5 replies to this topic

[lizcon]

Hello,

I went for a consult for my fist colonoscopy. The GI doctor noticed I had marked Hashimotos Thryroiditis on my health questionnaire. He suggested I test for Celiac since often Hashimotos and Celiac go "hand in hand."

Test results are back:
TT Ab IgA normal 1.2 (<4)
TT Ab IgG positive 18 (>9 positive)

Gliadin IgA normal 3.1 ( < 20)
Gliadin IgG normal 3.1 (< 20)

IgA 132 normal (71-397)

The only positive is the TT Ab IgG. He is recommending a biopsy to confirm the results. I'm thinking I should go ahead and do it, if nothing else then to spare my close relatives and kids the need to be tested for Celiac. Could the Hashimotos throw off the results? Do these results look typical of Celiac? Any help or advice would be appreciated.
(I do not have obvious GI problems so this has been a surprise....)

Thanks!

[haleym]

I have Hashimoto's and will be tested for celiac soon... Hope you get some answers!

[mushroom]

No, the Hashimoto's would not affect the results which are measuring antibodies to gluten in the bloodwork, and damage to the small intestine when they do the biopsy.

There is no "typical" set of celiac results. It is only necessary to be positive on one of the tests. Yours is a little unusual in that you tested positive on the IgG tissue transglutaminase and negative on the IgA, but yet you make normal quantities of IgA. Normally they run the IgG only if you make insufficient quantities of IgA, but your IgA was normal. I note that they did not run the newer, and more specific for celiac, DGP (deamidated gliadin peptide) which is often run in both IgA and IgG versions.

At any rate, the biopsy is often useful to make sure that everything else is normal in the upper intestinal tract and to check the level of damage. Sometimes the bloods are positive and the EGD negative. If this happens with you, don't let the doctor tell you that you don't have celiac, because it is often missed. Make sure he takes at least 6-8 samples because the damage can be patchy and easily missed. You can start the gluten free diet immediately after the biopsy, so now is a good time to start going through your pantry for foods to donate to a food pantry, and to start thinking about preparing your food gluten free. There is a lot of good reading on this site, beginning with Newbie 101, and plenty of threads on how to deglutenize, lots of recipes, etc. Happy reading, and best wishes for your EGD if you decide to go ahead with it.

Welcome to the board, and ask as many questions as you want.

[lizcon]

Thank you mushroom. I am definitely reading a lot about going gluten free and getting set-up to give it a try.

Edited by lizcon, 26 November 2012 - 09:00 PM.

[Cara in Boston]

I think it is different for each person. My son had normal IgA tests and was only positive on the IgG tests. He had ZERO GI symptoms. Our only clue something was wrong was a drastic change in behavior. He didn't even complain of feeling bad, he just turned in to the devil. (age 5). His biopsy was very positive.

My blood tests were the opposite. Only my IgA tests were positive. I had all the classic GI symptoms for about 5 years (maybe triggered by my pregnancy?). When I had the endoscopy, it came back negative.

We both went gluten free and it has made a world of difference. The other two in the family seem to tolerate gluten just fine, but I do have my older son checked every couple of years to make sure.

After you complete the tests, try the diet REGARDLESS of the results.

Good luck -

Cara

[guest134]

Yes the TTG can be falsely positive in Hashimoto's. Before some member asks "What does a false positive really mean?" or "There are no false positives"

A false positive means that in clinical evaluation members of a certain population sample with an elevated TTG did not actually have celiac upon further testing and never went on to develop it during clinical follow up years and even decades later. YES there are absolutely false positive in antibody tests, the endomysial is interpreting a staining pattern on monkey oesophagus, the whole point is that celiac blood tests are highly unreliable unless all very strongly positive (10 times the normal range). Your test is a very low number and is typical in the false positive range, do the biopsy and report back to us what happens.

http://www.uchospita.../uch_007935.pdf




What’s the problem with diagnosing celiac disease simply by measuring the decrease in antibodies once someone switches to a gluten-free diet?
The con is that you’ll never know if a patient truly has celiac disease versus other causes for elevated antibodies. tTG are thought to be 97-98% specific, but by definition this means that 3 in 100 persons who don’t have celiac disease will have elevated tTG (biological variations, nothing more). If you consider that celiacs are 1% of the general population, it follows that out of 100 persons tested for tTG: 1 has celiac disease and 3 do not. This could mean that only 1 out of 4 of those with positive antibodies will have celiac disease as the cause. This is why you need a biopsy to confirm it.


http://www.cureceliacdisease.org/archives/faq/whats-the-problem-with-diagnosing-celiac-disease-simply-by-measuring-the-decrease-in-antibodies-once-someone-switches-to-a-gluten-free-diet