Test Results Hard To Google :-)

[robbo1234]

Good Afternoon Board,

 

First and foremost thank you in advance to anyone that can help out here. I have just started poking around the internet to interpret some lab test results (my doctor contacted me and said I was gluten intolerant), but I would like to do my due diligence and research to interpret some lab results.

 

To give you a bit of background about myslef, I am a 29/M in good health- and haven't experienced any symptons I can really point out as gluten intolerant ( to the best of my knowledge). My girlfriend* has suggested that I look into root causes of my ADHD, and thus the journey of determining if diet may be one issue. Hence the reason for my celiac panel.

 

At any rate, if anyone can help me interpret the below results, any help would be greatly appreciated.

 

Thank you,

Edited July 21, 2014 by robbo1234

[nvsmom]

Hi Robbo,

Your results didn't show up.  Can you type or paste them into your reply?  Don't forget to include your reference ranges ad=s they can vary widely between labs.

 

Welcome to the boards.  

[robbo1234]

Hi Robbo,

Your results didn't show up.  Can you type or paste them into your reply?  Don't forget to include your reference ranges ad=s they can vary widely between labs.

 

Welcome to the boards.  

 

 

My Apologies, please see below results :-)

 

 

Deamidated Gliadin Abs, IgA 0 - 19 units 2

 

Negative 0 - 19

Weak Positive 20 - 30

Moderate to Strong Positive >30

 

Deamidated Gliadin Abs, IgG 0 - 19 units 2

 

Negative 0 - 19

Weak Positive 20 - 30

Moderate to Strong Positive >30

 

Tis Transglutaminase IgA 0 - 3 U/mL <2

 

Negative 0 - 3

Weak Positive 4 - 10

Positive >10

Tissue Transglutaminase (tTG) has been identified

as the endomysial antigen. Studies have demonstr-

ated that endomysial IgA antibodies have over 99%

specificity for gluten sensitive enteropathy.

 

Tissue Transglutaminase IgG 0 - 5 U/mL 30

Negative 0 - 5

Weak Positive 6 - 9

Positive >9

 

Endomysial Antibody Negative Negative

 

IgA 91 - 414 mg/dL 80

 

 

Thanks!

 

EDIT: Underlined are my results: italicized are the normal range

Edited July 21, 2014 by robbo1234

[LauraTX]

Welcome, Robbo!

 

Your total IgA is low, therefore the tissue transglutaminase (ttg for short) IgA result is invalid as it will not be accurate, in this case it is a false negative.  Your ttg IgG is definitely a positive.  

 

Overall, this means you have positive blood antibodies for Celiac disease, so your next step is to get a referral to a GI specialist (unless you already have one) and they will want to perform an upper endoscopy to cement a probable Celiac diagnosis.  Keep eating gluten until this step is completed.  Many people, including me, don't have obvious outward symptoms of Celiac disease, but the disease is hanging around causing damage.  Some people don't realize what their symptoms were until they go away!  So there is definitely a possibility your psychological health is being affected by untreated Celiac disease.  

 

If you need help finding a specialist, you can ask your primary care doctor for a recommendation, and make sure they are on your insurance plan.

 

Would write a little more, but I have to go cook for some hungry kids!    We have a lot of knowledgeable people here so feel free to ask any further questions! 

 

 

Edit:Grammar fail

[robbo1234]

Thanks Laura. I've scheduled a doctor appt in the next few weeks and i'll certainly investigate further with a GI specialist. Pretty wild that I just randomly requested a Celiac panel from my doctor (at my girlfriends advice) and had to convince him to prescribe it. Thanks again for all of your help- we'll see how this thing turns out.

 

Edit: I'd also like to add that I have a Vitamin D deficiency reported on one of the blood tests I got at the same time. Not sure if this has any relation.

Edited July 22, 2014 by robbo1234

[SMRI]

What if you are low IgA and low IgG?  Does the low IgG have the same effect as low IgA and not showing as a positive?

[LauraTX]

What if you are low IgA and low IgG?  Does the low IgG have the same effect as low IgA and not showing as a positive?

Yes, a low IgG would make the ttg IgG not reliable as well.  I have low IgA and IgG, therefore my ttg IgA and ttg IgG are worthless.  My ttg IgA was a 4, which was borderline high according to the lab, but since I have almost no natural IgA, you can take that to scale and see that is definitely a positive reading when there was so little IgA to go around in the first place.

 

Also, if you have low IgA and IgG, you need to see an immunologist and be evaluated for a possible immunodeficiency.  Unless this is is something you have already addressed, if so, welcome to the sick person club with me!  LOL (I have CVID with low IgG and IgA and reduced vaccine response)

[nvsmom]

Ditto everything Laura said. She's spot on.  

 

You most likely have celiac disease with a test result 6 times the upper normal limit - that's quite high. Don't go gluten-free until you are sure you are done testing, As Laura said, they may want to to an endoscopic biopsy on you.  Try to ensure 6 or even more samples are taken if you chose to have the procedure done.

 

Best wishes and welcome to the board.

[GottaSki]

Thanks Laura. I've scheduled a doctor appt in the next few weeks and i'll certainly investigate further with a GI specialist. Pretty wild that I just randomly requested a Celiac panel from my doctor (at my girlfriends advice) and had to convince him to prescribe it. Thanks again for all of your help- we'll see how this thing turns out.

 

Edit: I'd also like to add that I have a Vitamin D deficiency reported on one of the blood tests I got at the same time. Not sure if this has any relation.

 

Yes, the Vit D deficiency is relevant.  Celiac Disease damages the villi of the small intestine, which prevents proper absorption of nutrients.

 

If possible...add the following to future blood tests:

 

CMP - Comprehensive Metabolic Panel

CBC - Complete Blood Count

 

B6, B12, K, Iron, Ferritin, Copper and Zinc

 

More data is better...especially with your low Total Serum IgA.

 

You've had excellent advice and most importantly you are asking questions in order to understand a very frustrating process.

 

Hang in there

[SMRI]

Yes, a low IgG would make the ttg IgG not reliable as well.  I have low IgA and IgG, therefore my ttg IgA and ttg IgG are worthless.  My ttg IgA was a 4, which was borderline high according to the lab, but since I have almost no natural IgA, you can take that to scale and see that is definitely a positive reading when there was so little IgA to go around in the first place.

 

Also, if you have low IgA and IgG, you need to see an immunologist and be evaluated for a possible immunodeficiency.  Unless this is is something you have already addressed, if so, welcome to the sick person club with me!  LOL (I have CVID with low IgG and IgA and reduced vaccine response)

 

Thanks.  She has been under care for this for a few years (my daughter).  She has mild CVID and really only needs antibiotics if she gets sick at this point so that is good.  I'm surprised that she was never tested for Celiac during that time though, oops.  Her celiac test results should be back today or tomorrow so we will see.  She has way more symptoms than I do but her IgG 3 has never been low so they were never really able to explain the D.  She has appointments with my GI team next week but they wanted the labs before they saw her...but if they aren't going to be accurate, might have been a waste of time...

[GottaSki]

Thanks.  She has been under care for this for a few years (my daughter).  She has mild CVID and really only needs antibiotics if she gets sick at this point so that is good.  I'm surprised that she was never tested for Celiac during that time though, oops.  Her celiac test results should be back today or tomorrow so we will see.  She has way more symptoms than I do but her IgG 3 has never been low so they were never really able to explain the D.  She has appointments with my GI team next week but they wanted the labs before they saw her...but if they aren't going to be accurate, might have been a waste of time...

 

Hi SMRI!

 

If your daughter has Celiac Disease - running complete celiac antibody panels are never a waste of time.  They can be frustrating when they come back in the "normal" range, but can still provide valuable information.

 

Even folks with low IgA/IgG have tested positive on celiac antibody tests...the tests are not perfect, but are one of the best tools we currently have and are worth running.

 

Hang in there

[robbo1234]

Yes, the Vit D deficiency is relevant.  Celiac Disease damages the villi of the small intestine, which prevents proper absorption of nutrients.

 

If possible...add the following to future blood tests:

 

CMP - Comprehensive Metabolic Panel

CBC - Complete Blood Count

 

B6, B12, K, Iron, Ferritin, Copper and Zinc

 

More data is better...especially with your low Total Serum IgA.

 

You've had excellent advice and most importantly you are asking questions in order to understand a very frustrating process.

 

Hang in there

I did get a CBC with auto-differential at the same time as my Celiac Panel.

 

Was told nothing of significance with it. These are the results:

 

White Blood Cell Count 3.4 - 10.8 x10E3/uL     4

Red Blood Cell Count 4.14 - 5.80 x10E6/uL     4.78

Hemoglobin 12.6 - 17.7 g/dL    14.7

Hematocrit 37.5 - 51.0     % 43.5

Mean Corpuscular Volume 79 - 97 fL     91

Mean Corpus HgB 26.6 - 33.0 pg       30.8

Mean Corpus HgB Conc 31.5 - 35.7 g/dL         33.8

RBC Distribution Width 12.3 - 15.4 %       13.4

Platelets 150 - 379 x10E3/uL              189

Neutrophils 40 - 74 %              50

Lymphocytes % 14 - 46 %          38

Monocyte % 4 - 12 %          10

Eosinophil % 0 - 5 %           2

Basos 0 - 3 %         0

Neutrophil Absolute (ANC) 1.4 - 7.0 x10E3/uL        2

Lymphcytes Absolute 0.7 - 3.1 x10E3/uL     1.5

Monocyte Absolute 0.1 - 0.9 x10E3/uL     0.4

Eosinophil Absolute 0.0 - 0.4 x10E3/uL       0.1

Basophil Absolute Count 0.0 - 0.2 x10E3/uL      0

Immature Gran % 0 - 2 %      0

Immature Granulocytes ABS 0.0 - 0.1 x10E3/uL      0

 

 

Very impressed with the communities response on the board. I did not expect to get such amazing feedback. I'm glad I'm able to walk into to the doctors office with some useful information and make sure I get the appropriate diagnosis.

 

Thanks again everyone.

Edited July 23, 2014 by robbo1234

[robbo1234]

UPDATE:

 

Just wanted to provide an update on what actions I have been directed from my Doctor.

 

First and foremost, I suggested- per my research from the board here, that my tests were false negatives for the first two readings (due to a low total count). My doctor told me that I didn't have Celiac and that I was Gluten intolerant. I recommended a GI specialist, and she told me that didn't make much sense since I did not have any GI issues to date.

 

She suggested that I begin a gluten-free diet (as I have some ADHD issues, and a skin rash) and evaluate how I feel over the course of a few months, and see if it helps with the rash (it's like chicken skin but over much of my body). I was directed to go gluten-free now and if it's works... advised to stick with it. If it does not, to reevaluate and further investigate.

 

I have now started the gluten-free diet, and have been on it for a week now. The first two days on the diet, however, I felt like death. I had extreme stomach discomfort, and overall general feeling terrible.

 

It's now day 5 and I feel better.

[GottaSki]

Glad you are feeling better. Many of us have both good and bad days during the early days gluten free. Since your doctor was not as helpful as she could have been...I highly suggest keeping a symptom log...both good and bad details.

Hang in there and let us know if you have questions

[GottaSki]

PS. Make sure to get your vitamin d and other nutrients if possible tested at six months or a year gluten-free...if the deficiency you have improve that is more data that can be important down the road.

[nvsmom]

I agree, that doctor wasn't much help.Non-celiac gluten sensitivity (NCGS) never causes an elevated tTG IgG.  That indicates antibodies to the endomysial lining of your gut and NCGS does not damage the intestine.  It's a bit of a shame that she wouldn't test more.

 

I'm glad that you have gone gluten-free and are seeing improvements already.  With the positive test you had, I hope you have great success with the gluten-free diet for the rest of your days.    Best wishes, and let us know how it goes for you.  

[robbo1234]

UPDATE: 

 

First and foremost, thank you to anyone/everyone who is helped chime in so far. This is truly an excellent community of support and I really appreciate all the time and energy everyone puts in (not just to help myself). To give you an update, I got re-tested after re-introducing gluten into my diet for about 4-5 weeks and the (but with a different test) results are below.

Component	Your Value	Standard Range
IGA	61 MG/DL	70 - 400 MG/DL
TISSUE TRANSGLUTAMINASE IGA	NEGATIVE NEGATIVE: <20 UNITS WEAK POSITIVE: 20-29 UNITS MOD TO STRONG POSITIVE: >=30 UNITS UNITS	NEG UNITS
GLIADIN IGA	NEGATIVE NEGATIVE: <20 UNITS WEAK POSITIVE: 20-29 UNITS MOD TO STRONG POSITIVE: >=30 UNITS UNITS	NEG UNITS

My doctor just said, you don't have celiac disease, you can continue to eat Gluten. 

Since this test, I have continue to consume gluten for about a year now. I do have some intestinal discomfort, but nothing life crippling. Does the above test eliminate celiac?

 

Here are my previous results from a few years ago as well:

 

Tissue Transglutaminase IgG 0 - 5 U/mL 30

Negative 0 - 5

Weak Positive 6 - 9

Positive >9

 

Endomysial Antibody Negative Negative

 

IgA 91 - 414 mg/dL 80

 

 

I like to be proactive about my health so I am curious to if anyone has experienced similar results and what they may have learned about themselves. Thanks again for your help!

[robbo1234]

I will continue to provide updates as this site has helped me in the past with figuring out what to do and If someone googles this with similar results I hope this may help them. My latest update is that I basically demanded that I go see a GI specialist (after being told multiple times that I definitely did not have Celiacs). She finally referred me to a specialist who was rather short with me saying my symptoms weren't that severe enough since I was waking up in the middle of the night with issues. I calmly explained that I just want to make sure I am not causing additional inflammation/damage unknowingly (and generally like to know whats going on with my health). 

The specialist did say should would do a endoscopy if my genetic test came back positive. Below are the results to my test- I'm not sure how to interpret these, but she did recommend a biopsy after seeing them. 

 

Component	Your Value	Standard Range
INTERPRETATION	SEE NOTE
HLA-DQ2	Positive
HLA-DQ8	Negative
HLA-DQA1	01
HLA-DQA1	05
HLA-DQB1, BLOOD, QUAL	0201
HLA-DQB1, BLOOD, QUAL	0603
REVIEWED BY	SEE NOTE

I will keep you updated on the results and I wish others well. Kind of a pain in the ass that It's taken so much pro-activity (over the course of several years) to reach this point.

 

[pupppy]

Any update on this story? Why did your doctor say you were 'gluten  intolerant' but not celiac? She sounds incompetent

Edited August 5, 2018 by pupppy