earlier.

Dr. Whitney Baxter, ND: Yeah. And you get to eat bread, and it’s just a part of- it’s just a little blood test.

So- Yeah … it’s, it, there are worse things. Unless you’re in a lot of discomfort, it can be tough, but.

Dr. Dominique Vanier, ND: Mm-hmm. Mm-hmm.

Borderline Results Biopsy

Dr. Whitney Baxter, ND: let’s talk about if those test results are borderline or weak positive. So weak positives happen with other conditions. So we talked about other autoimmune conditions, type 1 diabetes, also liver disease, some infections, and that’s exactly why there’s a biopsy.

So a scope going in and taking a sample of that, that villi, the stom- the small intestine lining, [00:23:00] to really understand what’s going on at that level to actually, the actual damage. So do not self-diagnose off low-level numbers. don’t go gluten-free before your visit with a gastroenterologist, with your doctor to really pull all these pieces together and to help, really interpret these results.

Practical Takeaways Scripts

Dr. Whitney Baxter, ND: Okay, so

Practical Takeaways

Dr. Whitney Baxter, ND: let’s dive into some practical takeaways for listeners just so you can walk away from this episode and know how to talk to your doctor. So quick disclaimer, as always, we aren’t giving you a prescription here or any medical advice. We just wanna educate you, give you lots of information so you can know how to speak with your doctor or a healthcare provider before making a medical decision.

So we’ve got six practical takeaways on celiac testing and living gru- gluten-free. So I’ll get started. Test before you change your diet. So Dr. Dominique went through how important it is to have gluten in your [00:24:00] system for those antibodies to show up. The blood test and the biopsy both depend on you eating gluten, so if you suspect celiac disease, get the blood work done first, then experiment.

Dr. Dominique Vanier, ND: Mm-hmm, mm-hmm. And a note on that is, you know, I will say sourdough tends to be a little bit w- better tolerated than some other breads, and so work, like work with your provider ’cause there may just be, there may be some tips and tricks, while you’re, while you’re having to eat gluten leading up to the test.

point number two, if you’re already gluten-free, ask about a gluten challenge or gene testing. So we know that it’s six to eight weeks of about two slices of bread a day, which is Celiac Canada’s guidance for adults. If that’s not realistic, gene testing can at least tell you whether it’s worth pursuing.

but again, it’s the gene testing is more, we’ll say, complimentary. Like the real testing is that TTG-IGA and that, that separate IGA test. Point number three is [00:25:00] constipation counts, right? So roughly one in eight adults, in that study I mentioned earlier, presented with constipation, and Canadian survey data shows diarrhea is now reported by only about half of newly diagnosed people.

So we don’t wanna rule somebody out, of having celiac just because their symptoms don’t match this textbook picture.

Dr. Whitney Baxter, ND: It’s a really important point.

Dr. Dominique Vanier, ND: Mm-hmm.

Dr. Whitney Baxter, ND: and then make sure your test, your blood work order includes the total IgA. So this is part of the immune system that is going to show up and increase, so this TTG-IgA, if there is celiac disease.

But you can also be IgA deficient, so it’s not gonna be an accurate capture of what’s going on at the level of the small intestine.

Dr. Dominique Vanier, ND: Mm-hmm.

Dr. Whitney Baxter, ND: So it’s a quick one-line addition to the blood work, so talk to your practitioner about adding this test. And number five, a diagnosis is a starting point, not the [00:26:00] finish line.

So after a confirmed diagnosis, there is a team approach to really support you through, living with celiac disease. So we wanna look at any nutrient deficiencies that might have been happening in addition to your digestive symptoms, and maybe why you’re feeling not, like tired, maybe you’re getting sick a lot.

‘Cause for, on one side of the coin, there is an immune reaction happening, so that can make you feel really tired. But also, you weren’t absorbing things optimally, so we look at iron, vitamin B12, vitamin D. How are your bones? We wanna refer you to a dietician to really give you support on how to grocery shop, how to go out to eat, how to go to a friend’s house.

Also, testing first degree of relatives, ’cause there is a big genetic component and we don’t wanna miss anybody that might have those more mild symptoms And then follow-up blood work is really important, so TTG-IGA at 6 to 12 months to check if the diet is working.

Dr. Dominique Vanier, ND: Mm-hmm. [00:27:00] Mm-hmm. Yeah, that follow-up blood work is important, too.

and I will say, like, when I do the initial screen for patients and then they get referred back to their family doctor and they’re positive on scope is their GP can take over also at that point to do that routine monitoring. And even sometimes they’re, they are, sent to a GI specialist, too. But making sure that that stays on somebody’s radar of, repeating that blood work at the appropriate time is important.

And then last point, number six, we wanna worry about what we swallow, not so much what we touch, except for the, the cases where we’ve touched, creams and things like that and then we’re putting it in our mouth. Or maybe our kids have cream on them, and then they’re touching their mouths and touching yours.

so skin and hair products can’t trigger celiac. Only things that go in somebody’s mouth count. In the kitchen, soap and water is enough for shared dishes and utensils, but, the th- the, the, you know, the toasters, the cutting boards, the [00:28:00] spreads, we wanna make sure that somebody has their own there because those are high levels, or high surfaces of cross-contamination So let’s talk about how to talk about this with your practitioner.

Some phrases that you can bring to your appointment are as follows. So for example, you can mention that you’ve had ongoing, you know, insert here, constipation, bloating, fatigue, low iron, alternating bowel patterns, and have never been screened for celiac. Can we add tTG-IgA and total IgA to my blood work?

Another point that can be brought up is that somebody’s been eating gluten-free for a while. Before I get tested, should I do a gluten challenge, or maybe gene testing makes sense as the first starting point? Another point to bring up if somebody’s results are positive is, you know, understand that they should keep eating gluten until the endoscopy.

Can that be confirmed? So having that conversation with your practitioner, especially how much gluten somebody needs to be [00:29:00] eaten in- eating until they get their, their scope completed. if somebody’s family, like such as their sibling, was diagnosed with celiac disease, a question that you can ask is whether you should be screened as well even though you don’t have symptoms.

That’s an interesting conversation to have. you know, another point that we can talk about is if somebody’s tTG was normal but, for example, they’ve been off gluten for months when it was drawn, could that have affected their results? Of course, the answer is yes, especially if they’re still having symptoms.

And then lastly, an interesting point to bring up is I’m still getting symptoms on a gluten-free diet. Can we go through my kitchen setup and the products I use with celiac, with a c- with my celiac dietician, my naturopathic doctor, before we assume it’s something else? Or even having the conversation, could this be something else?

Like I mentioned before, my patient had two concurrent GI autoimmune issues happening at the same time.

Dr. Whitney Baxter, ND: Very common.

Dr. Dominique Vanier, ND: Mm-hmm.

Dr. Whitney Baxter, ND: Yeah. [00:30:00] okay.

Myth Recap Closing

Dr. Whitney Baxter, ND: So just to review, we busted three myths today. The first one is that the celiac blood test is only as good as the gluten you’ve been eating before it. The second, celiac doesn’t have one face, and for a growing share of people, that face is constipation, bloating, fatigue, brain fog, rather than the classic diarrhea that we think of.

And the third, the immune system reacts to gluten you swallow in the range of tens of milligrams a day, not to what’s on your skin, so those shampoos, and not to a properly washed dish. So soaps are great.

Dr. Dominique Vanier, ND: Mm-hmm. Mm-hmm. So if today’s episode made you wonder, could it be celiac, or maybe you were never tested for celiac, we wanna get tested before somebody goes gluten-free, and bring those suggested phrases that we talked about to your next appointment.

another really great resource for listeners that want more information is celiac.ca, and we’ll certainly link the studies in the show notes for [00:31:00] you.

Dr. Whitney Baxter, ND: Thanks again for listening to another episode of Team Gut Girls, because better gut health changes everything