08 September 2012

Low SIgA and why it matters to your gut health!


What is SIgA?

IgA is a type of antibody that protects against infections of the mucous membranes lining the mouth, airways, and digestive tract... it is your first line of defense on the mucosal lining and it makes up a majority of your entire immune system.

Some people have a genetic deficiency and present with low levels of SIgA and frequent infections.  Others acquire a low level after their intestinal tract becomes over-run with abnormal microbes.

SIgA helps to shape the composition of the microbes in your gut!

Extraordinary amounts of immunoglobulin A (IgA) are produced in your intestinal mucosa daily, it is known as SIgA and is secreted into the human gastrointestinal tract. SIgA production is driven largely in response to mucosal antigens (bugs or food) encountered by gut-associated lymphoid tissue (GALT).  It is clear that secretory antibodies are directed against at least two broad classes of antigens. The first is associated with enteric pathogens (the "bad guys" or infections) and their virulence factors, or things that the bugs secrete, like toxins.


The second broad class of antigens recognized by SIgA is associated with the intestinal microbes or commensal microflora (the "good" guys, like probiotics). In experimental animal models commensal bacteria are potent inducers of secretory antibodies; in humans, it is estimated that between 25 and 75% of intestinal bacteria are coated with SIgA.  This could explain why one of the most basic ways to improve levels of SIgA is to give a patient probiotics and saccromyces boulardii. 


There is also evidence from mice that secretory antibodies play an important role in shaping the composition of the intestinal microbiota, which in turn can influence your gut's defense against invaders and enhance resistance to the intestinal infections.

  
Profound Role in Intestinal Balance and Your Health

So because SIgA can neutralize the "bad guys" and shape the "good guys" SIgA plays a profound role in intestinal balance and health.  SIgA is the main immunoglobulin in mucus secretions. The intestinal cells produce about 2-3grams of SIgA every day!  And production tends to peak in childhood and start to decline after about sixty years old.

This is our first-line defense against gut pathogens like bacteria, food proteins, parasites, fungi, toxins and viruses. SIgA antibodies prevent micro-organisms, food proteins and cancer-causing substances from binding to the surface of absorptive cells. Effectively, they attach themselves to invading bugs and trap them in mucus to prevent them from going anywhere!

The antibodies also 'tag' foods as acceptable to the body and this suggests why low SIgA levels can be a factor in developing and progressive food allergy and intolerance. Intestinal permeability is also related since, if levels are low, repair of mucosal tissues can be compromised.  This is often referred to as Leaky Gut and can coexsist with low levels of SIgA.


Certain SIgA antibodies have been shown to directly quench bacterial virulence, whereas others help with uptake of SIgA–immune complexes by mucosal dendritic cells and result in down regulation of pro-inflammatory responses normally associated with pathogens and allergic antigens.

In fact it is becoming increasingly evident that human health is inextricably linked to the gut microbiota, intestinal homeostasis, and mucosal immunity. IgA is at the centre of this dynamic. 


Testing your SIgA

Secretory IgA is quite independent of blood IgA levels so just because one is normal, doesn’t mean the other is.   SIgA can be measured in different ways, including stool and saliva. Levels can turn out to be low or high. Stool measurements have traditionally been based on sample extractions from animal models – it is hard to ask a mouse to spit! Salivary samples provide a systemic overview of circulating SIgA.

Ongoing low levels can help to explain why people can’t shift an immune problem like allergies, chronic skin conditions or infections. It can also explain why they find it hard to get rid of a microbial infection, too. Celiacs and those with IBD can have low levels and chronic stress has a major effect on SIgA levels. Certain medications can lower levels – including anti-inflammatories.   Other factors  includeviral infections (like Epstein Barr viruses), poor nutritional status, food allergies, ongoing stress. Interestingly some studies have shown variations in levels with gender and age – male patients often have lower levels.


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125 comments:

  1. If someone has low SIgA, what should they do?

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  2. Hi Stephanie,
    It's important to find out why the SIgA is low and treat the root cause. I suggest finding a functional medicine doc in your area who does comprehensive digestive stool analysis. Often if the gut microbiome is imbalanced or there is an infection it will lower the SIgA. Other people are born with genetic deficiencies of IgA. Probiotics are helpful but treating the cause is essential.
    warmly
    Dr Jill

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    Replies
    1. So if a comprehensive stool analysis is done and shows pathogenic bacteria, would you give a patient antibiotics for that? Probiotics and herbs/natural substances don't seem to make any difference.

      Delete
  3. What if SIgA is above normal? Mine is 76.149 on a range of 10.0-60.0 ug/ml (done by saliva test).

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  4. High can indicate a chronic infection, like parasite or yeast. I suggest finding a functional medicine doctor to test the stool for infections and treat to balance your gut microbes.

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    Replies
    1. Thanks for replying! I do have an upcoming doctor appt.

      Delete
    2. Hello, I have just had a stool test and found I have high sIgA (3 times the upper limit). Not dysbiotic flora, yeast or parasites found. Only bad things found were commensal bacteria and low levels of some beneficial bacteria e.g. no Enterococcus and low growth of lactobacillus. Do you think that would be enough to cause high sIgA?
      Thank you

      Delete
  5. My secretory IgA was recently tested via stool sample and came back as 10.6mg/dL and the reference range was listed as 54-204mg/dL. My doctor said that it was okay that it was low because that means there is no chronic infection; however, I have digestive issues and possible food sensitivities. I just want to be sure I understand this correctly. To me it seems that my IgA is low and could be a contributing factor to some of my current issues. Can you offer any insight?

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  6. Hi Lauren, low sIgA usually means some chronic infection or dysbiosis or a stressed gut (food allergies, celiac disease, etc) Probiotics, saccromyces boulardii, and IgG or whey protein (if you are not sensitive to diary) may help.

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  7. Very helpful! My ND was good at telling me what my low number meant, but seeing the explanation written out is very helpful at solidying the information for me. Thanks for the post!

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  8. Hi Doctor. I am totally confused! What does it mean if you have very elevated (712) stool SIga but borderline low salivary SIga (5)? Also have elevated (11) intestinal lysozomes and my Alpha Anti-Chymotrypsin (Stool) borderline elevated (72) as well as low pancreatic output.

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  9. Elevated IgA on stool testing can signify inflammation or occult infection

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  10. Hi Dr Jill,

    My SIga is extremely low and I'm currently tackling dysbiosis and food intolerances. Can S-Boulardii and probiotics be taken at the same time, and is there an upper limit to the doses of those supplements? I would like to take the max I can tolerate in order to raise the Siga and obliterate the baddies! My other question is that I constantly have to cough up monumental amounts of mucus - definitely related to the gut/digestion. It doesn't seem to matter what the food is - any food in moderately large quantities (especially if oils and fats involved) will give rise to this symptom. My guess is that it's a defensive, anti-body reaction gone beserk. No one has been able to explain it. Any advice/insights, especially as to treatments?
    Thanks, Nick

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  11. Hi Nick, I suggest getting a comprehensive stool analysis, blood work, and Ig food sensitivity testing. Also recommend elimination of all gluten & grains and embracing a paleo-style diet. You should find a functional medicine doc in your area to help guide your treatment plan.
    warmly
    Dr Jill

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  12. Hi Dr Jill, I've done all of those things, including eliminating all grains and sensitive foods, and been on paleo-style diet over 4 years. All under the care of a good functional medicine doc. However, just can't seem to break through, including ongoing leaky gut and the above-mentioned mucus problem.

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  13. I suspect you have a parasite or other ongoing infection that is not showing up on testing - I would repeat stool testing with Genova, Metametrix, Doctor's data or BioHealth. You may also need to test for heavy metals, like mercury which can make healing the gut nearly impossible if they are not addressed. Sincerely wish you the best on your healing journey!
    Dr Jill

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  14. Many thanks for your reply!
    Kind regards,
    Nick

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  15. Hello Dr. Jill,
    thank you so much for putting this web site together. Your answers to all of these questions are very helpful.
    Should a person with high gliadin Ab, SIgA and showing positive for the same test take L-glutamine? Since l-glutamine is protein would it have adverse reaction on the numbers?

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  16. No unless you don't feel well taking l-glutamine, it is generally safe

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  17. I would like to understand the concept of SIgA correctly. So if the SIgA is low on the saliva test, it means there are not enough antibodies (proteins) to protect the mucous lining? So the barrier has been compromised. Therefore the person can have leaky gut. The reference values have changed. Last year my SIgA was 24 and the normal was 25-60, but now the normal is 10-20. I still have constipation and my number this year is 23. It means I don't have leaky gut, but maybe some type of inflammation?
    What about gliadin Ab, SigA? What does that indicate?
    I get better explanation from you than from my doc.

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  18. Not exactly... think of sIgA as your mucosal immune system.... low means it is under stressed or compromised. High means that it is actively fighting an infection, reacting to a food, such as gluten, or under chronic stress...

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  19. could you please explain the role of the gliadin Ab, SIgA?

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  20. If I have a consistently low SIgA, by both saliva and stool test, can a salivary IgA test for an allergy (e.g. gluten, eggs, dairy, soy) actually be trusted as accurate? From DiagnosTechs, all the saliva tests for food allergies are listed as SECRETORY or "s" IgA.

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  21. Gliadin triggers an immune response in genetically susceptible individuals. When the gut's immune system is activated (IgA) you may see elevated levels or depleted levels if there is gluten triggering the response

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  22. Hello,
    I am an active 42 yr old and have extremely high SIgA at 1340. My good bacteria is low and some have no reading. My yeast is Moderate. My DHEA is low at 2. My Thyroid went from 4.03 to 5.75 (Hypo) in 6 months.
    Can you make sense of this? my naturapath has some good game plan ideas but is unsure why my SIgA would be so high. I have been diagnosed with IBS-C (complete loss of motility), exhaustion, severe PMS, weight gain& inability to lose. thank you in advance for any thoughts or advice.

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  23. High sIgA may be sign that you are fighting off some sort of infection in the gut... OR that you are getting gluten in your diet and extremely sensitive. I recommend going 100% gluten free if you are not already doing so and repeat testing.

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  24. Dr. Carnahan,

    I am impressed that your dedication to helping people extends to putting together this blog and responding to strangers in need. Thank you.

    my question for you is do you think fecal transplants are a potential way to reset the mucosal gut immunity, and thus sIgA?

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  25. Fecal transplant has amazing potential and the data at present is pretty impressive. However, it is currently only indicated for c. diff colitis and regulated by the FDA so I am not sure we have any evidence to recommend for abnormal IgA levels...

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  26. Im not sure if my comment posted, so I will try again. Serum IgE= 19.8, SIgA=6, Gliadin AB= 3. Low cortisol, Low Vit D, Low Cholesterol, Low Homocysteine. Slight Milk allergy, gas after consuming fatty foods esp. pizza, breve's or ice cream. Can drink raw milk without cream or eat yogurt just fine. Fatigued and easily irritated or aggressive, chronic severe scalp irritation. Doc is trying to treat adrenal insufficiency but I do not think it is root problem. Does this sound like celiac? Could it be something else?

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  27. Sounds like you may have dysbiosis. Find a trained functional medicine doctor to do further testing to determine if that is the case, such as GI stool profile and organic acids.
    warmly
    Dr Jill

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  28. Dr Jill,

    I took a CDSAx3 and got a Secretory IgA: Outside 324 (Reference Range 51-204mg/dL)
    Since the level is high and not low, does this mean I don't have a leaky gut? thnaks

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  29. Elevated sIgA may be from gluten sensitivity or an infection. Something is triggering your mucosal immune system to be on high alert. This does not determine whether or not you have leaky gut and you met certainly have it with an elevated sIgA...

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  30. I got here by searching low sigA. Happy to find such an informative blog by a Functional doc! Curious to investigate if my genetics play a role in my sigA perhaps being a cofactor in dysbiosis. Do you have any idea which SNPs are implicated in low sigA?

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  31. Selective IgA deficiency is not a SNP but an autosomal dominant or recessive trait found in approximately 1:700 Europeans. Usually there is a family history and sometimes other autoimmune diseases present, like celiac disease or ulcerative colitis.

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  32. H Doc, is sigA the same as iga? Also, just got my blood work and my igA was 686. I did the yeast spit test and it did show something is going on. Additionally I have been on 5 antibiotics this past year due to a UTI and a tooth issues. Your thoughts are appreciated. Thank you.



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  33. Hi there - if your serum IgA is elevated, it could mean you are fighting an infection on some mucosal surface the largest of which is in the GI tract but IgA also covers other mucosal surfaces, such as sinuses, vaginal tissue and lung. I don't use the spit test but there are other ways to determine if you have yeast overgrowth such as stool testing, Candida antibodies in blood or organic acid testing. Of course if positive, I recommend finding a functional medicine doc to help you treat and eradicate the overgrowth.
    warmly
    Dr Jill

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  34. Hello Dr. Jill, I recently had blood test done and my IgA was elevated to 686 and my IgM was elevated a few points only. I have taken antibiotics a bit these past few years due to dental issues. Also, have been having gas and some bloating. Can you give me some insight? I have read online things like multiple mylenoma etc can be the culprit. I'm a bit freaked out to say the least. Thank you again.

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  35. Hi Rosie,
    I suggest getting food allergy testing and a stool profile to determine if there is an infectious cause or an allergen contributing to your elevated sIgA. And you need to eliminate gluten 100% as that can sometimes be the problem as well.

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  36. Hi Dr. Jill, Thanks for taking the time to answer us all. I have multiple food intolerances and very low SIgA (3mg/dL, reference range 54-204mg/dL). I am very intolerant to milk and an Elisa test proved me very intolerant to bakers yeast and brewers yeast as well. So is saccromyces boulardii and whey and option for me? I have taken probiotics and done FMT, but even though I am very low in bifido, lactic acid seems to irritate my gut lining to the extend that I get a rash on my belly on top of the place that feels irritated. I am on a low histamine, low salicylate paleo diet. When all this started I was on metronidazole for 2 month in order to shoot down hidden parasites, but this just gave me salicylate sensitivity on top. I am having my last amalgams removed now. Any other suggestions? Thanks Bridget

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  37. Hi Bridget,
    Usually low IgA in the face of high sensitivity to yeasts can indicate you have fungal dysbiosis in the intestines. Further proof would be white coating on tongue, carb or sugar cravings and any skin rashes. Taking anti-parasitics could also flare your yeast symptoms. I suggest working with a practitioner to do an intensive anti-fungal regimen to clear the yeast and support your immune system to recover. Yeast is opportunistic so will take advantage of a situation in which there is low sIgA..
    warmly
    Dr Jill

    PS _ read more here http://www.jillcarnahan.com/2014/08/17/rising-epidemic-yeast-syndrome-aka-fungal-dysbiosis/

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  38. Hello Dr Jill, MAny thanks for taking the time
    My daughter has effectively no blood IgA, although her general health is very good, and we are very watchful that coughs & colds dont deteriorate. I have two questions, if you dont mind
    1) IS there a correlation between blood serum IgA defficiency and secretory IgA? Is it worth getting a stool test for her?

    2) She has no diet problems to speak of, we live in Spain and my wife is Italian so its a very Mediterranean diet), takes probiotics and echinacia, but is there an "idiots guide" to what foods are good and what are more troublesome if she does have low saliva IgA as well. Or frankly, if there are no issues is it not worth bothering about?

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  39. Hi James, this condition is called selective IgA deficiency and is likely genetic, possible more serious than simple sIgA deficiency in the gut. It will put her at risk of any infection that affects mucosal surfaces (GI tract, sinuses, etc) as her mucosal immunity is impaired. There is a correlation with celiac disease and IgA deficiencies so I would have her on a gluten-free diet at the very least.
    It probably helps that you live in Europe where there are greater restrictions on genetically modified foods and additives because the cleaner her diet (whole real foods!) the better she will do life-long.
    Warmly
    Dr Jill

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    Replies
    1. Many thanks. (And sorry for the double post!)
      James

      Delete
  40. Hi Dr Jill, my mum has had chronic problems with diarrhoea and urgency and has had several fecal occult blood tests with her doctor which have not found anything.
    She has now done a comprehensive stool analysis with parasitology which found no pathogenic bacteria or parasites or signs of inflammation but did have raised secretory IgA levels. Does this mean that she is likely to have an underlying infection which the test has not picked up or that she has a food intolerance? Any suggestions for further testing would be much appreciated. Thanks. Sue

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  41. Hi there... raised sIgA makes me wonder about food sensitivities/gluten intolerance. If she is not already, I suggest an elimination diet for 30+ days off all of the following: gluten, dairy, egg, soy, corn, sugar, alcohol and see if she feels better.
    warmly
    Dr Jill

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  42. Hello Dr. Jill,
    I recently had a comprehensive stool test done that showed elevated siga at 1938. I also had a food sensitivity test that showed wheat, eggs, milk and 23 others that where 2+ on foods I should not eat. There was no blood found and no pathogens, but a little yeast and unknown bacteria. Also no infections either. What are your expertise thoughts on this? are the foods the culprit in this elevation? I would appreciate your insight. Thank you for all you do. Tina.

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  43. What we know is that elevated SIgA shows that the mucosal immune system is irritated/activated by something... with what you are describing, it could be exposure to gluten, eggs, milk or it could be the yeast overgrowth, even if only a little showed up in the stool. Also the testing isn't perfect and many times there is something else going on, like a parasite that doesn't show up on testing. I suggest an gentle anti-microbial regimen, like Xymogen Candicidal (https://www.xymogen.com/products/product-detail.aspx?pid=29) 2-3 caps twice daily x 8 weeks to clear any infections and avoiding your food triggers. You can order Candicidal direct from Xymogen using professional code: DrJill and last name: Carnahan.
    Best in health,
    Dr Jill

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  44. Dr. Jill,

    I ordered the Xymogen you suggested. Can I take this along with Probiotics?

    Thanks again,
    Tina

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  45. Hi Dr. Jill,

    I recently found your blog and first want to thank you for this excellent resource! My results from a Doctor’s Data comprehensive stool analysis show:
    1. my Secretory IgA (sIgA) level was high at 256 mg/dL (reference range was 51 to 204). Report says “Elevated levels of sIgA have been associated with upregulated immune response.”
    2. my Lysozyme level was high at 1050 ng/mL (reference level less than 600)
    3. I seem to be lacking some beneficial bacteria that are normally present. For example, I have no growth (NG) of Lactobacillus spp. and only “1+” of Clostridium spp. (on 0 to 4 scale).

    Does this point to leaky gut? Gluten sensitivity? Another site recommended a “PMN Elastase” test--do you recommend this? Would an organic acids test yield more information?

    These days I do NOT have any outward symptoms of gut trouble (e.g. bloating, discomfort, constipation, etc.) but I am struggling to to cure my depression which I think was caused by gut issues years ago.

    Thank you very much! Again, I really do appreciate your willingness to share your knowledge and experience.
    Dan

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  46. Hi Dan, Organic Acid testing would determine if you have bacterial or fungal dysbiosis which a stool profile may miss. The elevated sIgA could also be related to gluten intolerance or other food allergy. I'd try at the very least a gluten-free diet for 6 months and retest to see if markers go down.
    warmly
    Dr Jill

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  47. Hello Dr. Jill!
    I discovered about 9 months ago that I have low serum IgA, and now after 9 months of being gluten free and after doing a comprehensive elimination diet to find any other food triggers, my recent serum test shows even lower IgA levels, about 40 points lower. Why could this be? How else to manage this condition other than dietary intervention? Thank you so much for taking the time to comment!

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  48. Hi Gina,
    Diet can influence sIgA levels but so can pathogens, or small intestinal bacterial overgrowth. I suggest a comprehensive stool test and urinary organic acids to determine if there is some imbalance besides food contributing to your low IgA. You may also have a condition called selective IgA deficiency, which may not respond to diet.
    warmly
    Dr Jill

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  49. I just did a comprehensive stool analysis through my functional doctor, and the sIGA came back as < .1 (which seems basically non-existent). What does this mean?

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  50. Hi Jeremy, There is something suppressing your guts immune system. Check for food allergies and infections.
    warmly
    Dr Jill

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    Replies
    1. Thanks Doctor. I had a comprehensive stool analysis done and an ALCAT (which showed some food sensitivities). The stool analysis showed no ova or parasites, but showed moderate yeast, and moderate red blood cells. Lactoferrin (<0.5) and Calprotectin (<10) were within range and low. Lysozyme was elevated (1170 of range of <= 600), and few white blood cells and negative for mucus. sIga was very low < 0.1, pH 5.6, and no occult blood. There were some imbalanced flora that he did not like. He has ordered a colonoscopy, an anti-biotic for my gut, a bunch of supplements for gut restoration, adrenal support, and other deficiencies, and a stress/anxiety reduction regime. I'm in my late 30s, eat healthy, exercise everyday, and in otherwise good health, except my bowel movements have been 1 daily right when I get up, and soft to muddy and I sometimes deal with anxiety. To be honest, I'm very scared/anxious that it may be something very serious.

      Delete
    2. Sounds like you are on the right track. Follow your doctor's recommendations and recheck SIgA in 6-12 mos.

      Delete
    3. Thanks doctor. < 0.1 seems pretty non-existent. Is it possible for an infection or food allergy to lower it to such an extent? I read somewhere online that there is a genetic condition that could prevent production of sIga. Could that be possible?

      Delete
    4. There is a condition called selective IgA deficiency that is genetic

      Delete
  51. Hi Dr. Jill,

    Do you think H-pylori vacA and Blastocystis Hominis would account for a high sIgA1 (>5000) and a high sIgA2 (3016)? Should H-pylori be treated if asymptomatic? Thanks in advance!

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  52. yes, any infections can cause elevated in sIgA

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  53. I have had IgA deficiency for about 10 years. Is it possible to increase IgA levels by taking a probiotic?

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  54. Make sure you do not have candida overgrowth, SIBO or other infection. Eliminate gluten and any other food sensitivities (test with IgG) from your diet. Saccromyces Boulardii may be helpful as well as colostrum or Enterogam

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  55. Hello, I have just had a stool test (doctor's data) and found I have high sIgA (3 times the upper limit). Not dysbiotic flora, yeast or parasites found. Only bad things found were commensal bacteria (include some klebsiella) and low levels of some beneficial bacteria e.g. no Enterococcus and low growth of lactobacillus. Do you think that would be enough to cause high sIgA, perhaps the klebsiella? All other inflammatory markers were low.
    I already did a three month protocol last year for klebsiella though!
    Thank you

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  56. You need to get a SIBO breath test. I usually see klebsiella associated with SIBO and that would cause high IgA. Have your doctor test for that first.

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    Replies
    1. Thank you. The funny thing is my bowel movements are better than they have been for years. I now rarely get diarhrea or constipation. So you still think SIBO is a possibility?

      Delete
    2. What about klebsiella and low IgA?

      Delete
  57. You will never know unless you test...

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  58. OK. Thank you so much for your reply. I'll try get that test organised.
    Recently I sometimes get a sharp pain in my chest when breathing deeply. Any idea what that could be. I was wondering if it's the klebsiella as that can affect the lungs. High dose of Vitamin C seems to clear it.

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  59. Hi Doctor Jill,

    I am having digestive issues from few months which are very intermittent. They are

    a- Intermittent Bloating
    b- Intermittent Upper Abdominal Discomfort
    c- Gas(Very Rare)
    d- Constipation(Only sometimes)

    I do not have these

    a- Bleeding
    b-Weight loss
    c- Anaemia
    d- Diarehea

    Went to GP he didnt do any test and said might be IBS-C and was not happy so went to gastro. We did following tests

    a- Blood test( Thryiod, Kidney,bone,liver,pancreas,diabetes) all good
    b- Food Allergry(all ok and normal IgE)
    c- Stool parasite, yeast, infection(all ok)
    d- Fecal occult(All ok)
    e- Hpyroli(All ok)
    f- Iga(All ok)
    g- Coeliac profile(Only used tissue transglutamin and wasnt eliminating gluten and came fine so gastro said biopsy is not needed)
    h- SIBO(came back fine)
    i-CA19-9 and CA-50(All fine)
    j-Calcaprotectin(All normal)
    h- Fructrose and Lactose(Awaiting result but gastro believes they ARE going to be fine because we have done manual test and no diarhea was triggered)
    j- Serotinin(all normal)
    k-Anti ccp and c3 and c4(normal)
    l- vitb12 and vitd(both slightly low so got on supplement and tested again and was fine)

    Literally did so many test and then was recommended digestive test so gave it. Got really weird results but main things of attention were

    a- Negligible and very very low SIGA
    b- Leaky gut was fine(Tested by stool anti trypsin)
    c- Low fecal elastate
    d- High short chain fatty acids
    e- No dysbiosis but NO growth of Bifidobacterium

    Gastro said functional Elastaase low can be primarily because of cystic fibrosis which obviously is not case it might be secondary but go and check the pancreas so i went for ultrasound and all liver kidney spleen pancreas protase ok

    Went to dietitation and did FODMAP diet which didnt made symptoms better didnt worse. May be i dont notice improvements because symptoms are already not very bad they only happen few days of week at different times. We failed ot find a link to food. Dietitation released after six weeks and said no chance of having IBS as bowel function is normal and pain is all above not below belly button

    Did another test of elastate and was even low (67)

    Gastro said it might be a duct dilation or a stone some where so went for CT Colonosopy which said no stone, no malignancy, normal pancreas, no dilation, no hernia and nothing at all.

    Health is overall fine. Background is that went 10 years back for Colysystectamy because of gall stone and Also ercp with billiary spinchometry.

    CT mentioned about it and said no OVERT Complications found.

    I am now taking following

    a- Vit b12 supplement
    b- Vit d supplement
    c- Optibac pribiotics(General health with 20 million speci)
    d- OPtibac high fiber constipation removal pribiotics( With 5 million bifidobacteria)
    e- Multi vitamin

    I am now eating every thing as i didnt notice much change with diet.

    Last letter which i recieved form doctors is that iw ill get a call and my issues mostly are functional in nature.

    Cna i have an auto immune problem?

    Is there some further test i can do?

    How i can get rid of symptoms all together? They are manageable and do not effect quality of life btu they are there.

    I also drink quite lots of water. I am not very stressed.

    I do regular exersice and gym.

    These days i daily get upper abdominal discomfort.

    Lastly when i am very constipated(happens rarely) i also get heartburn but Gastro said it can be occasional reflux related to constipation and is not GERD we didnt do any endoscopy?

    Is there any hope for me?

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  60. You should have your doctor check you for SIBO and treat if breath test is positive

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  61. SIBO Breath test is negative.

    There is no Small intestine bacterial over grwoth

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  62. Dr, Jill, I have had on going severe depression and anxiety for the past 3 years along with gut problems. This presented with joint swelling as well at the time. I did have a stool sample which showed elevated Sig A upwards of 968 along with elevated Klebsella, Slightly elevated Candida 2+, High E coli and decreased Lactobacillis. I also have acne on my chest for a prolonged period of time which will break out at times as I take things to clean up my gut. ie Probiotics. I will also spit up yellow phlegm often in the morning after sleeping. I never have any energy in the morning with decreased energy and brain fog along with the depression. My gut wall is thickenened and my Serum IgA is 543 High. Lymphocytes are low range. Does this sound like SIBO and or leaky gut. Infection causing the problems? Symptoms will always change. and I seem very sensitive to more foods. What would be the best course of action? It feels like this may be the root of my depression and anxiety? Thank You

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  63. SIBO is testing by a methane hydrogen breath test. I would recommend finding a functional medicine doctor to help you heal your gut. The dysbiosis may contribute to mood disorders.

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  64. Hi Dr Jill,

    I just received my stool test results and I have dysbiosis. 4 plus ofseudomona aeruHi Dr Jill,

    I just received my stool test results and I have dysbiosis. 4 plus of uerginosa.. My SigA is low at 10.6 and the bifidobacterium spy have NG. I suffer from chronic fatigue and have been gluten free for 5 years, and grain free, dairy free, soy free, ( Autoimmune Paleo diet) for 1 year. I recently started the raw food diet.

    1. The remedy for the pseudomonas aeruginosa are strong antibiotics. The warnings on the antibiotics are for people with nerve and muscle disorders. I have lyme which effects the nerves and muscles. My choices for ridding my go tract of the bad bacteria are: Grapefruit seed extract, silver, or caprylic acid.
    Do you have a any suggestions for me?

    2. What can I do to increase my SigA ? Glutamine supplements?
    probiotics of a certain kind?

    Thanks for your help

    ReplyDelete
  65. You must treat the infections in order to restore sIgA - best in healing!

    ReplyDelete
  66. Hi Jill,

    Just wondering if you've heard of anything similar to my situation. I went to Vietnam and ate a raw sashimi rice bowl. A few hours later I developed nausea. I woke up with bad nausea and fatigue without any fever or diarrhea. A local hospital gave me liquid sucrulfate 1g and a simethicone with aluminium magnesium tablet taken 30 minutes afterward without a formal checkup. An hour after the medicine, I vomitted and I vomitted again about 3 hours after the first incidence. I recovered in about 5 days with a simple porridge diet. Suddenly after 15 days following the food poisoning I developed eye floaters, minor flickering once or twice a day and some sharp quick pain in the corner of the eyes like a pin prick.

    An opthomologist and a retina specialist said there is no damage and no medical treatment for my symptoms without surgery involved. I also developed upper abdominal bloating, lots of visible mucus in the stool and I have an inflamed throat with yellow mucus.

    I did comprehensive bloodwork, CDSA stool exam and an Alcat IgG food sensitivity test. The results showed slightly raised albumin 50, globulin 36, IgE 87, stool raised sIgA 682, raised Lysozyme 802 and butyrate 5. The Alcat food sensitivity test showed several foods in the severe and moderate ranging from ginger, pumpkin to flaxseed and coffee. Also a strong reaction to gliadin/gluten and mild to candida and milk/whey products. These foods seem to be the ones I ate after recovering from the food poisoning. All of the tests were taken about 6 weeks after the food poisoning. Everything else appeared normal.

    I found your informative post by looking the causes of a raised sIgA.

    Do you have any experience of clients who experienced eye floaters or flickering related to infections in the gut? Would you say that my numbers indicate an acute infection? I show absolutely no signs of food sensitivities aside sudden bloating, but the Alcat test shows a large number of items. I tend to think it's not coincidental to have all these problems shortly after an episode of food poisoning.

    I saw a functional medicine doctor who performed the CDSA stool and Alcat tests and assumed sudden leaky gut. I thought that would be low sIgA then.

    Do you have any experience with clients with my symptoms and what would you do as far as next steps? If there is an acute infection is there anything else you would screen for? I appreciate your kindness and expert experience sharing.

    Best,

    Andy

    ReplyDelete
  67. Dear Andy,
    It sounds like you may have post-infectious IBS which may trigger SIBO (small bowel bacterial overgrowth) due to an autoimmune mechanism which damages the migrating motor complex. You should also test for parasites as they are common in raw sushi. For the SIBO you can have your doctor order a lactulose breath test for methane/hydrogen and you may also want to order the new test IBSchek (http://ibschek.com) to r/o the post-infectious IBS
    Best
    Dr Jill

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  68. Dr. Jill,
    I'm working with a functional doc locally as I'm dealing with terrible cystic acne, and we began treatment as a Candida infection. I've been on a strict Candida diet for two months, without any other supplements (with the exception of Omega 3/6, Vit D, and multivitamin w/iron) as I needed to be free of any antibiotics/probiotics/antifungals for GI effects stool test. After one month, I started taking Candibactin BR & Megaspore probiotic. No improvements in my condition. This week, we received the GI test results - fat malabsorption, mildly elevated fecal SIGA, low in short chain fatty acids, mild bacterial dysbiosis, no growth of Lactobacilli, and surprisingly, no growth of yeast! Also, no parasites. I am now adding to my regimen Opticleanse GHI as a meal replacement, Ortho Digestzyme, and liposomal glutathione. Just started this week. I'm curious as it seems my skin condition is worse than when i started this program. I'm also supposed to add in bodybio butyrate but we are holding off for 2 weeks as my skin just erupted after taking it for only 2 days. I'm at my wits end.

    ReplyDelete
  69. Hi Btitt,
    Have your doctor check you for SIBO (lactulose breath test through Commonwealth labs)
    warmly
    Dr Jill

    ReplyDelete
  70. Hello Dr Jill
    First of all many thanks for taking your time and answering our questions, very useful!
    I have just run blood test as i have strong pain in multiple joints, skin issues (psoriasis and acne) and strong abdomen/intestinal pain. 4 surgeries did not help but worthen the inflammation. Here the abnormal results:
    SigA: 7926; Elastase expression: 168; C3AS: 0,36; C4AS:0,43; sCD14:3920; NAGA app Adult: 0,41; Yersinia serology igg positive and negative (¿)
    Borrelia burgdorferi Elispot LTT (reference <2):
    Borrelia burgd. Fully Antigen + 8
    Borrelia OSP-Mix (OSPA/OSPC/DbpA) +8
    Borrelia LFA-1 +6
    All the other blood results where normal. Could you help me understand the results? Many thanks in advance! Olive

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  71. Hi Olive
    I cannot give medical advice or interpret reports on the blog, I am sorry.
    warmly
    Dr Jill

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  72. Hi Dr Jill,

    Thanks for this great blog! I am 31 and for the last 5 years have been dealing with terrible fatigue, food allergies, brain fog, no short term memory, etc.

    Lab results show
    -low cortisol across the board
    -low T3 and other thyroid signifiers
    -low testosterone
    -Very high SIgA - 3571 (range:500-1500)
    -High histamine and Calprotectin

    Been gluten free and paleo for 5 years now. Have ups and downs but no real breakthroughs. Currently taking adrenal core extract. Any suggestions for next steps?

    Thanks!

    ReplyDelete
  73. Calprotectin high is worrisome for inflammatory bowel disease. To be safe you should have a colonoscopy to rule out anything more serious. If normal, identify and treat pathogens. The calprotectin high and sIgA elevated tell me you likely have something going on... You might also check for borrelia and toxic exposures, like mold

    ReplyDelete
  74. Hi Jill,

    I have the the opposite problem in that my IGA is consistantly raised. Normal range 0.8 - 2.8, mine has been over 4.5 for a year and half. I have a massive infection and was very ill, but i should have recovered from this by now, I am still very fatigued and IGA still high. I am wondering what else a raised IGA could indicate, maybe i am still fighting the infection or maybe my immune system has gone into overdrive because of the infection. I just dont know, the doctors i have seen havent offered much help, just that i probably had a virus. :/

    ReplyDelete
  75. high may indicate infection or food sensitivity like gluten intolerance...

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  76. I have had low SIgA for over 10 years (since I have been using Diagnostechs for testing) go my cortisol up but not SIgA - I have a feeling I have heavy metals - I am currently treating for SIBO and C-Diff (tested through Great Plains Laboratories) because my symptoms of chronic constipation don't fit anyones database. I know I need to get my gut working better before doing a heavy metal detox - do you feel that chlorella would work to help eliminate the heavy metals?

    ReplyDelete
  77. It's me again - my diet is clean - paleo - cleared up the candida - no sugars - just the SIBO and C-diff and constipation helped with Natural Calm

    ReplyDelete
  78. I would not recommend any sort of detox until your bowels are regular. If you decide to do a metal detox in future, I prefer Quicksilver formulas.

    ReplyDelete
  79. Hi Dr.
    I've been struggling for 3 years with on going symptoms that mimic chronic fatigue, fibromyalgia... Eye infections, vag infections etc. I've had major blood tests done and feel like I've ruled out all the "bad" things. In my anxious state knowing something isn't right, I've turned to doctors data. I have highly elevated SIga. Reading all the blogs above... I have to ask --- what's my next step? I feel like no Dr. Wants to see me anymore?! I know something isn't right. Thx Mela

    ReplyDelete
  80. Dr.
    I have been struggling for three years with ongoing symptoms that mimic Cfs, fibro, chronic eye infections, etc....have had numerous tests which have ruledout all the bad things. I resorted to doctors data and received abnormally elevated SIGA. I need to ask what are my next steps here? I feel like no doctor wants to see me anymore? Everything is "ok".... But clearly something isn't. I feel terrible. Pls help!

    ReplyDelete
  81. Hi Mel,
    Elevated sIgA is a sign that something is irritating the mucosal immune system. IF you haven't 100% eliminated gluten, try that. Otherwise, there is likely an occult infection that needs to be treated.
    Warmly
    Dr Jill

    ReplyDelete
  82. Hi,

    I'm struggling to understand if and how IgA plays a role in chronic lyme. I became sick in 2011 after being bite by hundreds of bugs at the beach and developed with acute flu like symptoms followed with what I can only describe as MS (ruled out) like symptoms. I was treated for suspected Lyme disease in July 2015. Since then my IgA has dropped to 0.5 and my C3 is elevated along with my ALT. C4 was normal. I'm also wondering how a low IgA would affect lyme testing...if at all?

    ReplyDelete
  83. Low IgA should not affect lyme western blot which uses IgG and IgM

    ReplyDelete
    Replies
    1. Thanks so much for responding. :) Hugely appreciated. I do however find it interesting the sudden deficiency after getting sick in 2011. I'm scheduled to have a biopsy for possible Celiac. My celiac blood test was negative.

      Delete
  84. Hi my daughter has just had her IGA level taken via blood test. It came back 0.3 ( the normal range indicated was 0.3 - 1.2) could this mean anything?

    ReplyDelete
  85. Hi, my stool test through Genova came back showing high secretory IgA and high PP Bacteria, low n-butyrate, low total SCFA. Dysbiosis? I also had blood Ig's tested and all were normal except IgA was high. My genetic Celiac test came back showing a low risk but I've been gluten free for 3 years due to symptoms when I ate gluten. Can you give me any insight to what this all means? Thank you so much!
    Jen

    ReplyDelete
    Replies
    1. Try an elimination diet (no gluten, dairy, egg, soy, corn, sugar, alcohol, peanut) for 90 days and retest

      Delete
  86. Hi Dr Jill, Many Thanks for this article. If a Coeliac has very low SIgA ( 2.5 on a scale of 52-300) has Clostridium SPP/Ramosum and Strep overgrowths, already eating AIP ,supplementing with Sacc B and probiotics, no parasites,should they take anything to help supplement the low SIgA or test for anything else. thank you. Suzanne.

    ReplyDelete
  87. Hi I forgot to say, no SIBO, Regards Suzanne.

    ReplyDelete
  88. You might try a course of herbal antibiotics for the strep and clostridia. Are you certain you don't have fungal dysbiosis?

    ReplyDelete
  89. Hi Dr. Carnahan,
    My daughter of 14 months has a low IgA level in blood (14 mg/dl). I'm still breast-feeding her but she had a prolonged rhinitis over the last month. Was this a consequence of low IgA or this respiratory problems decreased the IgA levels? She did not have digestive problems, except she has a constipated pattern.
    I'm not sure if to be much concerned about this or for babies IgA levels are not stabilized and should wait after 4 yrs.
    Many thanks and best regards,
    Mihaela (from Romania)

    ReplyDelete
  90. It could be a selective IgA deficiency, best to talk with her pediatrician. If she is less than 18 months it could reflect your Ig levels, too

    ReplyDelete
  91. Hi Dr Carnahan,

    I have just had a comprehensive stool sample and the results were low sIga and ph of stool too alkaline. However I did not show any signs of parasites , Candida or leaky gut. What could be causing this? I am currently under investigation for womb or urine infections could this be the cause? Also it was recommended to supplement with acidifying microbes. The Probiotic I usually take has several varying strains of lactobacillus and bifidobacterium. Would these be ok?

    Kind regards,

    Kirsty

    ReplyDelete
  92. Hi Kristy, Stool testing will show what is in the colon but you may still have massive bacterial overgrowth (SIBO) or candida in the small bowel. Have your doctor check a lactulose breath test to rule out SIBO and a urinary organic acid test for ruling out candida.
    warmly
    Dr. Jill

    ReplyDelete
  93. Hi Thank you for your reply. As part of my stool test I also did a mouth swab. Would you suggest I would still need a lactulose breath test?

    Kind regards ,

    Kirsty

    ReplyDelete
  94. A mouth swab will not diagnose SIBO, you need a breath test for that.

    ReplyDelete
  95. So I have very low Iga for stool and saliva and I struggle terribly with systemic candida. I cannot tell from my research if low IgA is the cause of candida or if candida is the cause of low IgA? I do EVERYTHING (strictest of diets, supplements, etc.) to fight the candida but I lose often. I have oral thrush as I type. How can one kick candida if they have low IgA and how can one raise IgA if they have candida? I feel stuck in a chicken or the egg situation.

    ReplyDelete
  96. Candidiasis is a sign of weakened immune system since it is an opportunistic infection. Fix the immune system and the yeast infection will go away!

    ReplyDelete
  97. Hi, just had my stool/saliva results back. Nothing nasty showed up, no parasites, candida or yeast overgrowth. No leaky gut. It did reveal low levels of good bacteria, secretory IgA at 48, stool alkaline at 8. Overweight. Dairy and wheat intolerant. Any suggestions?

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  98. Dr. Carnahan, I'm hoping you can help me. I have been on a long journey (10+ years) with immune issues. I have hypothyroidism and multiple issues with food allergies (yet negative for gluten allergy by endoscopy, without gluten challenge, and by blood test). I recently did a stool test (Genova) and the results came back with high levels of eosinophil protein X and secretory IgA; the thing I am most confused by is that I've had LOW levels of IgA in serum on several previous tests. Do you have any idea if there's any condition that could cause low serum IgA but high fecal secretory IgA, or what I could possibly look at next? My CAM provider mentioned addressing possible candida issues next (despite negative SIBO), but I'm not sure how this fits into the IgA situation!

    ReplyDelete
  99. Selective IgA deficiency can cause chronic low serum IgA

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  100. Dr. Carnahan,

    I have recently been diagnosed with autoimmune hepatitis, but from what I've read, it could just be a gluten sensitivity (and dairy?). How do I use the sIgA test to check for gluten sensitivity? I am trying to eliminate it from my diet. If I get the test what will a low result be vs. a high result as far as this is concerned? Will the results be different if I consume gluten before the test? Thanks in advance!

    ReplyDelete
  101. You may try 6months gluten free diet to see if the hepatitis reverses...

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  102. Dr. Carnahan,
    Hello, my son was recently diagnosed with candida and SIBO. We were strict paleo for 4 years, then autoimmune paleo for 1 year. We saw improvement, especially with the autoimmune version. His anti-gliadin SIgA recently came back as high. We are strictly grain-free & make all our own food. Could candida and/or SIBO cause the production of anti-gliadin SIgA? I am at a loss. Thank you!

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  103. Candida, SIBO or other infection could cause persistently high sIgA...

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  104. Umm, Jill I have Candida and SIBO, both are being treated at present, but also very low sIgA how does that make sense!? Thank you.

    ReplyDelete
  105. yes, infections and dysbiosis can suppress immune function

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  106. Hi. Don't understand your comment above. I too have a recent High Anti-gliadin SIgA. I'm Paleo and strictly gluten free for years, but have SIBO. Did you mean (above) that SIBO etc could cause persistently high ANTI-GLIADIN SIgA?

    ReplyDelete
  107. She is asking about low sIgA which indicates immune system dysfunction. High anti-gliadin means something entirely different, that you are being exposed and reacting to gluten

    ReplyDelete
  108. Dr. Jill
    Can a highly elevated sIgA (840) be a result of mycotoxin exposure. After having great gut function for many years I have suffered from chronic upset stomach with occult blood in my stool along with the above elevated sIgA after living in a home with toxic mold for 8 weeks. Thank you for your time!!

    ReplyDelete
  109. Hi Kris,
    Mold can cause severe intestinal permeability, dysbiosis and food sensitivities and these things can increase sIgA. It's more likely from the side effects of mold vs. mold directly
    Warmly
    Dr Jill

    ReplyDelete
  110. I have low sigA (3.5 on a scale of 51-204) and Geotrichum yeast (1+).
    Should the yeast be treated or should the SigA be treated? If your answer is SigA, how would you treat the sigA?

    ReplyDelete
  111. Dr. Carnahan,

    I have had significant health problems over the past year and become highly sensitive to everything including food, supplements, medication, smells, textures of clothing, makeup, and deodorant. A stool sample revealed no growth of Lactobacillus and Enterococcus and a very high Secretory SIGA of 773. No other concerns were noted with my stool sample. My colonoscopy was clear. My food testing came back high for eggs and dairy. I have stopped all dairy and gluten (with the exception of barley). This Fall I went three months without eating eggs and it didn't change my hypersensitivity so I'm still eating them....could the eggs alone be causing this despite going without for 3 months? What else could I look into or test for to try and find the root cause of the high SIGA? It's also ironic that over the past year I've had high levels of cortisol, which should lower the SIGA, but that isn't the case. Thanks for willingness to respond.

    ReplyDelete
  112. Dr. Carnahan,

    I have had significant health problems over the past year and become highly sensitive to everything including food, supplements, medication, smells, textures of clothing, makeup, and deodorant. A stool sample revealed no growth of Lactobacillus and Enterococcus and a very high Secretory SIGA of 773. No other concerns were noted with my stool sample. My colonoscopy was clear. My food testing came back high for eggs and dairy. I have stopped all dairy and gluten (with the exception of barley). This Fall I went three months without eating eggs and it didn't change my hypersensitivity so I'm still eating them....could the eggs alone be causing this despite going without for 3 months? What else could I look into or test for to try and find the root cause of the high SIGA? It's also ironic that over the past year I've had high levels of cortisol, which should lower the SIGA, but that isn't the case. Thanks for willingness to respond.

    ReplyDelete