Hopefully this will bring the testing a little more in focus.

At the time of this writing (updated 2022), these are the tests that are available. If I had carte blanche for running tests, I would run all of these.

Comprehensive blood profile (~$200)

Wheat/Gluten Antibody tests (Cyrex Labs Array 3x) (~$269)

Gluten Sensitivity Cross Reactive Food Antibodies (Cyrex Labs Arrays 4) (~$225)

Autoimmune Antibodies (Cyrex Labs Array 5) (~$575)

Gluten Genetic Test (Enterolab) (~$175),

These tests give a nice overview with some overlap. One test will pick up a problem that the others missed. We are in the $1500 range for these tests. We don't bill any insurance for any of these tests and can only send kits to California and Nevada addresses.

Where we start depends on the person. We make the assumption that anybody with an autoimmune condition is gluten sensitive based on our experience of dealing with many types of autoimmunity and due to our knowledge about how the immune system is activated by gluten ingestion by a gluten sensitive person. It has to do with activating powerful immune responses from chromosome six the same as if you had a poorly matched kidney transplant.

Some people will just go gluten free based on what we tell them and others want some kind of proof in the way of lab testing. We don't advise a small intestine biopsy that is commonly used in medical circles because damage won't show up there with a light microscope techniques until the pathology is fairly advanced. Scanning electron microscope analysis is better but is only available at some research centers.

Blood testing has improved dramatically over the last few years. Cyrex Labs was started to fill the gap between what was seen in the basic one or two anti-body tests and the clinical evidence that many of the people who tested negative never-the-less were healthier on a gluten free diet. The genetic test is excellent because it shows the predisposition to having a negative reaction to gluten.

Gluten sensitivity probably involves 10 different genes but the HLA-DQ gene on chromosome 6 is central to the response. We used to recommend the Alcat test but repeatability seems to be an issue. That is if you split a blood sample and send it to the lab under two different names, the results are not close enough. This doesn't mean that some people haven't gotten helpful information from the Alcat but we can't recommend it at this time. If you are having anxiety, depression or insomnia, the neurotransmitter profile is extremely helpful. So where to start? Here is a general list of order.

Many factors can change this sequence but it is easier to change the order than start from scratch.