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Do Elevated Anti-tissue Transglutaminase Levels Indicate Celiac Disease?
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I got my results back from enterolab a couple of weeks ago and had elevated Anti-gliadin IgA and anti-tissue transglutaminase IgA levels. I carry a celiac gene and a gluten sensitive gene.

I assumed that I had a 50/50 shot of having either a sensitivity or having celiac, since I've had positive results after being gluten free for 6 weeks. However, I was reading a book today about celiac and it said that elevated Anti-gliadin IgA levels indicate a gluten sensitivity while elevated Ttg levels indicate celiac, since it is an auto immune response.

Do I have this straight?:

Anti-gliadin IgA levels measure whether or not your body is creating antibodies against gluten.

Anti-tissue transglutaminase IgA levels measure whether or not your body is creating antibodies against your own tissue, which is an autoimmune response.

Since I had elevated levels of both, this indicates that I have more than a sensitivity, that I actually have celiac disease, and when I eat gluten, my body is creating antibodies to attack the gluten and to attack my own tissue, damaging my intestines.

I'm still trying to figure this all out...do I have it right? Thanks!!

Janie

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I got my results back from enterolab a couple of weeks ago and had elevated Anti-gliadin IgA and anti-tissue transglutaminase IgA levels. I carry a celiac gene and a gluten sensitive gene.

I assumed that I had a 50/50 shot of having either a sensitivity or having celiac, since I've had positive results after being gluten free for 6 weeks. However, I was reading a book today about celiac and it said that elevated Anti-gliadin IgA levels indicate a gluten sensitivity while elevated Ttg levels indicate celiac, since it is an auto immune response.

Do I have this straight?:

Anti-gliadin IgA levels measure whether or not your body is creating antibodies against gluten.

Anti-tissue transglutaminase IgA levels measure whether or not your body is creating antibodies against your own tissue, which is an autoimmune response.

Since I had elevated levels of both, this indicates that I have more than a sensitivity, that I actually have celiac disease, and when I eat gluten, my body is creating antibodies to attack the gluten and to attack my own tissue, damaging my intestines.

I'm still trying to figure this all out...do I have it right? Thanks!!

Janie

Great Questions!!!

I would love to hear the answers as well....MY results are similar to yours...

My IgA Anti-gliadin was a 9 and due to the presence of symptoms they suggested gluten free diet, and my ttg was a 10...but mine showed very high malabsorption...

I have one Celiac Gene (HLA_DQ-0201) and One Gluten Sensitive Gene (HLA_DQ2-0202)

which when combined together are quite the high risk combination....

I have wondered about the ttg levels vs Anti-gliadin IgA levels...and have wanted to ask the same questions...

I hope someone out in Celiac Land will lead us in the right direction...

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It doesn't matter whether you label it gluten sensitivity or celiac. Both require a strict adherence to the diet. Both cause antibodies that attack your system. IMHO the terms gluten senstivity and gluten intolerance need to be abolished. Many think unless the label says celiac they can get away with small amounts of gluten. They can't.

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It doesn't matter whether you label it gluten sensitivity or celiac. Both require a strict adherence to the diet. Both cause antibodies that attack your system. IMHO the terms gluten senstivity and gluten intolerance need to be abolished. Many think unless the label says celiac they can get away with small amounts of gluten. They can't.

Ahhh You have answered my puzzlement....

That BOTH gluten sensitivity and Celiac produce antibodies that attack your system...

I did not know that!

That was my confusion...I thought somehow that only Celiac caused high ttg....

THANKS! :)

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I didn't think an elevated ttg could mean gluten intolerance. I thought it was just an indicator of celiac.

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First and foremost, Enterolab cannot diagnose Celiac Disease, nor do they claim to. Stool testing is not an accepted form of testing for celiac disease.

http://celiacdisease.net/assets/documents/FAQs28Aug2009.pdf

11. Are stool tests acceptable to screen for or diagnosis celiac disease or gluten intolerance or gluten sensitivity?

No. There is currently no published evidence supporting the usefulness of any stool tests in

screening for celiac disease or any forms of gluten intolerance. In fact, there is currently no

medically accepted test

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I was already aware that Enterolab does not claim to diagnose Celiac Disease....

It is my humble opinion that current accepted testing for Celiac Disease is

woefully inadequate....The Gold Standard diagnosis will not be Gold Standard for long....

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It is my humble opinion that current accepted testing for Celiac Disease is

woefully inadequate....The Gold Standard diagnosis will not be Gold Standard for long....

Well said and I whole-heartedly agree! I first heard "Gold Standard" from my Celiac Specialist. He is a wonderful physician given what is currently understood about Celiac Disease.

In my never to be humble opinion -- Our current medical system needs to somehow remove the insurance companies from the driver's seat -- now if I could only come up with how that could be accomplished I'd truly have an opinion that should be read by all!

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I was already aware that Enterolab does not claim to diagnose Celiac Disease....

It is my humble opinion that current accepted testing for Celiac Disease is

woefully inadequate....The Gold Standard diagnosis will not be Gold Standard for long....

I have no opinion on Enterolab per-se. I am confident that testing methods for Celiac will evolve. I don't think Dr. Fine's tests will be filling in for the bloodwork/biopsy anytime soon, however. He seems to be quite content to do business outside of mainstream medicine. More power to him. Everybody has to take their own path. I personally hate the term "gold standard." I think it is very polarizing. I get that it is the medically accepted term, but it just makes people with and without it get into fights, KWIM? We have lots of people in my support group on both sides of the equation, and we have all gotten results from removing gluten from our diets. Apologies to the OP for the topic drift.

My purpose for replying to the original poster is to clarify the following: Antigliadin IgA antibodies indicate an anti-gluten response. TtG antibodies indicate an anti-self response. You can have one or the other or both, and still not be able to consume gluten.

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I have no opinion on Enterolab per-se. I am confident that testing methods for Celiac will evolve. I don't think Dr. Fine's tests will be filling in for the bloodwork/biopsy anytime soon, however. He seems to be quite content to do business outside of mainstream medicine. More power to him. Everybody has to take their own path. I personally hate the term "gold standard." I think it is very polarizing. I get that it is the medically accepted term, but it just makes people with and without it get into fights, KWIM? We have lots of people in my support group on both sides of the equation, and we have all gotten results from removing gluten from our diets. Apologies to the OP for the topic drift.

My purpose for replying to the original poster is to clarify the following: Antigliadin IgA antibodies indicate an anti-gluten response. TtG antibodies indicate an anti-self response. You can have one or the other or both, and still not be able to consume gluten.

Your clarification was spot on but elevated tTg may also indicate another autoimmune disease present other than Celiac Disease. Hashimoto's thyroid disease and liver disease may also be indicated with elevated tTg levels.

To the original poster...if you went through Enterolabs to have testing done and came back with these results, I would highly suggest blood screening for Celiac Disease, especially since you carry a gene for it. Of course, that means eating the dreaded gluten again for awhile...... :(

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Your clarification was spot on but elevated tTg may also indicate another autoimmune disease present other than Celiac Disease. Hashimoto's thyroid disease and liver disease may also be indicated with elevated tTg levels.

You are correct, which is another reason why Enterolab's tests cannot diagnose celiac disease. TtG can be elevated in quite a few other conditions, and not just Celiac - even some that are not autoimmune.

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To the original poster...if you went through Enterolabs to have testing done and came back with these results, I would highly suggest blood screening for Celiac Disease, especially since you carry a gene for it. Of course, that means eating the dreaded gluten again for awhile...... :(

Yikes, you couldn't pay me to eat gluten again. I've tried a couple of times, just to see for myself whether or not it truly is the problem, and have become very sick each time I eat gluten or accidentally cross contaminate. There's no way I would go back to eating gluten for a test when I'm finally starting to feel better...for me, gluten brings painful stomach cramping, gas, intense nausea, and debilitating exhaustion. My reactions are enough diagnosis of a gluten problem for me. :)

Yay for finally starting to get my life back a bit! :D

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Good for you! I second that! I would never go back to gluten...I have embraced a gluten free life totally...My body tells me gluten is not my friend, I only used Enterolab testing as a guidepost to direct my own decision making process.

I know that Enterolab does not make a diagnosis...BUT...again...it was used as a tool in my own decision making process...it helped confirm for me what my body had been trying to tell me...

I do not go around telling people that I have Celiac disease...but I do tell them my body does not like gluten...that I get sick...and really? Isn't that all we need to know...

Who knows when all is said and done where the future of Celiac Testing will take us...

But I am sure of this...it will be more sophisticated and definitive...What we have today will be considered archaic and antiquated....

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    • To answer some of your questions.... Non celiac gluten sensitivity does not cause any damage to the small intestine so that is not the source of the "little holes or bumps".  You need to get her records including the report of the endoscopy to see exactly what it says as well as the pathology report of the biopsies. You should always get medical records anyway & keep a copy for yourself. How many biopsies did he take? There should be a minimum of 4, ideally 6. The small intestine is very vast even in a small child. An adults is the size of a tennis court! That's a whole lot of territory so biopsies can miss damage especially when enough of them are not taken! She has 2 positives on the serum panel. This crap about "weak" positives should be thrown out of the nomenclature! A positive is a positive, weak or not! Her DgP IGG is way over the range and extremely telling. As far as my knowledge goes, there is nothing else that causes a positive DgP IGG other than celiac disease. False positives are really rare and to have 2 false positives would be astronomically rare! You are right & smart that she really does need an official diagnosis! IMHO, keep her on gluten for right now. Get a second opinion pronto & I believe you'll be able to get her a dx based on the 4 out of 5 rule if nothing else. I wouldn't think it's going to take more than a month to get to see another doc for a second opinion. Then you can take her off gluten. Kids heal up really fast, way faster than us old geezers! I'm sure as others  wake up & get on their computers they will be along to voice their knowledge. I am in the eastern time zone & rise before the birds so I was on here early. Hang in there mom! You're doing the right thing!
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