the patient celiac

Hope for a Less Challenging "Gluten Challenge"

30 comments July 06, 2014

The current “gold standard” tests for celiac disease include testing for celiac antibodies in patients’ blood and performing an endoscopy to obtain small bowel biopsies. In order for these tests to be accurate, one has to be eating gluten up until the time of testing.  If a patient is already on the gluten-free diet when these tests are done, the diagnosis of celiac disease can easily be missed.

Since starting this page I've encountered many people who have decided that they’d like to be tested for celiac disease after starting on the gluten-free diet.  Per the celiac disease experts, a “gluten challenge” must be performed in these cases to assist in the diagnosis of celiac disease. A gluten challenge requires eating foods containing gluten for a prescribed period of time prior to an endoscopy and/or blood testing for celiac disease. The length of time and amount of gluten that need to be consumed for a gluten challenge vary from source to source. Here are some examples of different recommendations for a gluten challenge (current as of July 5, 2014):

University of Chicago Celiac Disease Center: “For a gluten challenge we recommend eating 1/2 slice of bread or a cracker each day for the duration of the challenge. Prior to blood testing we recommend 12 weeks of eating gluten. Prior to an endoscopic biopsy we recommend 2 weeks of eating gluten. In the case of a severe reaction to gluten, a medical professional may opt to shorten the 12-week challenge and move immediately to an endoscopic biopsy.”

Celiac Disease Center at Columbia University: “In individuals who are willing to further pursue the question of whether they have celiac disease, we will advise a gluten challenge. This consists of ingesting at least 4 slices of bread a day for one to three months followed by an endoscopy and biopsy. There is no evidence that following antibody tests is beneficial in establishing a diagnosis of celiac disease because these tests are not sensitive in this setting.”

Celiac Disease Center at Beth Israel Deaconess Medical Center: “Gluten is reintroduced into the diet and after a period of time (ideally 6 to 8 weeks if the challenge can be tolerated for that long) blood tests and an intestinal biopsy are performed. If the gluten challenge is not tolerable for the full 8-week period blood tests and biopsy can be performed sooner but this can lead to a false negative result.”

In addition, Dr. Leffler and colleagues published a paper in 2013 showing that the majority of patients with celiac disease will test positive after eating >3g gluten/day for 2 weeks. A typical piece of wheat bread contains about 5g of gluten.

Despite all of the confusion, there is hope on the horizon for a shorter gluten challenge in the future.  Researchers at the Walter and Eliza Hall Institute in Australia have been developing a blood test that measures gluten-reactive T cells, immune cells that increase in response to gluten in those with celiac disease, via cytokine release assays.  In a pilot study published earlier this year, patients with celiac disease had a significant jump in blood levels of gluten-responsive T cells, compared to controls, after only 3 days of consuming gluten. Per Dr. Jason Tye-Din, one of the researchers working on this test, “We hope that larger studies can validate these findings and establish its role in the diagnosis of celiac disease.” For the sake of my gluten-light kids, and everyone else who is in a similar situation in regards to diagnosis, I hope he is right.

A press release regarding the study can be found here.

Out of curiosity, have any of you been diagnosed with celiac after doing a gluten challenge? If so, do you remember how much gluten you had to eat and for how long prior to testing?

Full reference:

Ontiveros NTye-Din JAHardy MYAnderson RP. Ex-vivo whole blood secretion of interferon (IFN)-γ and IFN-γ-inducible protein-10 measured by enzyme-linked immunosorbent assay are as sensitive as IFN-γ enzyme-linked immunospot for the detection of gluten-reactive T cells in human leucocyte antigen (HLA)-DQ2·5(+) -associated coeliac disease. Clin Exp Immunol. 2014 Feb;175(2):305-15.


In reply to Jess.
Thank you for replying. Yes hopefully this will all be worth it for some sort of conclusion and then an action plan for my health. It’s been almost a year since I stopped working and I was on a promising career path… All of this is extremely difficult because it’s derailing my life. My partner in the meantime is exceeding in his studies at a prestigious law school which is fantastic but I feel like I’m not pulling my weight. I’ve also been estranged from my immediate family for years so I’m entirely financially dependent on my partner (we’re not yet married) and sometimes physically dependent. I want my life back!

I’m now 2 weeks in, eating at least 4 slices of bread a day, and have 4 more weeks to go. I’m waking up in the middle of the night with abdominal pain, and not being able to sleep while it persists – but I need to get my sleep so I sometimes end up waking up around midnight then not getting back to sleep until around 3, then waking up around 10, 11 or 12. I don’t keep a scale but I’m certain I’ve lost more weight so my BMI is probably underweight at this point. I am rarely hungry any more. The joint pain has spread from my wrists and arms to my ankles now. A half hour after eating bread, this extreme exhaustion sets in for 2-3 hours. My thinking is fuzzy. Every other day my hearing has been coming and going in both ears for a few months now (beyond going back on wheat) which is very scary – my hearing goes for a second and then I hear a high frequency sound, then my hearing returns. The worst symptom is the crushing emotions that have come since I started this gluten challenge. I’m obviously in a bad situation but these feelings are definitely correlated to eating bread, it’s not like me to be so negative. Last night I ate wheat crust pizza and today I am full of despair. I am trying to separate these feelings from myself and recognize them as a physical symptom. My last complaint is that this has impacted my sex life; sounds strange to complain about but sex is important to me and now I barely have the energy for it or my abdominal pain will be too much for me to ‘perform’. My partner is now turning to pornography and I’m feeling so unattractive.

I will update here if anything changes. My biopsy is scheduled in 4 weeks. If this GI doctor doesn’t find anything, then my family doctor will be referring me to a neurologist to look at nervous system diseases. I was reading about celiac disease versus MS or lyme disease, and frankly it sounds like celiac disease is the worst since it has the greatest risk of impacting life expectancy. I hate to announce that here and I apologize if I’ve offended anyone!

Jess, thank you for your support. This is so isolating, not many people understand how sick I am or what I’m going through. Thank you, I appreciate it!
7/26/2016 4:01:53 PM
Hi there,

Thank you for the great site. I am on Day 4 of the Gluten Challenge. My doctor here in New Zealand has told me to eat 4 pieces of bread every day for 4 weeks. I am already feeling quite tired but I figure that there is never a good time to do this so am just ploughing ahead. What I am finding difficult to find out if how else I can get the same level of gluten into my diet, without it being bread? I have managed to discover that these 4 pieces amount to 20 (sorry, forgot the unit) but I cannot find any details anywhere of how much pasta or pizza etc is the equivalent. The reason I am doing it is to work out why I am low in iron as there is no discernible cause. Only because a friend got diagnosed coeliac and explained that that’s why she was low in iron did I think the same could be true of me. First blood test came back negative but that’s because I had actually started excluding gluten naturally from my diet but without really realising it. Hence the gluten challenge. I would really appreciate learning how I can keep at this challenge with more variety.
7/26/2016 4:01:18 PM
Hi Jess! I am SO excited that I found this blog. I have recently found a Family Physician who has taken me seriously about my abdominal pain. I am 35 and for as long as I can remember have had abdominal pain, bloating and constipation. I also have times where I am depressed or anxious and I have psoriasis. The last few months I have had very intense upper right abdominal pain along with all the other symptoms above. I had the blood test for celiac disease and it came back negative. I had an ultra sound to check for gallstones, negative. Had a HIDA scan and it came back with an EF of 29%. At this point the doctor thinks it is a good idea to get an endoscopy to further rule out celiac. I am completely on board with this. I would hate to have the gallbladder removed only to still have problems. However, I stopped eating gluten 10 days ago. From what I have read here if I do a gluten challenge for 2 weeks then if I have celiac disease it should still show up in the biopsy right??? The doctor performing the surgery suggested 2-4 weeks 4 weeks being optimal. But I have been in so much pain that 4 weeks seems like an eternity. I would love to know your thoughts!
7/26/2016 4:00:42 PM
In reply to Amy.
Hi Amy,
Thank you for sharing your experience. I hope that your challenge and testing go as well as possible.
At least at the end you will know for sure whether you have celiac or NCGS. This is important as if you actually do have celiac it is important to know so that your children and relatives can be monitored and screened for symptoms, and also so you can have all necessary celiac follow-up testing done, like vitamin levels, monitoring for anemia, osteoporosis/osteopenia, etc.
If you get a chance to write again I would be interested in learning about your results.
7/26/2016 4:00:06 PM
I’m a 31 year old female who lives in Canada and has been off gluten for 8 years because it causes me to have severe abdominal pain lasting days, bloating, exhaustion and joint pain. Unfortunately a year ago, when my stomach issues had gotten worse (despite being off gluten but still eating wheat-free food prepared in restaurants, likely a little glutinous), I visited a naturopath because I hadn’t had productive experiences with doctors, and she put me on a bunch of pills. My symptoms got far worse and new ones cropped up, so I actually stopped working. All this despite my efforts to avoid gluten.

I got a new family doctor who is great. She discovered low ferritin, fatty liver (I am 5’6.5 and 115 lbs, don’t drink), a kidney stone and CIN3 cervical precancer. One time I even had low diastolic blood pressure that was so low she put me in an ambulance (of course the ER found nothing). She’s referred me to a GI doctor. The GI doctor wants to rule out celiac disease before she investigates anything else. She wants me to do a gluten challenge for 6 weeks then have a colonoscopy, endoscopy and biopsy. I’m on day 3, last night I ate pizza and the night before lasagna. I’ve never been this tired in my life – slept 14 hours last night and struggling to stay awake right now. Wrists hurt a little. Upper right abdominal pain isn’t too bad but has been constant. Will write more later but am too tired right now.
7/26/2016 3:59:13 PM
In reply to Rebeca.
Hi Rebeca, From what I’ve read and learned you can eat gluten for 2-3 weeks for a gluten challenge before an endoscopy and small bowel biopsy, but it takes longer than that for the TTG antibodies to rise (usually 6-12 weeks of gluten ingestion is recommended before blood tests, depending on the source). Hope this helps and I hope everything goes well for all of you!
7/26/2016 3:49:07 PM
Hi Tracy,
My son and I are having blood tests done to check for Celiac and Gluten intolerance. We’ve been on a gluten-restricted diet for several years (not 100% gluten free, but I’d say 80%). We aren’t pure by any means. But my son has less than me. He has gluten about 1 a week or less. We put him back on heavy gluten for the last three weeks. Will this be enough for blood tests to be accurate? I don’t want the tests to come back inconclusive for him and have him go through the whole drawing of blood ordeal. I “cheat” more often so have more gluten in my system. I’m also getting the test done. A gastroenterologist is the one that said three weeks of elevated gluten would be enough. What do you think?
7/26/2016 3:45:42 PM
In reply to Tracy Smith.
Hi Tracy,
Your symptoms sound just like mine prior to my diagnosis with celiac in 2010.
You are correct, you need to start eating gluten now in order for your results to be reliable on March 9th. Anyone who has been GF for more than about 2 weeks needs to do a gluten challenge before having an EGD to evaluate for celiac, otherwise the test can be falsely negative. Your plan, eating a half slice of bread per day, sounds perfect. I hope that your testing goes well and that you are able to get some answers. And that you don’t get too sick from your gluten challenge. Good luck!
7/26/2016 3:45:06 PM
Tracy Smith
I have been struggling to find a diagnosis that explains my symptoms for years. I’ve been chronically anemic for 5+ years, have had chronic “explosive” diarrhea for more than a year, horrible epigastric bloating following meals, joint pain, extreme fatigue, depression…..text book Celiac, but have not found a lot of support from my doctor to find a cause until recently. I’ve started to go through menopause, so no longer can we blame my anemia on my menstrual flow (which I’ve argued has actually been somewhat lite the last few years, to no avail). I decided to go gluten free on my own about 2 months ago, and the improvement was immediate and profound. I went to see my doctor with my results, and he’s now decided to order an EDG with biopsy. I’m booked for one on March 9, but was told by both my doctor and my surgeon that I didn’t need to add gluten back in my diet. ?? I’ve had an EDG before for gastric polyps, and I REALLY don’t want to go through this again for nothing! Everything I’m reading says that you must be eating gluten at the time of testing for an accurate diagnosis. I’ve been diligent about not consuming ANY gluten, and the thought of going back to my symptoms scares me! But I’m thinking starting tomorrow, I should add 1/2 piece of bread back in. I can’t believe that they both said I didn’t need to!
7/26/2016 3:44:38 PM
In reply to mandi.
Hi Mandi,
I am sorry that you have to go through this and I hope you are feeling okay. Please keep us updated on your results if you get a chance. Either way, it sounds like you already know that you will need to stay GF.
Good luck!
7/26/2016 3:43:12 PM
In reply to Ann Hurst.
Hi Ann, I hope that your challenge goes as well as it can. Please keep us updated on your results (if I had to bet, based on your TTG levels and symptoms, I’d say you have celiac).
7/26/2016 3:42:53 PM
In reply to Sherri.
Hi Sherri,
I think that different celiac centers give different recommendations because there are no clear universal guidelines for this.

If I had to undergo a gluten challenge (the thought of which makes me shudder because I would be so ill), I would probably eat 1/2 slice of bread everyday for about 8 weeks before blood tests, but only for 2 weeks if I was going to have a biopsy. Based on all I have read, I would feel comfortable that my tests would be positive with this intake and duration.

I hope this helps. I wish you the best!

7/26/2016 3:42:28 PM
In reply to Jess.
My daughter has recently had a biopsy confirming celiac. Her symptoms are only bloating, excessive weight gain and forehead acne. No diarrhea, constipation or pain. No headaches. She is 5’8″ tall and 150 pounds. Nothing like the textbook cases.
Now our whole family needs to be tested. I have been gluten free more or less for 6 months only eating gluten occasionally. The doctor at the Celiac Center of Philadelphia is telling me to eat two bread products a day for only 4 weeks before my blood test. This seems much lower than anything else I’ve seen recommended. Why do they say two bread products for 4 weeks and others say 3-4 for at least 12 weeks? I already feel fatter and sluggish after only 3 days of gluten. My brain tells me to just suffer for 12 weeks. 4 weeks seems like an automatic negative. Should I trust the experts at CHOP when they say 4 weeks? Any thoughts?
7/26/2016 3:42:07 PM
Hi there,
I also am in the same boat. After being so sick for years and having every food allergy test come back negative, my allergist suggested I get off wheat and see what happens. I did immediately. Two weeks later, the Dr said I can eat it again for testing, now that I was finally starting to feel better, or I could just not do the invasive and expensive testing as the end result was to not easy gluten anyway. So I went with that! Well, 2 years later I’m still noticing issues even with a gf diet so they want to do a colonoscopy to make sure all else is good except when they do that they are doing both biopsies and said I need to eat it. The gastro Dr said CONSTANTLY for the two weeks but he’d prefer a month. I’m scared to death! One crumb sets my throat off, my stomach off, my eyes burn and feel the need to immediately close, my brain turns to mush and every inch of my joints will hurt for days. I can’t even imagine what meal after meal will do. Immediately after I’m going back to my Paleo diet, that’s the only time I’ve actually felt “good” and in hoping it’ll help to flush me quickly. But after tomorrow, it’s on from the 7th thru the 24th when my test is. Fingers crossed I’ll just be swollen and miserable not throwing up the whole time! But it’s nice to know we’re not alone so thanks!
7/26/2016 3:40:46 PM
Ann Hurst
Hi Jess,
My CD symptoms were fatigue, anemia, weakness, brain fog, bloating, and constipation. I feel that I have had this since childhood. I have mixed feeling about the gluten challenge because the gastroenterologist said it is quite obvious that I have Celiac Disease: anti-ttg 133 (now 4 after one year GF diet), osteopenia at age 35, ferritin 9). The gastro said that a pathological diagnosis is important but gave no reason why. I waited a year for my consultation so am reluctant and scared to re-inflame my insides when I worked so hard to heal. However, I have 3 kids so it will be helpful to them and my siblings. So, I am going to follow the 1 slice for 2 weeks challenge, starting March 6, my scope is on March 20. I’ll let you know how it goes.
7/26/2016 3:40:24 PM
I have been gluten-free for about three months before doing my blood test for Celiac Disease and yet I “managed” to test positive for all three auto-antibodies (Anti-Endomysial, IgA, and IgG) all with at least two times higher than normal. Maybe it had to do with me accidentally ingesting gluten and not being as careful as I should (I spent Christmas and New Year at my parents’ place), but I haven’t done the biopsy. I wonder if I’ll have to do the gluten challenge. At my parents’ place , sometimes I would get the symptoms I used to get while eating gluten, but they were less severe. I hope the challenge duration is short since I get miserable with gluten. I’ll find out tomorrow.
7/26/2016 3:39:25 PM
Hi, thanks for thinking of me! I have completed the gluten challenge. the tg coeliac test came back negative. they have also done a gene test which will come back in a few weeks but that i have been told will only tell me that i could possibly have it, or i definitely cant be ceoliac.
So to be honest i am a bit lost. I had hoped that they would do the endoscopy test as my symptoms are so bad, but unfortunately not.
the gluten challenge has been hard, iv not been working and can hardly function.
they have advised me to do another week of eating gluten (to take it to 4 weeks) and redo test to see if i then get a positive result. it just seems with out the positive tg test the doctors are not interested.
i asked if i can get any help if i am ‘just gluten intollerant’ and they said no. it seems ridiculous that gluten makes me just as ill as it does to someone with coeliac disease and yet i get no support.
i wonder if there are many people out there in the same situation?
7/26/2016 3:22:24 PM
In reply to cat.
Hi Cat,
If I’m doing the math correctly, you should just about be done with your gluten challenge and should be getting your scope.
I hope it all goes well for you and that you are able to get answers.
My daughter’s GI doc told us that he has seen some celiac patients who primarily get constipated, so perhaps it is not that unusual.
Please keep us updated!
7/26/2016 3:21:41 PM
im on day 3 of my gluten challenge. I have been told 1 piece of bread for 2 weeks (although I had pizza last night – it was sooo good!!!) my biggest problem is from migraines as if I eat gluten I get constant migraines as well as the rest of the ‘textbook’ gluten symptoms. the only thing I get which seems to be odd to the doctors is that I get constipation when I eat gluten, and then occasionally the very urgent need to go.
I will let you know how I do after 2 weeks. all I know at the moment is that its going to be a very long 2 weeks, followed by a month of trying to get better..
7/26/2016 3:21:15 PM
Thanks. I appreciate your response. I did tell her to put up with it for four weeks, so glad to see that you think that is reasonable too.

I would go ahead and have her tested now and then have her retested if the tests are inconclusive, but the test is going to cost me $200, so I would rather not do that!

Thanks again.
7/26/2016 3:17:53 PM
In reply to Michele.
Hi Michele,
I wish that the 3 day gluten challenge test was available for all of you!
Based on taking all of the recommendations (and averaging them), it looks like she’s need to do at least 4 weeks of gluten for the blood tests and 2 weeks for biopsy. But, if she’s only been off of gluten for a month, then you might want to see where she is with her celiac antibody numbers at baseline (prior to the gluten challenge), because if they’re elevated you might be able to go straight to biopsy after a shorter gluten challenge. It can take a few months for the celiac antibodies to normalize on the GF diet, so perhaps you might still have a window of opportunity to test?
7/26/2016 3:17:30 PM
My daughter went off gluten for a month – just experimenting to see if it helped relieve her symptoms. She felt so much better – her stomach felt better, she didn’t feel so achey and tired, and the chronic hiccups she has had for 8 years decreased dramatically. We did realize though the she needs to know if she is gluten sensitive or actually celiac. She has started eating gluten again, and doesn’t feel well. Her stomach doesn’t feel right, she feels foggy and achey, and her hiccups have returned. We have gotten an Dr. order for the blood test, but aren’t sure how long she needs to be eating gluten to be tested. There is so much vague and conflicting information out there. We want an accurate test result, but she wants to go off gluten again asap because she feels better without it. Any advice?
7/26/2016 3:17:12 PM
Hi Jess! Interesting thought! The immune system seems to be working in different ways in different people. I only found one other person describing a similar progression of her disease (can’t remember where but I stumbled upon a comment somewhere while researching celiac disease).
Also, I’d like to add one more thing as I believe doctors need to be aware of this.. I had some very serious middle ear infections growing up that resulted in a number of surgeries on my left ear (the infection spread on the bones). I have some level of hearing loss on my left ear, thankfully, I don’t need a hearing aid as I have no problem hearing the frequencies where human speech occurs. However, I will need to go to a specialist yearly for the rest of my life as my left ear cannot clean itself naturally.
My point is that I found some info on the net that indicates that there may be a higher risk for kids with celiac disease to experience recurring and chronic ear infections that may have some serious implications. So, I think celiac did affect me many ways while growing up and I would have benefitted from keeping a gluten free diet. But science was not there at the time yet.
(Sorry for spelling errors, I usually type on my phone.)
7/26/2016 3:16:30 PM
In reply to Molly (Sprue Story).
Hi Molly,
It sounds like you made the right decision to go back for testing, as had you not, you might still be walking around with undiagnosed celiac disease (and at risk of ending up with a lot of other autoimmune crud like I did due to not being diagnosed until my thirties).
Yes, a 3 day gluten challenge, if it pans out, will be a huge step for diagnosis in all who have already started on the GF diet. I have a few family members who are GF, feel better, but cheat a lot b/c they don’t believe they have celiac disease (but were actually never tested before going GF so really don’t know if they do or not).
I hope you’re having a good summer!
7/26/2016 3:16:04 PM
In reply to Dhead.
Hi D,
I hope your gluten challenge is going okay. How much gluten do you need to eat and for how long?
I would love to read about your experience if you eventually blog about it.
Even if you test negative for celiac and end up with a diagnosis of non-celiac gluten sensitivity (NCGS), please know that you are welcome in our celiac community, as we know that many with NCGS get just as sick from gluten as those with celiac disease.
Good luck to you and thanks so much for sharing your decision.
7/26/2016 3:14:24 PM
In reply to Amy.
Hi Amy,
Thanks so much for sharing your experience. I agree that 4 to 5 months is a horribly long time to have to be on gluten and I would never have been able to tolerate that long of a gluten challenge either. I think back to how ill I got prior to being diagnosed and I would never be able to do that again (maybe for 3 days if I really had to, but not for 4 to 5 months!)
It is so interesting that you had the experience of being diagnosed as a toddler and then “outgrowing” celiac disease…only to find out years later that you had it all along. I have heard that this happened to many who were diagnosed decades ago, but you’re the first person whose story I’ve actually heard. Makes me wonder about all of the other pediatric illnesses that we currently believe that kids outgrow, like milk allergies.
Anyway, thanks again, and I’m glad that you are feeling better now. I was not diagnosed until I was in my 30s either.
7/26/2016 3:13:59 PM
In reply to ester benatti.
Hi Esther,
You bring up a great idea, but as far as I know the rectal challenge is not available in the U.S., outside of for research purposes. Where do you live? Did you have this done?
7/26/2016 3:13:29 PM
In reply to Vik.
Hi Vik,
Thanks for sharing your experience. And yes, I know we’ve talked about our pre-diagnosis binges before, I believe that mine was the worst in the history of celiac disease (cheesy bread and thin mint cookies).
Anyway, it’s great that you received the advice to continue to eat gluten for your testing (which sadly does not always seem to be the case).
7/26/2016 3:13:07 PM
Molly (Sprue Story)
I was sort of fortunate in this regard because, although I did try going gluten-free before getting tested for celiac disease, I didn’t actually notice any improvement after six weeks on the diet, so it was no skin off my back to start eating gluten again. I did want to be absolutely sure that I didn’t have celiac, so I got tested after several months of eating gluten, and…sure enough…I actually do have celiac. Six weeks just hadn’t been long enough for me to heal.

I can see how anyone who does feel a lot better immediately after giving up gluten would feel iffy about going back on it, especially for several weeks or months, just for the diagnostic seal of approval, so I too hope that the gluten challenge time period will turn out to be lower than many currently call for. It’s definitely best to get tested FIRST (though I know that for various reasons it’s not always possible).
7/26/2016 3:12:44 PM
Hi Jess,
This is the exact situation I am in now. It is extremely frustrating. To piggyback on Amy’s point – I have been SO reluctant to start the gluten challenge after 6 months of being gluten free and feeling incredible. It is mind blowing that the only way (for now at least) to get tested for celiac disease is to put this stuff back into your body.
When I first started, I labeled myself as someone with a gluten intolerance. I even attacked the celiac community a little bit which I now deeply regret. With that said, I have learned a great deal over the past month or so that I feel has made me a better person. This disease is not a laughing matter by any means. There are too many people out there who are suffering with this and that is certainly NEVER something to take lightly.
At first, I thought to myself that it wouldn’t be a big deal if I had a diagnosis or not. I figured if I stopped eating gluten and felt better then all was good. Why even bother trying to get a diagnosis? What difference does it make? Check out my post asking for help with all of this here: Those are probably two of the most ignorant questions I have asked myself. The good news? My stupid questions were answered based on my research and advice from great people in the Celiac community like yourself! Receiving an accurate diagnosis is extremely important for several reasons which you have outlined in your articles. Thank you for that!
I decided to go ahead and start the stupid gluten challenge. I hate that I have to do it this way, but it is what it is. I will keep you updated! Here’s to feeling like crap again! UGHHHH
7/26/2016 3:11:51 PM
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