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Please Help Me Understand A Test Result

gancan

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gancan Apprentice
gancan
Posted

Hi Everyone,

I have gotten part of my results for a blood test I had my doctor run and I am totally confused... The woman who is my doctor's assistant right now is not very helpful in explaining what the results mean..

She gave me the result of my Immunoglobulin A resut and said it was 78 and normal is between 82-453. I asked her what that means and she said "well thats because you took gluten out of your diet"... ?? Which I know I got tested while having gluten out of my diet for about 6 days, I knew the result maybe wouldn't show the correct results but I just wanted to try anyways because I felt so good keeping gluten out of my diet I didn't want to reintroduce and and feel crappy again..

Does that mean the result is abnormal because it was not in the "normal" range??

Also my Transglutaminase IgA Abs was 2 and she said normail is if it is under 20.

Can someone help me understand? Thanks so much!

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mushroom Proficient
mushroom
Posted

The first test is run to check if you are a producer of normal quantities of IgA antibodies, which everybody produces. Your test is abnormal, in that you do not produce enough antibodies (only 78, when the normal range is between 82 and 453. This test has nothing directly to do with celiac disease. It does, however, mean that any test for celiac using an IgA measurement is invalid because you don't produce enough of it. The normal procedure is then to run the tests using IgG (and the total serum IgG should also be checked because some people don't make enough of that either).

Wait for your other results to see what other tests were run, and then you will probably have to have a do over - but they may have done the DGP IgG which would be helpful. :)

gancan Apprentice
gancan
Posted
  • Author

Thanks.

The only other tests I am waiting on are the HLA-DQ2 & HLA-DQ8 so I doubt they ran a DGP IgG.. I had them run those 2 genes because I thought that if it shows up that I don't have them then it would be unlikely that I have celiac disease (is what I was thinking). Right? Then I would think I may be leaning more in the direction that I have an intolerance to gluten rather than the celiac disease.

mushroom Proficient
mushroom
Posted

DQ2 and DQ8 are the most common genes associated with celiac, but are not exclusive, so no, you can't rule out celiac if you don't have either although it makes it less likely.

The celiac tests you have not had (and need) are the following:

  • AGA-IgG
  • tTG (anti-tissue transglutaminase)-IgG
  • EMA (anti-endomysial antibodies)-IgG
  • DGP (deamidated gliadin peptide)-IgG

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      High TTG-IgG and Normal TTG-IgA

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    • SamAlvi
      High TTG-IgG and Normal TTG-IgA

      By SamAlvi · Posted

      Thanks again for the detailed explanation. Just to clarify, I actually did have my initial tests done while I was still consuming gluten. I stopped eating gluten only after those tests were completed, and it has now been about 70 days since I went gluten-free. I understand the limitations around diagnosing NCGS and the importance of antibody testing and biopsy for celiac disease. Unfortunately, where I live, access to comprehensive testing (including total IgA and endoscopy with biopsy) is limited, which makes things more complicated. Your explanation about small-bowel damage, nutrient absorption, and iron-deficiency anemia still aligns closely with my history, and it’s been very helpful in understanding what may be going on. I don't wanna get Endoscopy and I can't start eating Gluten again because it's hurt really with severe diarrhea.  I appreciate you taking the time to share such detailed and informative guidance. Thank you so much for this detailed and thoughtful response. I really appreciate you pointing out the relationship between anemia and antibody patterns, and how the high DGP IgG still supports celiac disease in my case. A gluten challenge isn’t something I feel safe attempting due to how severe my reactions were, so your suggestion about genetic testing makes a lot of sense. I’ll look into whether HLA testing is available where I live and discuss it with my doctor. I also appreciate you mentioning gastrointestinal beriberi and thiamine deficiency. This isn’t something any of my doctors have discussed with me, and given my symptoms and nutritional history, it’s definitely worth raising with them. I’ll also ask about correcting deficiencies more comprehensively, including B vitamins alongside iron. Thanks again for sharing your knowledge and taking the time to help. I’ll update the forum as I make progress.
    • knitty kitty
      Son's legs shaking

      By knitty kitty · Posted

      Blood tests for thiamine are unreliable.  The nutrients from your food get absorbed into the bloodstream and travel around the body.  So, a steak dinner can falsely raise thiamine blood levels in the following days.  Besides, thiamine is utilized inside cells where stores of thiamine are impossible to measure. A better test to ask for is the Erythrocyte Transketolace Activity test.  But even that test has been questioned as to accuracy.  It is expensive and takes time to do.   Because of the discrepancies with thiamine tests and urgency with correcting thiamine deficiency, the World Health Organization recommends giving thiamine for several weeks and looking for health improvement.  Thiamine is water soluble, safe and nontoxic even in high doses.   Many doctors are not given sufficient education in nutrition and deficiency symptoms, and may not be familiar with how often they occur in Celiac disease.  B12 and Vitamin D can be stored for as long as a year in the liver, so not having deficiencies in these two vitamins is not a good indicator of the status of the other seven water soluble B vitamins.  It is possible to have deficiency symptoms BEFORE there's changes in the blood levels.   Ask your doctor about Benfotiamine, a form of thiamine that is better absorbed than Thiamine Mononitrate.  Thiamine Mononitrate is used in many vitamins because it is shelf-stable, a form of thiamine that won't break down sitting around on a store shelf.  This form is difficult for the body to turn into a usable form.  Only thirty percent is absorbed in the intestine, and less is actually used.   Thiamine interacts with all of the other B vitamins, so they should all be supplemented together.  Magnesium is needed to make life sustaining enzymes with thiamine, so a magnesium supplement should be added if magnesium levels are low.   Thiamine is water soluble, safe and nontoxic even in high doses.  There's no harm in trying.
    • lizzie42
      Son's legs shaking

      By lizzie42 · Posted

      Neither of them were anemic 6 months after the Celiac diagnosis. His other vitamin levels (d, B12) were never low. My daughters levels were normal after the first 6 months. Is the thiamine test just called thiamine? 
    • knitty kitty
      Son's legs shaking

      By knitty kitty · Posted

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    • lizzie42
      Son's legs shaking

      By lizzie42 · Posted

      Thank you! That's helpful. My kids eat very little processed food. Tons of fruit, vegetables, cheese, eggs and occasional red meat. We do a lot of rice and bean bowls, stir fry, etc.  Do you think with all the fruits and vegetables they need a vitamin supplement? I feel like their diet is pretty healthy and balanced with very limited processed food. The only processed food they eat regularly is a bowl of Cheerios here and there.  Could shaking legs be a symptom of just a one-time gluten exposure? I guess there's no way to know for sure if they're getting absolutely zero exposure because they do go to school a couple times a week. We do homeschool but my son does a shared school 2x a week and my daughter does a morning Pre-K 3 x a week.  At home our entire house is strictly gluten free and it is extremely rare for us to eat out. If we eat at someone else's house I usually just bring their food. When we have play dates we bring all the snacks, etc. I try to be really careful since they're still growing. They also, of course, catch kids viruses all the time so I  want to make sure I know whether they're just sick or they've had gluten. It can be pretty confusing when they're pretty young to even be explaining their symptoms! 
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