Gut Health Testing Guide: Leaky Gut, Celiac, Gluten Sensitivity, and Food Allergies Unraveled
- Dr. Heather
- Jun 21
- 6 min read
If you’re dealing with digestive issues, fatigue, or unexplained symptoms, you might be wondering whether the culprit is a leaky gut, celiac disease, or a food sensitivity like gluten intolerance. With so many testing options out there, it can feel overwhelming to figure out which one is right for you. In this post, we’ll compare Gut Barrier Testing, celiac disease panels, gluten sensitivity panels and testing for food allergies and sensitivities to help you understand their purposes and when to use them. We’ll also tackle a common question: Can you test for gluten sensitivity without eating gluten? (Spoiler: We’ll look at the ALCAT test and others to find out!) Let’s dive in and explore how to approach testing based on your health goals.
Why Start with Gut Barrier Testing?
Before jumping into food sensitivity or celiac testing, it’s often smart to assess the health of your gut barrier. Why? Your gut lining acts like a gatekeeper, controlling what gets absorbed into your bloodstream. If it’s compromised—often called “leaky gut”—undigested food particles, toxins, or bacteria can sneak through, triggering inflammation and symptoms that mimic food sensitivities or even autoimmune conditions like celiac disease. Ruling out gut barrier issues first can save you time and misdiagnoses.
Gut Barrier Testing: A Deep Dive
The KBMO Gut Barrier Panel is a blood-based test designed to evaluate the integrity of your gut lining. It measures immune responses (IgG 1-4, C3d, and IgA 1-2) to four key markers that identify levels of gut dysfunction, from mild sensitivity to severe leaky gut. It’s especially useful if you suspect your symptoms (bloating, fatigue, joint pain) stem from a compromised gut rather than specific foods. The four markers are:
Zonulin: A protein that regulates tight junctions in the gut. Elevated levels suggest increased intestinal permeability.
Occludin: A structural protein in tight junctions. Antibodies to occludin indicate gut lining damage.
Candida: Overgrowth can disrupt gut health and contribute to permeability.
LPS (Lipopolysaccharide): A bacterial toxin that, when present in the blood, signals leaky gut and systemic inflammation.
When to use it: If you’re experiencing chronic digestive issues, systemic symptoms, or suspect leaky gut, start here. Fixing the gut barrier can reduce false positives in food sensitivity tests and clarify whether symptoms are due to gut dysfunction or specific foods like gluten.
Testing options you can order yourself with my practitioner code: 850409
1. The basic panel: KBMO Gut Barrier Panel
2. Add the above Gut Barrier Test with The FIT 132 that measures sensitivities of 132 different foods and additives spanning all major food groups.
3. The FIT 176 Test KBMO is focused on Food Sensitivity Testing with the patented FIT (Food Inflammation Test) Test, which includes the Gut Barrier Panel. The FIT 176 Test employs unique methods that detect both lgG antibodies and Immune Complexes together to determine the reactivity of each sample against a wide variety of food antigens. Measuring IgG and Immune Complexes together increases the sensitivity over other tests which measure IgG alone.
Celiac Disease Panels: The Gold Standard for Autoimmune Diagnosis
If you suspect celiac disease—an autoimmune condition triggered by gluten—specific testing is crucial. Celiac disease damages the small intestine, leading to malabsorption and symptoms like diarrhea, weight loss, and fatigue. Unlike general gut issues, celiac requires a lifelong gluten-free diet, so accurate diagnosis is essential.
What’s in a Celiac Disease Panel?
Celiac panels typically include blood tests for antibodies produced in response to gluten:
tTG-IgA (Tissue Transglutaminase IgA): The most sensitive and specific test for celiac disease. Positive results strongly suggest celiac when gluten is in the diet.
Total IgA: Checks for IgA deficiency, which can cause false negatives in tTG-IgA tests.
DGP-IgA/IgG (Deamidated Gliadin Peptide): Useful for confirming celiac, especially in IgA-deficient individuals or children.
EMA-IgA (Endomysial Antibodies): Highly specific but less commonly used due to complexity.
If blood tests are positive, a small intestinal biopsy is often recommended to confirm villous atrophy, the hallmark of celiac disease. Genetic tests for HLA-DQ2 and HLA-DQ8 can assess risk but aren’t diagnostic alone.
What’s it for? Diagnosing celiac disease in people with symptoms like abdominal pain, diarrhea, or nutrient deficiencies, or those with risk factors (e.g., family history, type 1 diabetes).
Pros:
Highly accurate when gluten is consumed (93% sensitivity for tTG-IgA).
Clear diagnostic path with biopsy confirmation.
Essential for determining celiac disease.
Cons:
Requires gluten consumption (2 slices of bread daily for 6–8 weeks) for accurate results.
False negatives possible, especially if IgA-deficient or already gluten-free.
Invasive biopsy may be needed for confirmation.
When to use it: If you have symptoms suggestive of celiac disease or a family history, and you’re willing to consume gluten for testing. This is not the test for non-celiac gluten sensitivity or general gut health.
Gluten Sensitivity Panels: Navigating Non-Celiac Reactions
Non-celiac gluten sensitivity (NCGS) is trickier. It causes symptoms like bloating, brain fog, or joint pain after gluten consumption but lacks the autoimmune damage of celiac disease. Unfortunately, there’s no definitive test for NCGS, so diagnosis relies on ruling out celiac disease and wheat allergy, followed by a gluten-free diet trial.
What’s in a Gluten Sensitivity Panel?
Some labs offer panels claiming to detect gluten sensitivity, often measuring:
IgG antibodies to gluten or gliadin: Elevated levels may suggest sensitivity, but these tests are controversial and not validated.
Wheat IgE: Rules out wheat allergy, which can mimic gluten sensitivity.
Genetic markers (HLA-DQ2/DQ8): Indicates predisposition to gluten-related issues but isn’t diagnostic for NCGS.
What’s it for? Exploring whether gluten is causing symptoms when celiac and wheat allergy are ruled out.
Can You Test for Gluten Sensitivity Without Eating Gluten?
If you’re already gluten-free and feeling better, you might want to confirm gluten sensitivity without reintroducing gluten (a “gluten challenge” can be miserable!). Sadly, most tests—like tTG-IgA or IgG panels—require gluten consumption to detect antibodies. But are there alternatives?
Genetic Testing
Genetic tests for HLA-DQ2 and HLA-DQ8 (offered by labs like Gluten Free Society) can assess your risk for celiac disease or NCGS without gluten in your diet. A negative result rules out celiac (and likely NCGS), but a positive result only indicates predisposition, not a diagnosis.
ALCAT Test: Does It Fit the Bill?
The ALCAT Test measures white blood cell responses to foods, including gluten, claiming to identify sensitivities. Unlike antibody tests, it doesn’t rely on gluten consumption, as it assesses cellular reactions. However, its role in gluten sensitivity is limited. This is a test that reveals what food cause inflammation in your body. I use it as a one-time test. It is valuable but also closely matches the foods categorized as neutral, beneficial or food as poison, so to speak of the blood type diet.
How to Choose the Right Test
Your testing journey depends on your symptoms, goals, and whether you’re consuming gluten. Here’s a roadmap:
Suspect leaky gut or broad symptoms? Start with the KBMO Gut Barrier Panel to assess gut integrity. Healing the gut may resolve symptoms mistaken for food sensitivities.
Worried about celiac disease? Get a celiac disease panel (tTG-IgA, DGP, etc.) while eating gluten, followed by a biopsy if positive.
Think you have non-celiac gluten sensitivity? Rule out celiac and wheat allergy first, then try a gluten sensitivity panel or genetic test. A gluten-free diet trial is often the best “test.”
Already gluten-free? Consider genetic testing for HLA-DQ2/DQ8 to assess risk without a gluten challenge. Avoid relying on ALCAT or GIP tests for diagnosis.
Gluten Immunogenic Peptide (GIP) Tests: At-home urine or stool tests (e.g., Gluten Detective) detect gluten fragments (GIPs) to monitor accidental gluten exposure. These are useful for celiac patients on a gluten-free diet but require recent gluten ingestion to be positive, so they’re not suitable for confirming sensitivity without eating gluten.
6. Below are options for testing food allergies/sensitivities. Take a look at the different options for foods tested for and let me know which panel you feel would be best. Below is the section of the webpage to look for:
Final Thoughts
Testing for gut barrier is a big step toward feeling better, but it’s not a one-in-done test. Starting with gut barrier testing like the KBMO panel can clarify whether leaky gut is driving your symptoms, setting the stage for more targeted tests like celiac or gluten sensitivity panels. If you’re avoiding gluten, genetic testing is your best bet to explore sensitivity without eating it, while the ALCAT test falls short for this purpose, it can be an important piece of the puzzle if our inflammation markers remain high (DBA and UA oxidative stress index).
Have you tried any of these tests, or are you considering one? Share your thoughts in the comments, and let’s keep the conversation going!
Sources:
KBMO Gut Barrier Panel: Rupa Health
Celiac Disease Testing: Celiac Disease Foundation, Mayo Clinic
Non-Celiac Gluten Sensitivity: Beyond Celiac, Gluten Free Society
ALCAT Test: Celiac.com
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