Are intolerance and allergy related?

[DysonsMom]

I cannot believe how much I have learned about this little niche of the world in the last couple of weeks! 

I have looked around for an answer to this question, but I suspect you guys will have a bit more knowledge on the subject. I am presuming that food allergies sometimes run in families, and there has never been any history of a food allergy in my family. However, a year ago, I was diagnosed with an intolerance to gluten. (The doctor wanted to do an endoscopic biopsy to check for actual Celiac, but I turned it down. The treatment for intolerance and Celiac are the same--eliminate gluten. Since I was going to have to give up my beloved donuts, anyway, I turned the biopsy down.)

Anyway, are intolerances and allergies related? The question is purely academic--I am just curious. 

[twinturbo]

Generally speaking intolerances are digestive issues and allergy involves the immune system, although ultimately with Celiac it does involve the immune system due to damage from the inability to digest gluten.

Celiac to my knowledge is much more than merely avoiding gluten which is the danger of self-diagnosis. A GI specialist does more than tell you to avoid gluten, s/he would know best practices for monitoring the condition of your GI system and anything else that should be monitored in relation to Celiac such as an IgA deficiency, and much more. Celiac is nothing like a lactose intolerance (which I have) which is the inability to digest milk sugar. Celiac is serious business.

In general they are two different systems, intolerance and allergy. Celiac is also genetic so it would possibly be of benefit for you to get a gold standard diagnosis if you are fairly certain you have it as it does indeed run in families.

[CMdeux]

What she said.

Any of your first-degree relatives needs to know, if you're diagnosed with celiac.

While both things have a genetic component (atopy and some types of food intolerance) that seems to be about the only major link between them.

We do have several members here with celiac (either themselves or the allergic family member).   It's unusual to find yourself in BOTH somewhat rare groups-- but far from impossible.

[YouKnowWho]

I understand what you are saying about not wanting to be tested for Celiac but keep in mind that if you are diagnosed with Celiac, there are a variety of things you need to keep an eye on down the road (various cancers, thyroid issues, etc).

[DysonsMom]

Okay--longer explanation:
When my doctor finally said, "Hmmm...that sounds like a problem with gluten," I went home, looked up what gluten was, and cut it out of my diet. I was sick and desperate at that time--and constantly feeling like I was in a fog, so I was willing to do pretty much anything. She had done some blood work that day. It eventually came back as not positive for whatever markers they were looking for--which I know now is not definitive. I was just seeing my GP, by the way. I never made it to a specialist.

After the fog started to clear and I stopped being so sick all the time, I did a bit more research. That was when I found out that in order to do the biopsy, the gold standard, a patient has to actually be ingesting gluten. I would have to go back to eating it for a time in order to have the biopsy done. However, there was no way I could go back to that at that moment--not and keep my job at the same time.

Summer came around (I am a teacher), and I did consider it. I ate a doughnut one night, just to see if I could handle it. (Okay-- I was actually hoping that I could somehow eat gluten again, because I just miss some stuff so badly.) For the first few hours, I thought I might be okay. But by the next morning, I was laying in the bathroom convinced I would never even have the strength to crawl to my bed.

So at this point, I am not sure how I should proceed. Honestly, I did not know anything further needed to be done, and no one in my known family has any similar issues. (I don't really know my dad's side of the family.)

[twinturbo]

Let's put it this way.

There's what's known about Celiac in terms of diagnosis, damage, risk, co-morbid conditions or disease, treatment and its genetic component. We have more than one person on FAS with Celiac and have managed it for years. I've reached the end of what I know unless I (1) use a search engine (2) reach into anecdotal second hand experiences of people I know. Neither of those really add to the discussion.

There are people who do have Celiac and IgE-mediated allergies to wheat, in most cases you have one or the other. My youngest is anaphylactic to wheat and barley, most likely at least strongly cross-reactive to rye and oats.

Then's there's what you decide for yourself but should not necessarily recommend as a standard for anyone who suspects they have Celiac if you see what I mean. When you throw in the genetic likelihood and the concern for what it called silent reactions with Celiac obviously getting tested as an adult to rule it out saves your kids the process*. Again, not making a recommendation only answergin the question that was asked as completely and honestly as I can without a shred of judgment for what you decide on your own care. You're a grown woman I'll leave that to you.

To bring it back to the title, no. No relation.

*At least if one strongly suspects, no medical advice intended. I'm not a doctor.

[CMdeux]

Have you been skin tested...


just a thought.

That might be a way to take a look at potential for actual allergy without having to be on gluten.

[maeve]

I have a first cousin with celiac and one of my younger sisters was diagnosed as gluten intolerant because her celiac testing came back inconclusive. It's an autoimmune disorder; your body is attacking itself. It has a strong genetic component. Yes, the "treatment" is the same: complete avoidance of gluten. However, the long-term health implications if you mess up with celiac are more severe than if you are gluten intolerant.

I would get the testing done. It's possible you could have other GI disorders (Chrohn's disease, IBS). For your long-term health, you should get tested. My cousin was finally diagnosed when her BP fell dangerously low and she had to be rushed to the hospital.

[rebekahc]

I agree with CM, my thought when reading your further explanation was to consider allergy testing to wheat and/or gluten.  I totally get why you don't want to gluten yourself and become so ill just for the biopsy - especially since your blood tests were negative.  Plus, I think you'd need to eat gluten regularly for several weeks for the biopsy to be accurate.

If the allergy testing is negative, I think I'd want to see a GI to rule out any other causes or to confirm Celiac.  My son was tested for Celiac a long time ago because of malabsorption issues and symptoms.  His antigliaden IgA was negative, but his IgG was the highest the GI had ever seen.  He told us the IgA was considered more definitive, but since the IgG was so high he wanted to do a biopsy.  The biopsy showed tissue changes, but not those seen in Celiac.  I think now there's another test they run, tissue transglutaminase antibody, that's considered better than the IgA and IgG tests.  However, if you just had one test or the other, a GI doc might want to order both just to double check.  I don't know if you need to be consuming gluten for those tests to be accurate.

To answer your question, my opinion is that auto-immune diseases can be more common in allergic individuals.  I Googled and found a recent article supporting the link.  http://www.nih.gov/news/health/jun2013/nci-02.htm

Scientists at the National Institutes of Health, and their colleagues, have discovered that a gene called BACH2 may play a central role in the development of diverse allergic and autoimmune diseases, such as multiple sclerosis, asthma, Crohn's disease, celiac disease, and type-1 diabetes.

[twinturbo]

^In murine models. In plain English, mice.

[rebekahc]

Yes, I realize in this particular research they used mice, but...

From the same link:

The results of previous research had shown that people with minor variations in the BACH2 gene often develop allergic or autoimmune diseases, and that a common factor in these diseases is a compromised immune system.

The finding that a single component of the immune system plays such a broad role in regulating immune function may explain why people with allergic and autoimmune diseases commonly have alterations in the BACH2 gene, said NCI researcher Rahul Roychoudhuri, M.D.

[CMdeux]

Yeah-- there are clearly a series of genes that confer epigenetic vulnerabilities of some sort-- but the problem is that with a lot of those genes, this is just correlation at this point.  Nobody is very sure if they truly have some causative potential or not. 

Both autoimmune diseases and atopic conditions have been rising at feirce rates, too-- which opens up the possibility that it's a coincident rise in people with both conditions (which would also be expected, since a no-longer-rare condition like RA would totally be expected to have increased incidence in an also no-longer-rare condition like asthma).  Some people consider allergy to be "autoimmune" in nature, though most immunologists don't seem to see it that way because for whatever reason, they aren't ongoing and unprovoked the way lupus or MS is.  Things like type 1 diabetes, though-- definitely autoimmune.

So it's not entirely clear that there's a direct linkage-- but there may not need to be, either. 

[twinturbo]

The fact that it's your immune system is a given. But causative effects, reverse or no? Virus? Bacteria? And we already know some diseases need another to act as a gateway. To me it's one of those things that in the researchers' minds put in clinical speak it's something vastly different than when you individually read the conclusions in the paper. We may add some meaning that was not necessarily the intention of the research.

There was another root cause paper out where the interpretation got a little... embellished? I don't know how to describe it. It's early and I still feel like I peeled myself off a windshield. Someone smarter than me had an excellent write up though.

http://foodallergysleuth.blogspot.com/2013/07/genetic-glitch-at-root-of-food-allergies.html

[YouKnowWho]

Not answering your question but wanted to point out that Kinninnick has GF donuts in the freezer section (Kroger, Whole Foods, etc carry them).