GUT Manual v1.2 - NutriPATHnutripath.com.au/.../2016/09/NPATH-GASTROINTESTINAL-Manual-v1.2.pdf · from traditional organic farming, or become super bug resistant. It is common practice

GASTROINTESTINAL TESTING

PRACTITIONER MANUAL

2

NutriPATH Pty. Ltd.

18a Harker Street, Burwood, VIC, 3125, Australia

Phone: 1300 688 522 (Australia)

+613 9880 2900 (International)

Fax: +613 9880 2999

Web: www.nutripath.com.au

V1.2

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Contents

Health Starts in the Gut....................................................................................................................5

Assessments of GI Function ........................................................................................................5

Options in GI Testing ...................................................................................................................5

FOOD SENSITIVITIES .........................................................................................................................6

Tests for Food Sensitivies.................................................................................................................6

IgE.................................................................................................................................................6

IgG ................................................................................................................................................7

IgA ................................................................................................................................................7

IgG / IgE / IgA Allergy Panels ..................................................................................................8

Combination Panels..............................................................................................................13

ALCAT (Antigen Leukocyte Cellular Antibody Test)..................................................................14

ALCAT Food Cartridge Panels...............................................................................................15

ALCAT Additives, Environmental chemicals, Antibiotics & Moulds Panels ........................16

ALCAT Herbs Panels..............................................................................................................17

ALCAT Combination Panels ..................................................................................................18

Measuring Gut Health....................................................................................................................19

COMPREHENSIVE DIGESTIVE STOOL ANALYSIS (CDSA) ................................................................19

CDSA Panels...............................................................................................................................20

CDSA Levels Comparison Chart.................................................................................................21

INTERPRETATION GUIDELINES FOR CDSA ................................................................................23

4

INDIVIDUAL GASTROINTESTINAL TESTS ........................................................................................28

Calprotectin ...............................................................................................................................28

Helicobacter pylori ....................................................................................................................28

M2 Pyruvate Kinase...................................................................................................................29

Pancreatic Elastase....................................................................................................................29

Transglutaminase ......................................................................................................................29

Clostridium difficile....................................................................................................................30

Gastrin........................................................................................................................................30

Faecal Occult Blood ...................................................................................................................30

Organic Acids ‐ Intestinal Dysbiosis ..........................................................................................31

LIVER DETOXIFICATION PROFILE...............................................................................................31

INTERPRETATIVE GUIDELINE FOR LIVER DETOX..................................................................32

Intestinal Permeability ..............................................................................................................35

Candida Antibodies ...................................................................................................................35

COELIAC PROFILES.....................................................................................................................36

HLA‐DQ TESTING and ‘Serologic Equivalent’.......................................................................36

Secretor Status ..........................................................................................................................38

Secretory IgA .............................................................................................................................38

5

Health Starts in the Gut

The cornerstones to good health are the ability to digest and absorb nutrients from food

effectively. When your gut function is poor, you can experience symptoms associated with

digestive, absorption, metabolic and excretion disorders which can be uncomfortable and

debilitating.

The impact on general health and wellbeing can be detrimental if the gastrointestinal system is

out of balance.

Gastrointestinal (GI) health incorporates optimization of:

Diet

Digestion

Absorption

Metabolism

Excretion

Immune reserve

Microbiota

Eradication of gastrointestinal infections

Liver function

Assessments of GI Function

Metabolic and functional assessments of GUT health allow the practitioner to determine the

underlying cause of dysfunction throughout the entire gastrointestinal tract.

The journey of food translating to energy as ATP starts in the food we eat.

Options in GI Testing

Diet ‐ You are what you Eat!

Food allergies, intolerances or sensitivities are the underlying cause of many disease states,

especially irritable bowel syndrome, fatigue, constipation, diarrhoea, skin conditions, weight

gain, mouth ulcers, chronic tonsillitis and other chronic immune dysfunction conditions.

6

FOOD SENSITIVITIES

Food sensitivity, or food intolerance, is becoming increasingly prevalent in today’s society

predominantly as we eat foods that are adulterated; our agricultural processes are deviating

from traditional organic farming, or become super bug resistant. It is common practice to hear

of gluten or dairy intolerance or allergic to foods.

Many people are unaware that they may be sensitive or allergic to one or more foods because

their reactions are masked by other symptoms, or take some time to appear.

Tests for Food Sensitivities

IgE IgE antibodies are found primarily in mucous secretions. An IgE reaction occurs about the time

immediately after exposure to the allergen; food or inhalant. This type of reaction is referred

to as a Type I immediate hypersensitivity reaction. In serum IgE is present in very low

concentrations and elevated in atopic diseases such as allergic asthma, hay fever and atopic

dermatitis. IgE antibodies that are specific for the allergen bind onto immune cells called mast

cells and basophils. The allergen latches onto the mast cell‐bound IgE antibodies in a cross‐

linking manner. This initiates the release of histamine and other inflammatory mediators from

these cells. The allergic IgE response is comprised of not only an immediate event but in many

cases a late event as well. The early phase reaction usually occurs within 15 minutes of

exposure to the allergen. The late phase reaction may then occur 4‐6 hours later and persist

for days with increased oedema and inflammation.

Allergy Panel ‐ IgE Asian Foods 96 Asian foods 3201

Allergy Panel ‐ IgE General Foods 96 General (Western) foods 3202

Allergy Panel ‐ IgE Inhalants 64 Inhalants 3203

Allergy Panel ‐ IgE Vegetarian Foods 95 Vegetarian foods 3204

7

IgG Food sensitivities can cause a wide range of symptoms and disorders. The foods that cause

these delayed reactions are often hard to diagnose because of the time between consumption

and the physical reaction. The IgG food allergy test offers a useful tool for detecting the foods

causing this response. The results are patient specific and provide an easy, precise and

effective starting point for dietary manipulation. Representing approximately 75% of serum

immunoglobulins in humans, IgG is the most abundant antibody found in the circulation and is

found in all body fluids. IgG molecules are synthesised and secreted by plasma B cells. IgG

antibodies are very important in fighting bacterial and viral infections.

Allergy Panel ‐ IgG Asian Foods 96 Asian foods 3205

Allergy Panel ‐ IgG General Foods 96 General (Western) foods 3206

Allergy Panel ‐ IgG Herbs & Spices 48 Herbs & Spices 3207

Allergy Panel ‐ IgG Inhalants 16 Inhalants 3208

Allergy Panel ‐ IgG Vegetarian Foods 95 Vegetarian foods 3209

IgA Immunoglobulin A (IgA) is an antibody that plays a critical role in mucosal immunity. More IgA

is produced in mucosal linings than all other types of antibody combined; between three and

five grams are secreted into the intestinal lumen each day. This accumulates up to 15% of the

total immunoglobulin produced in the entire body.

Allergy Panel ‐ IgA General Foods 96 General (Western) foods 3197

Allergy Panel ‐ IgA Asian Foods 96 Asian foods 3198

Allergy Panel ‐ IgA Inhalants 16 Inhalants 3199

Allergy Panel ‐ IgA Vegetarian Foods 95 Vegetarian foods 3200

8

IgG / IgE / IgA Allergy Panels

96 GENERAL Food Panel

Dairy* Fruits Grains/Legumes/Nuts

Casein Apple Almond

Cheese, Cheddar Apricot Amaranth

Cheese, Cottage Banana Barley

Cheese, Mozzarella Blueberry Bean, Kidney

Milk Cranberry Bean, Lima

Milk, Goat Grape Bean, Pinto

Whey Grapefruit Bean, Soy

Yogurt Lemon Bean, String

*Bovine‐derived Orange Buckwheat

unless specified Papaya Coconut

Vegetables Peach Corn

Avocado Pear Gliadin, Wheat

Beet Pineapple Gluten, Wheat

Broccoli Plum Hazelnut

Cabbage Raspberry Lentil

Carrot Strawberry Oat

Cauliflower Meat/Fowl Pea, Green

Celery Beef Peanut

Cucumber Chicken Pecan

Garlic Egg White, Chicken Rice, White

Lettuce Egg Whole, Duck Rye

Mushroom Egg Yolk, Chicken Sesame Seed

Olive Lamb Spelt

Onion Pork Sunflower Seed

Pepper, Green Bell Turkey Walnut, English

Potato, Sweet Miscellaneous Wheat, Whole

Potato, White Cocoa Bean Fish/Crustacea/Mollusc

Pumpkin Coffee Bean Clam

Radish Honey, Bee Cod

Spinach Sugar Cane Crab

Squash, Zucchini Yeast, Baker’s Halibut

Tomato Yeast, Brewer’s Lobster

Red Snapper

Salmon

Scallop

Shrimp

Sole

Tuna

9

96 VEGETARIAN Food Panel Dairy* Fruits Grains/Legumes/Nuts

Casein Apple Almond

Cheese, Cheddar Apricot Amaranth

Cheese, Cottage Banana Barley

Cheese, Mozzarella Blueberry Bean, Kidney

Milk Cantaloupe Bean, Lima

Milk, Goat Cherry Bean, Pinto

Whey Cranberry Bean, Soy

Yogurt Grape Bean, String

*Bovine‐derived Grapefruit Buckwheat

unless specified Lemon Cashew Nut

Vegetables Orange Coconut

Artichoke Papaya Corn

Avocado Peach Flaxseed

Bean Sprout Pear Gliadin, Wheat

Bean, Navy Pineapple Gluten, Wheat

Beet Plum Hazelnut

Broccoli Raspberry Lentil

Cabbage Strawberry Oat

Carrot Watermelon Pea, Green

Cauliflower Miscellaneous Peanut

Celery Cocoa Bean Pecan

Cucumber Coffee Bean Pistachio

Eggplant Honey, Bee Rice, Brown

Garlic Pepper, Black Rice, White

Kamut Pepper, Chilli Rye

Lettuce Sugar Cane Sesame Seed

Millet Yeast, Baker’s Spelt

Mushroom Yeast, Brewer’s Sunflower Seed

Olive Egg Walnut, English

Onion Egg White, Chicken Wheat, Whole

Pepper, Green Bell Egg Whole, Duck

Potato, Sweet Egg Yolk, Chicken

Potato, White

Pumpkin

Quinoa

Radish

Spinach

Squash, Zucchini

Tomato

10

96 ASIAN Food Panel

Dairy* Fruits Grains/Legumes/Nuts

Casein Apple Almond

Milk Banana Bean, Kidney

Whey Cantaloupe Bean, Red

Yogurt Cherry Bean, Soy

*Bovine‐derived Coconut Cashew Nut

unless specified Grape Corn

Vegetables Grapefruit Gluten, Wheat

Bamboo Shoot Guava Job’s Tears

Bitter Gourd Honeydew Mung Bean

Broccoli Kiwi Oat

Cabbage Lemon Peanut

Carrot Lian Woo Rice, White

Cauliflower Mango Sesame Seed

Celery Orange Sunflower Seed

Cucumber Papaya Walnut, English

Eggplant Peach Spices

Garlic Pineapple Curry Powder

Kelp Strawberry Ginger

Leek Watermelon Mustard

Lettuce Meat/Fowl Pepper, Black

Mushroom Beef Pepper, Cayenne

Olive Chicken Vanilla Bean

Onion Duck Woo‐hsiang Powder

Pepper, Green Bell Egg Whole, Chicken Fish/Seafood

Potato, Sweet Egg Whole, Duck Abalone

Potato, White Goose Clam

Radish Lamb Cod

Spinach Pork Crab

Taro Miscellaneous Cuttlefish

Tomato Cocoa Bean Lobster

Vegetable Sponge Coffee Bean Oyster

Water Spinach Honey, Bee Salmon

Tea, Woo‐long Sea Bass

Yeast, Baker’s Sea Perch

Yeast, Brewer’s Shrimp

Tuna

11

IgG / IgA 16 Allergen INHALANTS

Grass Indoor Moulds

Bahia Cat Dander Alternaria tenuis

Bermuda Cockroach, German Aspergillus fumigatus

Brome, Smooth Dog Dander Cladosporium herbarum

Johnson Dust Mite Mix Penicillium notatum

Rye, Perennial House Dust

Sweet Vernal

Timothy

IgE – 64 Indoor & Outdoor Allergen INHALANTS Trees Grass Indoor

Acacia Bahia Cat Dander

Alder, White Bermuda Cockroach, German

Ash, White Brome, Smooth Dog Dander

Beech, American Johnson Dust Mite Mix

Birch, White Meadow Fescue House Dust

Box Elder Rye, Perennial Moulds

California Pepper Sweet Vernal Alternaria tenuis

Cedar, Mountain Timothy Aspergillus fumigatus

Cottonwood mix Weeds Cladosporium herbarum

Cypress, Arizona Dog Fennel Penicillium notatum

Elm Mix Firebush

Eucalyptus Iodine Bush

Hazelnut, American Lamb’s Quarters

Hickory, White Marsh Elder, Rough

Maple, Red Mugwort, Common

Mesquite Nettle

Mulberry, Red Pigweed, Rough

Mulberry, White Plantain, English

Oak, Arizona Poverty Weed

Oak, Black Rabbit Bush

Oak, White Ragweed, Short

Palm, Queen Russian Thistle

Pecan Sagebrush, Common

Pine Mix Saltbush, Annual

Pine, White Sorrel, Sheep

Sweet Gum

Sycamore, Eastern

Sycamore, Western

Walnut, Black

Walnut, English

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48 HERBS & SPICES Panel

Spices Herbs

Allspice

Basil

Bay Leaf

Cinnamon

Clove

Cumin Seed

Curry Powder

Dill

Fennel

Ginger

Horseradish

Marjoram

Mustard

Nutmeg

Oregano

Paprika

Parsley

Pepper, Black

Pepper, Cayenne

Peppermint

Rosemary

Sage

Thyme

Vanilla Bean

Aloe Vera

Ashwaganda

Astragalus

Bilberry

Black Cohosh

Chamomile

Dandelion

Dong Quai

Echinacea

Ginseng, Siberian

Goldenseal

Grape Seed

Gymnema

Licorice

Milk Thistle

Psyllium

Rose Hip

Saw Palmetto

Spirulina

St. John’s Wort

Tea, Green

Uva‐Ursi

Valerian

Wild Yam

13

Combination Panels Often, a patient may present with an IgG and an IgE response to a suspected offending food.

For example, a patient exhibiting signs and symptoms of bloating and gastrointestinal

discomfort with bread may not reflect an IgG response as one would expect, bit may be

reflected in an IgE panel.

It is therefore recommended to perform IgG and IgE testing together (cost effective option).

Allergy Panel ‐ IgE & IgG Asian Foods 96 Asian foods 3210

Allergy Panel ‐ IgE & IgG General Foods 96 General (Western) foods 3211

Allergy Panel ‐ IgG & IgA General Foods 96 General (Western) foods 3217

Allergy Panel ‐ IgG General or Asian Foods

AND 15 Vegetables

96 General (Western or Asian) foods, 15 Vegetables

3213


AND 16 Inhalants

96 General (Western or Asian) foods, 16 Inhalants

3214

Allergy Panel ‐ IgE & IgG General Foods

AND 64 IgE & IgG Inhalants

96 General (Western or Asian) foods, 64 Inhalants

3215

A tissue transglutaminase (tTG) IgA and/or IgG test is used as part of an evaluation for certain

autoimmune conditions, most notably celiac disease. Celiac disease blood tests measure the

amount of particular auto antibodies in the blood. Tests that detect the IgA class

(immunoglobulin A) and IgG class (immunoglobulin G) of the auto antibodies are available, but

the types that measure IgA are more specific and are used almost exclusively.


(96 Foods) AND Coeliac Antibody Panel

96 General (Western or Asian) foods

AND Transglutaminase IgA, Gliadin

IgG, Gliadin IgA

3216

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ALCAT (Antigen Leukocyte Cellular Antibody Test)

The ALCAT test is a simple blood test that can be used to identify food and other factors that

induce innate immune system activation. It measures changes in size and volume of white

blood cells in response to ex vivo challenges with foods, chemicals and other environmental

stimuli. The ALCAT test is not an allergy or IgE test.

The advantage of the ALCAT involves the identification of specific foods that are triggering

an inflammatory cascade. The identification of these specific foods works synergistically with

the thesis that gut health is one of the primary and crucial organs responsible for chronic

inflammatory states, whereby the aetiology of the vast majority of chronic inflammatory or

autoimmune conditions can be traced back through a series of mechanisms to delayed food

hypersensitivity via impaired intestinal permeability (so called ‘leaky gut’).

A significant advantage of this system is that it uses whole blood which contains all of the

immune factors, cells and serum proteins that might be involved in an adverse reaction to a

foods, chemicals and moulds. Regardless of the pathways that may underlie an adverse

reaction to an analyte, i.e. immune or non‐immune, the final common pathway may involve

release of chemical mediators. These substances such as histamine and cytokines will alter

the activity of the white blood cells which is detectable using the ALCAT® technique. In

addition, the ALCAT® test will theoretically detect changes in the innate immune system

(phagocytic white blood cells) and any cytotoxic effects of a tested analyte.

ALCAT Intolerance Test ‐ 50 Foods 50 Foods (Select 1 x cartridge ‐ A, B, C or D)

3301

ALCAT Intolerance Test ‐ 100 Foods 100 Foods (Select 2 x cartridges from A, B, C or D)

3302

ALCAT Intolerance Test ‐ 150 Foods 150 Foods (Select 3 x cartridges from A, B, C or D)

3303

ALCAT Intolerance Test ‐ 200 Foods 200 Foods (All 4 cartridges A, B, C & D) 3304

15

ALCAT Food Cartridge Panels A variety of options are available for testing foods with an ALCAT test. Foods that are

highlighted tend to be the most offending foods today.

The practitioner has the option of choosing the most efficacious and cost effective panel to

suit the patient.

Foods Cartridge A Apple, Barley, Beef, Broccoli, Baker's Yeast, Banana, Black pepper, Brown/White rice, Butternut squash, Cabbage, Cantaloupe, Casein, Cane sugar, Carrot, Corn, Cow's milk, Cauliflower, Chicken, Cinnamon, Cocoa, Cottonseed, Egg white, Egg yolk, Fructose, Garlic, Gluten/Gliadin, Grape, Green pea, Lamb, Iceberg lettuce, Lemon, Mustard, Oat, Onion, Orange, Peanut, Pear, Pork, Shrimp, Soybean, Sweet potato, Tomato, Tuna, Turkey, Squash (yellow), Strawberry, String bean, Vanilla, Wheat, White potato.

Foods Cartridge B Almond, Asparagus, Avocado, Basil, Bell peppers (Capsicum), Blueberry, Brewer's Yeast, Brussels sprouts, Candida albicans, Carob, Cashew, Celery, Cherry, Clam, Coconut, Codfish, Coffee, Crab, Cranberry, Cucumber, Eggplant, Ginger, Goat's milk, Grapefruit, Halibut, Honey, Hops, Lime, Lobster, Millet, Mushroom, Olive, Oregano, Parsley, Peach, Pecan, Pineapple, Pinto bean, Plum, Psyllium, Rye, Salmon, Scallop, Sesame, Snapper (red), Sole, Spinach, Tea, Watermelon, Whey.

Foods Cartridge C Amaranth, Apricot, Artichoke, Bay leaf, Black Beans, Blackberry, Black‐eyed pea, Buckwheat, Caraway, Cayenne pepper, Chickpea, Clove, Cumin, Date, Dill, Duck, Fig, Flaxseed, Haddock, Hazelnut, Honeydew melon, Kidney bean, Kiwi, Lentil bean, Lima bean, Malt, Mango, Navy bean, Nutmeg, Oyster, Papaya, Paprika, Peppermint, Pistachio, Pumpkin, Radish, Raspberry, Red Beet/Beet Sugar, Safflower, Sage, Sardine/Herring, Sea Bass, Sunflower, Tapioca, Thyme, Trout, Turnip, Veal, Walnut, Tilapia.

Foods Cartridge D Acorn Squash, Anchovy, Blackcurrant, Bok choy, Brazil nut, Buffalo, Canola Oil, Cardamom, Catfish, Chamomile, Chicken liver, Chilli pepper, Coriander, Endive, Fava bean, Fennel seed, Flounder, Jalapeno pepper, Kale, Kelp, Leaf lettuce, Leek, Licorice, Macadamia nut, Mackerel, Mahi Mahi, Maple sugar, Mung bean, Mussel, Nectarine, Okra, Parsnip, Pine nut, Pomegranate, Portobello mushroom, Quinoa, Romaine lettuce, Rosemary, Saffron, Scallions, Sorghum, Spelt, Squid, Swiss chard (Silverbeet), Swordfish, Turmeric, Venison, Wild rice, Watercress, Zucchini.

16

ALCAT Additives, Environmental chemicals, Antibiotics & Moulds Panels

ALCAT Intolerance Test ‐ CHEM20

20 Food Additives / Chemicals (FSANZ code number)

Yellow 5 (Tartrazine 102), Yellow 6 (110), Red 1, Red 40 (129), Blue 1 (132), Blue 2 (133), Green 3 (143), Sorbic acid (200), Benzoic acid (210), Sodium sulphite (221), Potassium nitrite (249), BHA (320), BHT (321), MSG (621), Polysorbate 80 (433), Aspartame (951), Saccharine (954), Sucralose (955), Xylitol (967), Erythritol (968)

3305


20 Food Additives / Chemicals & 10 Environmental Chemicals

20 Food Additives/Chemicals AND 10 Environmental Chemicals: Ammonium Chloride, Benzene, Chlorine, Glycophosphate, Fluoride, Formaldehyde, Deltamethrin, Orris Root, Phenol, Toluene

3306


20 Food Additives / Chemicals, 10 Environ. Chemicals & 20 Antibiotics /Anti‐Inflammatories

20 Food Additives and Food Chemicals, 10 Environ. Chemicals AND 20 Antibiotics/Antinflammatories: Amoxicillin, Ampicillin, Acetaminophen, Naproxen, Cephalosporin, Gentamicin, Aspirin, Clinorol, Neomycin, Nystatin, Diflunisal, Ibuprofen, Penicillin, Streptomycin, Penicillamine, Piroxicam, Sulfamethoxazole, Tetracycline, Indocin, Voltaren

3307

ALCAT Intolerance Test ‐ Moulds

20 Inhalants / common Moulds

Alternaria, Aspergillus, Botrytis, Candida albican, Cephalosporium, Clado herbarum, Curvularia, Epicoccum nigrum, Fusarium oxysporum, Helminthosporium, Hormodendrum, Monilia sitophila, Mucor racemosus, Penicillium, Phoma herbarum, Pullularia, Rhizopus nigricans, Rhodotorula rubra, Spondylocladium, Trichoderma

3308

17

ALCAT Herbs Panels

ALCAT Intolerance Test ‐ Herbs General

50 functional foods used in dietary supplements

Acai Berry, Agave, Aloe Vera, Ashwagandha, Astragalus, Barley Grass, Bee Pollen, Bilberry, Black Walnut, Cascara, Chlorella, Dandelion, Echinacea, Elderberry, Essiac, Feverfew, Ginkgo Biloba, Goji Berry, Goldenseal, Grape Seed Ext., Guarana Seed, Gymnema, Hawthorn, Huperzine, Kava Kava, Lutein, Lo Han, Maitake, Mangosteen, Milk Thistle, Mullein, Noni Berry, Pau D'arco, Pine Bark, Red Clover Seed, Red Yeast, Reishi, Resveratrol, Rhodiola, Rooibos, Schizandra, Senna, Spirulina, Stevia Leaf, St Johns, Valerian, Vinpocetine, Wheatgrass, Wormwood, Yellow Dock

3309

ALCAT Intolerance Test ‐ Herbs Female

50 functional foods used in dietary/herbal supplements for women

Arnica, Black Cohosh, Blessed Thistle, Blue Cohosh, Boswellia, Buchu Leaf, Buplerum, Chaparral Root, Chasteberry, Cramp Bark, Dong Quai, Evening Primrose, False Unicorn, Fo‐Ti Root, Gotu Kola, Horse Chestnut, Horsetail, Irish Moss, Juniper Berry, Korean Ginseng, Lavender, Lemon Balm, Maca Root, Marshmallow Root, Mistletoe, Motherwort, Myrrh, Partridge Berry, Pennyroyal, Peony Root, Red Clover Flower, Red Raspberry Leaf, Rehmannia Root, Sarsaparilla, Siberian Ginseng, Skull Cap, Slippery Elm, Uva Ursi, White Willow Bark, Wild Yam Root, Nettle Leaf, Calendula, Alfalfa Leaf, Cat's Claw, Lobelia, Damiana, Yarrow, Yerbe Mate, Burdock, Butcher's Broom

3310

ALCAT Intolerance Test ‐ Herbs Male

40 functional foods used in dietary/herbal supplements for men

Alfalfa, American Ginseng, Burdock, Butcher's Broom, Calendula, Cat's Claw, Catuaba, Chaparral, Chondroitin, Cnidium Monnier, Damiana, Dong Quai, Fo‐Ti Root, Glucosamine, Gotu Kola, Horny Goat Weed, Juniper Berry, Korean Ginseng, Lobelia, Lycopene, Maca Root, Mistletoe, Mucuna pruriens, Muira puama, Myrrh, Nettle Leaf, Pumpkin Seed, Pygeum Bark, Rehmannia, Sarsaparilla, Saw Palmetto, Siberian Ginseng, Skull Cap, Stinging Nettle Root, Tribulus territories, Uva Ursi, Velvet Deer Antler, Yarrow, Yerbe Mate, Bohme Bark

3311

18

ALCAT Combination Panels

ALCAT Intolerance Test, Paediatric Profile

50 Foods AND 20 Food Additives/Chemicals 3312

ALCAT Intolerance Test, Comprehensive Profile 6



100 Foods, 20 Food Additives/Chemicals, 10 Environmental Chemicals AND 20 Inhalants/Moulds

3314




150 Foods, 20 Food Additives/Chemicals, 10 Environmental Chemicals AND 20 Inhalants/Moulds

3316




200 Foods, 20 Food Additives/Chemicals, 10 Environ. chemicals AND 20 Inhalants/Moulds

3318

ALCAT Intolerance Test, Comprehensive Profile, Platinum

200 Foods, 20 Food Additives/Chemicals, 10 Environ. chemicals, 20 Moulds, 20 Antibiotics / Anti‐Inflammatories AND 50 Herbs ‐ General

3319

19

Measuring Gut Health

A healthy digestive system absorbs the required nutrients from food and rids the body of

waste and harmful substances.

The microorganisms in your digestive system, such as bacteria, yeast and moulds make up a

unique ecological environment. It is important for this environment to be balanced in order

for the gut to function, process and absorb nutrients effectively.

COMPREHENSIVE DIGESTIVE STOOL ANALYSIS (CDSA)

The Comprehensive Digestive Stool Analysis (CDSA) is an advanced non‐invasive diagnostic

tool for assessing gastrointestinal function. As the CDSA combines a large number of tests

that evaluate the function of the gastrointestinal tract, a comprehensive picture of a patients

gut health can be obtained. The analysis investigates digestion + metabolism + pancreatic

function + the balance of beneficial bacteria + presence of pathological bacteria,

yeast and parasites.

Seven different CDSA panels are available through NutriPATH which evaluate the following

areas of gastrointestinal function:

Digestion & metabolism

Pancreatic function

Gluten sensitivity

Inflammation – Inflammatory Bowel Disease versus Irritable Bowel Syndrome

H. pylori, Gastritis, peptic ulcers and gastric cancer markers

Colorectal cancer markers

Beneficial & potentially pathogenic bacteria

Yeast & parasites

20

CDSA Panels

CDSA Level 1 Macroscopic & Microscopic Description, Beneficial & Bacteria,

Yeasts, Parasites (visual detection)

2003

CDSA Level 2

Macroscopic & Microscopic Description; Digestive, Absorption &

Metabolic Markers; Beneficial & Other Bacteria; Yeasts; Parasites

(visual detection)

2004

CDSA Level 3



(visual detection) & Sensitivities

2005

CDSA Level 3+


Metabolic Markers; Inflammation Markers; Tumour/Ulcer

Markers; Beneficial & Other Bacteria; Yeasts; Parasites (visual

detection) & Sensitivities

2006

CDSA Level 4



(visual & chemical EIA detection) & Sensitivities

2007

CDSA Level 4+


Metabolic Markers; Inflammation Markers; Tumour/Ulcer

Markers; Beneficial & Other Bacteria; Yeasts; Parasites (visual &

chemical EIA detection) & Sensitivities

2008

CDSA Level 5

Macroscopic & Microscopic Description; Beneficial & Other

Bacteria; Yeasts; Parasites (visual & chemical EIA detection) &

Sensitivities

2009

21

CDSA Levels Comparison Chart

MARKERS CDSA

Level 1

CDSA

Level 2

CDSA

Level 3

CDSA

Level 3+

CDSA

Level 4

CDSA

Level 4+

CDSA

Level 5

MACROSCOPY Stool colour & form Mucous / Blood

MICROSCOPY RBC, WBC, Food remnants, Fat globules, Starch

DIGESTIVE MARKERS Chemotropism SCFA, putrefactive Meat fibre Vegetable fibres Pancreatic elastase 1**

ABSORPTION MARKERS Triglycerides (stool) Long chain fatty acids Cholesterol (stool) Phospholipids

METABOLIC MARKERS Beneficial SCFAs, pH, Butyrate, Acetate, b‐Glucuronidase, Propionate

INFLAMMATION MARKERS Transglutaminase IgA** Eosinophil Protein X Calprotectin **

TUMOUR/ULCER MARKERS M2 Pyruvate kinase** H. pylori antigen **

Beneficial BACTERIA Bifidobacteria, Lactobacilli E. coli, Enterococci Other: Klebsiella Pseudomonas Campylobacter Citrobacter Yersinia

22

CDSA Comparison Chart (contd.)

MARKERS CDSA

Level 1

CDSA

Level 2

CDSA

Level 3

CDSA

Level 3+

CDSA

Level 4

CDSA

Level 4+

CDSA

Level 5

YEASTS / FUNGAL

Candida albicans

Other yeasts

PARASITOLOGY

Cryptosporidium

Giardia lamblia

Entamoeba histolytica

Blastocystis hominis

Other parasites

Cryptosporidium EIA

Giardia lamblia EIA

Entamoeba EIA

SENSITIVITIES

Penicillin

Ampicillin

Erythromycin

Tetracyline

Sulphonamides

Trimethoprim

Ciprofloxacin

Gentamycin

Ticarcillin

Tobramycin

Augmentin

Cephalexin

23

INTERPRETATION GUIDELINES FOR CDSA CDSA MARKER INCREASED

LEVELS DECREASED /

NORMAL LEVELS

MACROSCOPY

Stool colour Other colours may indicate abnormal GIT conditions.

Brown is normal.

Stool form (See Bristol Stool chart) Variations may indicate abnormal GIT conditions.

Formed stool is normal.

Mucous May indicate presence of infection, inflammation or malignancy.

Blood May indicate possible GIT ulcer. INVESTIGATE or REFER.

MICROSCOPY

RBCs May indicate presence of infection, inflammation or haemorrhage.

WBCs May indicate presence of infection or inflammation.

Food remnants May indicate maldigestion.

Fat globules May indicate fat maldigestion.

Starch May indicate carbohydrate maldigestion.

DIGESTION

Chymotrypsin May indicate protein maldigestion due to pancreatic insufficiency.

SCFAs, Putrefactive Produced with anaerobic bacteria, ferment undigested protein.

May indicate protein maldigestion.

Meat fibres May indicate maldigestion from gastric hypoacidity or diminished pancreatic output.

24

Vegetable fibres May indicate maldigestion from gastric hypoacidity or diminished pancreatic output.

Pancreatic elastase **

Used to assess pancreatic exocrine function. Levels decline with age.

Not affected by enzyme therapy.

May indicate poor absorption; pancreatitis

May indicate increased absorption; pancreatic insufficiency; hypochlorhydria

ABSORPTION

Triglycerides, stool May indicate lipid maldigestion; hypochlorhydria; pancreatic insufficiency; bile salts insufficiency.

Long chain fatty acids May indicate inadequate lipid absorption.

Cholesterol, stool May indicate inadequate absorption.

Phospholipids May indicate inadequate absorption.

METABOLISM

SCFAs, Beneficial May indicate bacterial overgrowth.

May indicate inadequate normal bowel flora; lack of prebiotics and/or probiotics.

Butyrate Butyrate is a major metabolite in colonic lumen arising from bacterial fermentation of dietary fibre and is a mediator of the colonic inflammatory response.

Predominant SCFA and preferred fuel for colonocytes.

Associated with carbohydrate intolerance and diarrhoea.

May indicate inadequate colonic function.

May indicate constipation or increased risk of inflammatory bowel disease.

‐Glucuronidase May indicate poor Phase II detoxification processes.

25

pH Imbalances will influence SCFA production. Affected by gut biome.

May indicate dysbiosis; low SCFAs, low prebiotics; slow transit time, constipation; hypochlorhydria

May indicate dysbiosis; bacterial overgrowth, elevated SCFAs; carbohydrate maldigestion, pancreatic insufficiency; fast transit time, diarrhoea

Acetate May indicate inadequate colonic function.

Propionate May indicate inadequate colonic function.

INFLAMMATION

Transglutaminase IgA **

Tissue transglutaminase is the most specific test for Coeliac disease.

May indicate gluten sensitivity. Confirm with blood Transglutaminase IgA, Gliadin IgA & IgG [2002] and anti‐Endomysial antibodies.

Coeliac tendency can be determined by HLA‐DQB1 molecular analysis [2019] or blood HLA‐DQ2 & HLA‐DQ8.

Eosinophil protein X

Calprotectin ** Protein in neutrophilic granulocytes and indicator of bowel inflammation.

May indicate IBD, infection, inflammation.

May indicate milk or multiple food allergies.

May indicate IBS.

TUMOUR / ULCER

M2 Pyruvate kinase **

Key regulator of tumour metabolism.

May identify GIT tumours.

Investigate further.

H. pylori antigen ** May identify H. pylori infection. Confirm with urea breath test.

** These markers can be ordered as separate individual tests

26

BENEFICIAL BACTERIA

Lactobacilli, Bifidobacteria, Enterococci and E coli are normally present in the healthy gut:

Lactobacilli and Bifidobacteria, in particular, are essential for gut health because they

contribute to:

1) the inhibition of gut pathogens and carcinogens.

2) the control of intestinal pH,

3) the reduction of cholesterol,

4) the synthesis of vitamins and disaccharidase enzymes.

OTHER BACTERIA

Klebsiella, Pseudomonas, Campylobacter, Citrobacter, Yersinia

Reduced numbers of these organisms ‐ whether caused by antibiotic use, chronic

maldigestion or bacterial overgrowth – leave the intestine susceptible to colonization by

pathogens and production of carcinogens.

YEASTS

Candida albicans and other yeasts

Fungal infections are detected and reported if present.

PARASITES

Cryptosporidium, Giardia lamblia, Entamoeba histolytica, Blastocystis hominis, other parasites

ANTIBIOTIC SENSITIVITIES

If an infection is present, the offending organism is challenged against pharmaceutical

antimicrobials. The antimicrobials tested are:

Penicillin, Ampicillin, Erythromycin, Tetracycline, Sulphonamides, Trimethoprim,

Ciprofloxacin, Gentamycin, Ticarcillin, Tobramycin, Augmentin, Cephalexin.

27

PARASITOLOGY

Parasitic infections are measured in stool (visual) or by Elisa method (EIA). Elisa method of

parasite testing is more definitive and involves collection of 3 stool samples on 3 consecutive

days.

Cryptosporidium ‐ Cryptosporidiosis is a type of gastroenteritis (gastro) caused by the

parasite Cryptosporidium. Cryptosporidiosis occurs when the parasites are taken in by

mouth through eating contaminated food and water or, more commonly, from person

to person or animal to person.

Giardia ‐ Giardiasis is a form of gastroenteritis caused by the parasite Giardia lamblia.

It can lead to diarrhoea, fatigue and weight loss, although many people do not develop

any symptoms at all. Giardiasis can be spread by contaminated drinking water.

Entamoeba histolytica ‐ Entamoeba histolytica is a type of gastroenteritis. Most

infections are asymptomatic but occasionally clinically important intestinal or extra‐

intestinal disease may result.

Parasitology Profile

(Faecal) – 3 day

Cryptosporidium enzyme immunoassay EIA, Giardia lamblia EIA, Entamoeba histolytica EIA; Other parasites (visual detection)

2015

28

INDIVIDUAL GASTROINTESTINAL TESTS

Calprotectin Measurement of faecal calprotectin is a biochemical test for intestinal inflammation

including inflammatory bowel disease. Under specific clinical scenario, the test may eliminate

the need for invasive colonoscopy. It is resistant to enzymatic degradation and can be easily

measured in faeces.

The main diseases that cause an increased excretion of faecal calprotectin are infectious

colitis, Crohn’s disease, ulcerative colitis and neoplasms (cancer). Levels of faecal calprotectin

are usually normal in patients with irritable bowel syndrome (IBS).

Calprotectin (Faecal) Calprotectin – inflammation marker (IBS vs IBD) 2001

Helicobacter pylori Helicobacter pylori are a spiral‐shaped bacterium that colonizes the stomach and induces

chronic gastritis, a long‐lasting inflammation of the stomach. It infects well over 30% of the

world’s population making it one of the most common bacterial infections. The bacterium

persists the stomach for decades in most people and most individuals infected by Helicobacter

pylori will never experience clinical symptoms despite having chronic gastritis (up to 85%).

Approximately 10–20% of those colonised by Helicobacter pylori will ultimately develop gastric

and duodenal ulcers. Helicobacter pylori infection is also associated with a 1–2% lifetime risk

of stomach cancer and a less than 1% risk of gastric MALT lymphoma.

Helicobacter pylori

Antigen (Faecal)

Helicobacter pylori antigen 2010

29

M2 Pyruvate Kinase M2 Pyruvate Kinase (M2‐PK), as measured in faeces, is a tumour marker for colorectal cancer.

Though M2‐PK can be elevated in many tumour types, rather than being an organ‐

specific tumour marker, increased stool (faecal) levels can be used as an early detection of

colorectal carcinomas.

M2 Pyruvate Kinase (Faecal) M2 Pyruvate Kinase (M2PK) – tumour marker 2012

Pancreatic Elastase This test is used to diagnose certain pancreas disorders related to not producing enough

digestive enzymes and aid in diagnosis of the exocrine pancreatic function or insufficiency.

Pancreatic Elastase 1 (Faecal) Pancreatic Elastase 1 (PE1) – pancreatic insufficiency marker

2014

Transglutaminase Faecal anti‐tissue transglutaminase IgA antibodies indicate a reaction of the immune system to

the tissue transglutaminase enzyme produced by the body when gluten is ingested, leading to

an autoimmune reaction that may destroy the intestinal lining or other tissues in the body.

Transglutaminase IgA (Faecal) Transglutaminase IgA – gluten sensitivity marker

2016

30

Clostridium difficile Human infection with Clostridium difficile (CD) can take many forms. Some may have recurrent

mild to moderate diarrhoea resembling Irritable Bowel Syndrome (IBS) and may not be at all

concerned with these symptoms. Still other patients may have a condition indistinguishable

from colitis, with cramps, diarrhoea, urgency, mucus and variable amounts of blood.

[NOTE: Can only be performed on loose stool specimen]

Clostridium difficile Test Clostridium difficile 2017

Gastrin Gastrin is the main hormone that controls the release of acid in your stomach. When there is

food in the stomach, gastrin is released into the blood. As the acid level rises in your stomach

and intestines, your body normally makes less gastrin.

Gastrin Gastrin 2018

Faecal Occult Blood Faecal occult blood can be a sign of a problem in your digestive system, such as a growth, or

polyp, or cancer in the colon or rectum.

Blood may appear in conditions like:

Benign (non‐cancerous) or malignant (cancerous) growths or polyps of the colon

Haemorrhoids, anal fissures

Intestinal infections that cause inflammation

Ulcers, Ulcerative colitis, Crohn's disease

Meckel’s diverticulum, Diverticular disease

Faecal Occult Blood Faecal Occult Blood (chemical & immunological) 2020

31

Organic Acids Intestinal Dysbiosis The testing procedure measures the overflow or build‐up of intermediate organic acid

products in the urine, determining where ‘aberrations’ are occurring in metabolic pathways.

Intestinal dysbiosis markers measure microbial growth by the release of products of their

metabolism that may be absorbed and excreted in urine. Several organic acids are known to

be specific products of bacterial metabolic action on dietary polyphenols or unassimilated

amino acids or carbohydrates. Detection of abnormally elevated levels of these products is a

useful diagnostic tool for patients with gastrointestinal or toxicological symptoms.

Organic Acids ‐ Intestinal

Dysbiosis Panel (Urinary)

Indoleacetic Acid, Phenylacetic Acid,

Dihydroxyphenylproionic Acid, Succinic Acid,

Benzoic/Hippuric Acids ratio; Citramalic Acid,

Arabinose, ‐ketoglutaric Acid, Tartaric Acid

2013

LIVER DETOXIFICATION PROFILE The process of detoxification is one of the chief roles of the liver. It works to convert lipid‐

soluble xenobiotics into water soluble substances that can be excreted from the body. It does

this via a two‐step process designated phase I and phase II. Specific measurements of the

different phases of liver detoxification including phase I and phase II (glycination,

glucuronidation, sulphation and glutathionation) are obtained, guiding the design of effective

and specific therapeutic strategies which can optimise liver function. When the function of the

liver is sub‐optimal, toxins can build up and poison the body. The liver detoxification profile

evaluates the ability of an individual to process caffeine, aspirin (salicylate) and paracetamol

(acetaminophen) by assessing certain metabolites in salivary and urinary specimens.

Liver Detoxification Profile Phase I Detoxification: Caffeine Clearance; Phase II

Detoxification: Measures of Glucuronidation,

Glycination, Glutathionation & Sulphation

4010

32

INTERPRETATIVE GUIDELINE FOR LIVER DETOX

PHASE I – Caffeine clearance

Causes Treatment Considerations

HIGH Phase 1

Increased exposure to

toxins and production

of free radicals.

Exposure to P450 enzyme

inducers:

Drugs e.g. barbiturates, HRT, steroids, sulphonamides;

Environmental pollutants e.g. exhaust fumes, paint fumes, dioxin and pesticides;

Gut‐derived toxins from gut dysbiosis or leaky gut;

Others: alcohol, Cruciferous vegetables, charcoal‐broiled foods, tobacco.

Assess and remove exposure to any P450 inducing substances.

Reduce exposure to environmental toxins.

Assess and treat gut dysbiosis and/or intestinal permeability (IP).

Antioxidant supplementation e.g. acai, Se, vitamin C & E, Zn.

Botanical liver support e.g. ellagic acid, green tea, silymarin, grapefruit juice.

LOW Phase 1

Reduced activity of P450 enzymes

from exposure to pharmaceutical

medications:

Benzodiazepines

Antihistamines

Ketoconazole

H2 blockers

Green tea (catechins)

Turmeric

Vitamin B complex

Bioflavonoids

Amino acids ‐ glutathione, glycine, glutamine, cysteine

33

PHASE II Causes Treatment Considerations

LOW Glucuronidation

Reduced

acetaminophen

glucuronide recovery,

impaired

glucuronidation

detoxification.

Increased exposure to drugs and xenobiotics requiring glucuronidation

e.g. steroid hormones,

oxazepam, carbamates,

phenols, aniline.

Genetic enzyme defect e.g. Gilbert’s disease.

Medications, such as antibiotics, e.g. chloramphenicol, novobiocin.

Nutritional and metabolic causes:

Decreased energy production or reduced energy from dietary sources;

Hypothyroidism;

Insulin resistance; Vitamin K excess

Upregulation of other Phase II

pathways.

Discontinue medications which may affect glucuronidation.

Reduce xenobiotic exposure. High quality protein source. Support mitochondrial function to help improve energy production

e.g. antioxidants, coQ10,

magnesium, zinc, EFAs; aspartic

acid, iron, L‐glutamine, niacin,

vitamin B complex.

Increase Cruciferous vegetable intake.

Reduce enterohepatic re‐circulation of toxins e.g. calcium D‐glucurate.

Support other Phase II pathways.

LOW Glycination

Reduced salicyluric

acid recovery,

impaired glycination

detoxification.

Increased levels of drugs and xenobiotics requiring glycination e.g. aspirin, benzoate, phenylacetic acid, aliphatic amines.

Glycine and glycination cofactor deficiencies.

Liver disease. Genetic enzyme defect.

L‐glycine supplementation.

Supplement glycination cofactors, e.g. cysteine, magnesium, vitamin B5, B6.

Reduce benzoate exposure e.g. sodium benzoate (211).

Reduce xenobiotic exposure. Reduce salicylate exposure from cosmetics, drugs and diet.

HIGH Phase 2 pathways

Use adequate cofactor and nutrient support ‐ this will ensure that these molecules do not

become depleted and liver detoxification does not become impaired.

Phase 1: Phase 2 ratio ‐ Glycination

These two ratios reflect the relationship between Phase 1 and these two conjugation

pathways and will demonstrate whether the biochemical load from Phase 1 is high or low.

34

PHASE II Causes Treatment Considerations

LOW Glutathionation

Reduced

acetaminophen

mercapturate

recovery, impaired

glutathionation

detoxification.

Increased exposure to drugs and xenobiotics requiring glutathionation e.g. acetaminophen, penicillin, tetracycline, styrene, toxic metals, bacterial toxins.

Increased oxidative stress. Impairment of other Phase II pathways.

Genetic enzyme defects.

Enhanced bile production (increases mercapturate elimination via the bile).

Assess and remove exposure to xenobiotics.

Glutathione and glutathioine precursor and cofactor supplementation e.g. glutathione, L‐glycine, L‐glutamine, L‐methionine, N‐acetylcysteine.

Vitamin B5, B6, B12.

Botanical liver support supplementation, e.g. silymarin, artichoke, Cruciferous vegetables.

Antioxidant supplementation e.g. vitamin C & E, Zn, Se.

Support other Phase II pathways.

LOW Sulphation

Reduced

acetaminophen

sulphate recovery;

impaired sulphation

detoxification.

Increased exposure to drugs and xenobiotics requiring sulphation e.g. minoxidil, terpines, amines, phenols.

Increased oxidative stress. Impaired sulphoxidase activity.

Molybdenum or vitamin B6 excess (can inhibit sulphation).

Liver disease. Genetic enzyme defects.

Upregulation of other Phase II pathways.

Assess and remove exposure to xenobiotics.

Sulphate precursors and cofactor supplementation – e.g. glutathione, L‐methionine, N‐acetylcysteine, Zn.

Supplement inorganic sulphate (MSM) and/or Molybdenum if inadequate cysteine to sulphate conversion (sulphoxidase activity) is suspected.

Reduce dietary phenols and amines.

Phase 1:Phase 2 ratio ‐ Sulphation

Demonstrates the relationship between Phase 1 and the sulphation pathway and

demonstrates whether the biochemical load from Phase 1 is too high.

Phase 1: Phase 2 ratio ‐ Glucuronide

These two ratios reflect the relationship between Phase 1 and these two conjugation

pathways and will demonstrate whether the biochemical load from Phase 1 is high or low.

35

Intestinal Permeability Changes in intestinal permeability are associated with many health conditions including

autism, autoimmune disorders, food sensitivities and inflammatory bowel disease. This

‘leaky gut’ causes disease because the perturbed intestinal barrier allows toxic molecules to

enter the bloodstream and poison the body. Intestinal permeability can be measured using

the lactulose/mannitol test. Furthermore, the intestinal permeability test has been used to

monitor the compliance and effectiveness of a gluten‐free diet in patients with Coeliac

disease. In addition to assessing leaky gut, this test can also help diagnose malabsorption.

The test works on the principle that small molecules (i.e. mannitol) are readily absorbed by

the intestinal villi, whilst larger molecules such as disaccharides (i.e. lactulose) are not. These

water soluble non‐metabolised sugar molecules after penetrating the intestinal tract are

excreted into the urine. Under normal circumstances the ratio of lactulose to mannitol in

urine is low (i.e. lactulose is not absorbed), mannitol is absorbed. When the structure of the

intestinal epithelium is jeopardised (‘leaky gut’ is present), the large sugar molecule can

permeate the mucosa and is recovered in the urine. In this situation the level of lactulose is

increased in the urine and therefore the ratio of lactulose to mannitol is high.

Intestinal Permeability Test Lactulose % recovery, Mannitol % recovery, Lactulose/Mannitol ratio

2011

Candida Antibodies A systemic candida infection may cause a diverse set of symptoms. Symptoms may include

poor concentration, premenstrual syndrome, fatigue, food sensitivities, irritable bowel, cystitis

and, muscles and joint aches. Although yeast is found in everyone’s gastrointestinal tract,

problems arise when the ratio of friendly bacteria to harmful microorganism is disturbed.

This test measures the presence of both anti‐candida IgA and IgG antibodies in a salivary

sample. The levels of the antibodies detected indicate the state of the condition, i.e. whether

there is a current candida infection (IgA) or whether there has been a past candida infection

(IgG).

Candida Antibodies (Salivary) Candida IgA & IgG Ab 3001

Candida Antibodies/Antigen

(Serum)

Candida IgG, IgA, IgM, Candida Antigen 3002

36

COELIAC PROFILES It is one of several blood tests that may be used to help diagnose coeliac disease. Tissue

transglutaminase IgA and/or IgG test is used as part of an evaluation for certain autoimmune

conditions, most notably coeliac disease.

Tissue transglutaminase is an enzyme that repairs damage in the body. People with coeliac

disease often make antibodies that attack tissue transglutaminase. They are called anti‐

tissue transglutaminase antibodies or immunoglobin A (IgA) antibodies. Therefore, a blood

test that shows higher levels of anti‐tissue transglutaminase antibodies can give indication of

possible coeliac disease or gluten sensitivity.

The test detects the genes (human leukocyte antigens or HLA) that control the immune

system’s reaction to gluten. There are several types of HLA genes within each person and it is

HLA‐DQ that is most useful in the assessment of the probability that a person may be gluten

sensitive. The reason gene testing assesses probability rather than disease itself is because

some people have the genes for gluten sensitivity but have no detectable evidence of the

immune reaction to gluten or have no symptoms.

Coeliac Profile (serum) Transglutaminase IgA , Gliadin IgG & Gliadin IgA 2002

Gluten Sensitivity Genetic Test HLA‐DQB1 Molecular Analysis 2019

Gluten/Antigenic Food Sensitivity

Faecal IgA to 4 Foods: Gliadin, Casein, Ovalbumin and Soy

2021

Expanded Antigenic Food Sensitivity

Faecal IgA to 11 Foods: Almond, Beef, Cashew, Chicken, Corn, Egg, Milk, Pork, Rice, Soy, Walnut

2022

Coeliac Antibody Panel Transglutaminase IgA, Gliadin IgG & Gliadin IgA 3003

HLADQ TESTING and ‘Serologic Equivalent’ Today HLA‐DQ gene testing is done by analysing DNA using molecular techniques. In the past,

the methods were done by analysing blood cells for the antigens produced by the genes, and

these past methods were responsible for the most commonly known nomenclature for HLA‐

DQ genes even today (using integers such as DQ2). These are called ‘serologic equivalents’ to

the specifically analysed gene material.

37

If have one gluten sensitive gene then your offspring have a 50% chance of receiving the gene

from you and one of your parents passed it to you. Having two gluten sensitive or Coeliac

genes means that both of your parents and all of your offspring will possess at least one copy

of the 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 Coeliac

Disease may be more severe.

Molecular type

Serological equivalent

Gene predisposition

0201 DQ2, subtype DQ2 COELIAC

0202 DQ2, subtype DQ2 Gluten sensitivity Slight risk for coeliac

0203 DQ2, subtype DQ2 Gluten sensitivity Rare, little known regarding predisposition to coeliac



0301 DQ3, subtype DQ7 Gluten sensitivity Predisposed to Microscopic colitis

Neurological manifestations often seen when coupled with DQ1

0302 DQ3, subtype DQ8 COELIAC

0303 DQ3, subtype DQ9 Gluten sensitivity

0304 / 0319 DQ3, subtype DQ7 Gluten sensitivity

0305 / 0310 DQ3, subtype DQ8

0306 DQ3, subtype DQ3 Gluten sensitivity

0307 / 0308 / 0309 / 0311 / 0312 / 0313 /

0314 / 0315 / 0316 / 0317 / 0318 / 0320 / 0321

No serological equivalents

Gluten sensitivity

04‐‐ DQ4, subtype DQ4 All DQ4 genes are considered low risk for gluten issues

05‐‐ DQ1, subtype DQ5 Gluten sensitivity All DQ1 genes carry high predisposition to neurological manifestations of gluten sensitivity

06‐‐ DQ1, subtype DQ6 Gluten sensitivity All DQ1 genes carry high predisposition to neurological manifestations of gluten sensitivity

38

Secretor Status The term ‘secretor’ or ‘non‐secretor’ refers to the ability of an individual to secrete ABO blood

group antigens in bodily fluids such as saliva, sweat, tears, serum and the gastrointestinal

mucus secretions. The function of ABO antigens remain an enigma, however it has recently

been suggested that blood groups and secretor status are part of innate immunity against

infectious disease. Non‐secretors have an increased risk for urinary tract infections, candida,

autoimmune disorders and heart disease.

A person who is a ‘secretor’ will secrete antigens according to their blood group, i.e. a group O

individual will secrete H antigen, a group A individual will secrete A and H antigens etc.

Obviously a ‘non‐secretor’ or weak secretor will have no or little antigen present in their bodily

fluids.

Secretor Status (Salivary) Secretor status – relative to blood type 3006

Secretory IgA Secretory IgA (sIgA) is found in high concentrations in the secretions of the gastrointestinal,

genitourinary and respiratory mucosal linings. The most recognised function of sIgA includes

its role in ‘immune exclusion’ in which it prevents viruses, bacteria and other antigens

adhering to and penetrating epithelial mucosa. SIgA may also inhibit inflammatory processes

that damage the mucosa and preliminary evidence suggests that it may play a role in

inducing an antigen specific immune response by a non‐inflammatory mechanism. A sIgA

deficiency may lower resistance to infection.

Secretory IgA (Salivary) Secretory IgA 3007

Documents

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