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  4. A patient with MS, depression, and fatigue. Had a Cyrex Array 3 panel, and she had equivocal IgG wheat agglutinin, tTG3 out of range, everything else normal. Should I consider intestinal permeability and/or anything else?
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  4. A patient with MS, depression, and fatigue. Had a Cyrex Array 3 panel, and she had equivocal IgG wheat agglutinin, tTG3 out of range, everything else normal. Should I consider intestinal permeability and/or anything else?

A patient with MS, depression, and fatigue. Had a Cyrex Array 3 panel, and she had equivocal IgG wheat agglutinin, tTG3 out of range, everything else normal. Should I consider intestinal permeability and/or anything else?

Dr. Amy Nett: I would suggest that she does remove wheat and gluten entirely from her diet. Again, we consider an equivocal result as positive, so having two antibodies out of range, including the tTG3, I would probably say that that is positive. Then, again, I don’t go straight to intestinal permeability testing, so if you want to investigate underlying causes of intestinal permeability, SIBO breath test and stool testing. Look at the potential causes that might be contributing to intestinal permeability. I would suggest a SIBO breath test and then stool testing, preferably through Doctor’s Data and BioHealth, and if she’s only willing to do one, then I would probably do the Doctor’s Data stool test because you get a few more markers, including markers for inflammation, short-chain fatty acid production, etc. Then, yeah, the dietary changes. Just remove wheat and gluten completely.

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