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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

Antibody Tests For Celiac Disease
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9 posts in this topic

I've been looking for a better test than IgE, since that is immediate response, and the one the docs always want to give us. Since celiac disease is autoimmune, that doesn't make sense. What also doesn't make sense to me is having an IgA test done, being it only indicates having an unspecified auto-immune disease. Since I have already been diagnosed having Hashi's, this test would not make sense, as I already know I have an auto-immune disease, so I got to thinking, what test did they give me to determine the thyroid test, specifically? I looked it up, and it was a thyroid antibody test. That led me to wonder why there isn't one for intestinal antibodies....or was there? Googled it, and came up with PubMed article with a study on:

Intestinal anti-tissue transglutaminase antibodies in potential coeliac disease.

As a result of the data collected in this study, it shows "the measurement of intestinal anti-TG2 antibodies may prove useful in clinical practice to predict evolution towards mucosal atrophy in potential coeliac patients and identify patients with gluten sensitivity." Thoughts, anyone???

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I've been looking for a better test than IgE, since that is immediate response, and the one the docs always want to give us. Since celiac disease is autoimmune, that doesn't make sense. What also doesn't make sense to me is having an IgA test done, being it only indicates having an unspecified auto-immune disease. Since I have already been diagnosed having Hashi's, this test would not make sense, as I already know I have an auto-immune disease, so I got to thinking, what test did they give me to determine the thyroid test, specifically? I looked it up, and it was a thyroid antibody test. That led me to wonder why there isn't one for intestinal antibodies....or was there? Googled it, and came up with PubMed article with a study on:

Intestinal anti-tissue transglutaminase antibodies in potential coeliac disease.

As a result of the data collected in this study, it shows "the measurement of intestinal anti-TG2 antibodies may prove useful in clinical practice to predict evolution towards mucosal atrophy in potential coeliac patients and identify patients with gluten sensitivity." Thoughts, anyone???

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ahhh....missed an important part of the study.... [[[biopsy]]] which means, this is not a blood test. how frustrating that they can obtain an antibody test from your blood for thyroid, but not for intestinal, because it needs to be from the mucosa and not the blood...ahhhh...okay.

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opps, looks like I hit the reply button to my own post :rolleyes:

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I had an Elisa test. I believe it looked for IgG, total IgA and IgE. I had IgG antibodies to Pracitically everything I was eating. I could not cut out eatting everything, so I am doing a rotational diet and eating them all.

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I'm confused - have you had a complete celiac antibody panel?

Total IgA

tTG - both IgA and IgG

EMA

DGP - both IgA and IgG

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I'm confused - have you had a complete celiac antibody panel?

Total IgA

tTG - both IgA and IgG

EMA

DGP - both IgA and IgG

No, I've been wondering whether I should, as from what I understand it doesn't diagnose celiac disease specifically, only that I would have an auto-immune disease? If this is the case, then it would come up positive because I have auto-immune thyroid disease and it would be a waste of my money. If this is specific, I would get it done in a heartbeat, but from my reading, the only test that is specific are the intestinal and dh rash biopsies?

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No, I've been wondering whether I should, as from what I understand it doesn't diagnose celiac disease specifically, only that I would have an auto-immune disease? If this is the case, then it would come up positive because I have auto-immune thyroid disease and it would be a waste of my money. If this is specific, I would get it done in a heartbeat, but from my reading, the only test that is specific are the intestinal and dh rash biopsies?

I am currently traveling so I have no access to specific research, but you should keep researching or perhaps someone else will chime in with some papers for you to read.

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Below is from Lab Tests Online ( http://labtestsonline.org/understanding/analytes/celiac-disease/tab/sample ):

Common tests for celiac disease include:

  • IgA class of Anti-tissue Transglutaminase Antibody (anti-tTG): Tissue transglutaminase is an enzyme that causes the crosslinking of certain proteins. Anti-tTG, IgA is the most sensitive and specific blood test for celiac disease but may be negative in children under 3 years old. The IgG class of anti-tTG may be ordered as an alternative in those who have a deficiency of IgA. Although "tissue" is in the name of these tests, they are measured in the blood.
  • Anti-Gliadin Antibodies (AGA), IgG and IgA classes: Gliadin is part of the gluten protein found in wheat (similar proteins are found in rye, barley, and oats). AGA is an autoantibody directed against the gliadin portion.
  • Quantitative immunoglobulin A (IgA): Used to determine if someone is deficient in the IgA class of antibodies and whether the IgG class of autoantibody tests should be performed.
  • Deamidated Gliadin Peptide (DGP) Antibodies, IgA: Anti-DGP test is a relatively new test that may be positive in some people with celiac disease who are anti-tTG negative, including children less than 3 years old.

Other tests less commonly performed include:

  • Anti-Endomysial Antibodies (EMA), IgA class: Endomysium is the thin connective tissue layer that covers individual muscle fibers. Anti-Endomysial antibodies are developed in reaction to the ongoing damage to the intestinal lining. It has been found that tTg is the substance detected in this test. Almost 100% of patients with active celiac disease and 70% of patients with dermatitis herpetiformis (another gluten-sensitive condition that causes an itchy, burning, blistering rash on the skin) will have the IgA class of anti-EMA antibodies. The test is more difficult to do and interpret properly than anti-tTg.
  • Anti-Reticulin Antibodies (ARA), IgA class: Anti-ARA is not as specific or sensitive as the other autoantibodies. It is found in about 60% of celiac disease patients and about 25% of patients with dermatitis herpetiformis.
  • Anti-Actin (F-actin), IgA class: The F-Actin antibody test may indicate increased intestinal damage.

As I understand it, ttg IgA can come up positive in thyroid patients but the other tests are not linked to thyroiditis. The EMA IgA shows a reaction to ongoing damage to the lining of your intestines, meaning if you have a positive test there has been a LOT of damage done; I believe the EMA IgA is extremely specific to celiac disease BUT there are a few other more rare health issues that can cause extensive damage to the gut as well. It you end up with a couple of positive tests, chances are it's celiac.

TPO Ab, which is used to diagnose Hashimotos, is not just specific to Hashimotos either; it is also used to diagnose other health problems as well... like the celiac tests can do as well.

But, I find that if it looks like a duck, and quacks like a duck, it's probably a duck. Those tests usually point to one disease, not always but when you consider symptoms and history, it gives you a better idea of what a test result indicates.

This is just my interpretation, but I hope that made sense. :) Best wishes to you.

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    • Weird Reaction
      Hi Richard Glad you are feeling better!   Sorry - DX is an abbreviation for diagnosis.   Thanks so much  for the info about MSG, broccoli and IBS.  Like you say, there is v. little bad press about broccoli. My aunt, who is a farmer's wife, put forward another theory that it might not have been the broccoli itself but rather some insecticide a farmer sprayed on it.   I just can't bring myself to try organic broccoli however...  Thankfully cauliflower is fine.  I just can't figure it out as I thought they were the in the same vegetable family?  So maybe it is MSG. Regarding anemia, there can be a link with iron anemia and anxiety. http://www.livestrong.com/article/471225-iron-anxiety/ And I was definitely breathless before my diagnosis; I remember finding myself  walking up a hill behind a  huge crowd of friends on a church walk, and many of them were at least 20 years older than me, and wondering why I was in last place! My B12 levels were very low at DX and I found B12 supplements helped enormously with anxiety.   I remember drinking Berroca and feeling so much better within hours of drinking it, on more than one occasion, before even understanding the link. I have just been told however that I can't take any more iron because my hemoglobin is on the high side.  It is a good thing my doctor was monitoring my supplementation as I gather too much iron can be dangerous.  Have you been told to supplement by your doctor?  If you are supplementing make sure you get your levels monitored. All the very best - and welcome to the forum!    
    • Weird Reaction
      Thank  you Flowerqueen and Cristiana for your replies. I'm actually feeling much better today. I got my appetite back yesterday lunchtime (a few hours after I typed the original post) and managed to keep in/hold down some chicken and lettuce!!! I also had a "fat" coffee (as I call it) before work with MCT Oil and butter (your probably going "yuk" right now but it's really nice...really haha) and started feeling a bit better after that. The nausea went away almost immediately after that although just the thought of having all that fat nearly made me sick but I just wanted to get back to normal asap. I usually have a lot of fat in my diet anyway which is normal for me so the coffee choice isn't unusual. Plus it was also the third day which was when I started feeling better after the first time. I didn't eat til lunchtime and I was good and hungry by then so I knew I was coming out of it. That nausea and trembling feeling is something I don't want ever again. I think after the workout and tearing down muscle tissue (which is a form of stress) and then not being able to hold the nutrients in for repair affected my nervous system. My theory only but to me it makes sense. Although Vitargo also comes in flavors I always get the Natural / Unflavored one so the barley is the only ingredient. As for there being something wrong with that particular batch, well, you be on to something there. Also I'm not knocking the product because as I said, I have used it before and it did exactly what it was supposed to do. But, I will never have it again. Cristiana, my last blood test revealed I had slight anaemia which really surprised me with the amount of red meat I've eaten during my life and the anxiety thing is also new as I'm usually a happy, positive person. Life is good but after this recent reaction I think it is an indirect cause of the glutening. I'm also surprised at how sensitive I've become to it and how quickly. Also what is DX? I also follow a FODMAP eating plan (I can give you more info if you haven't heard of it) which also eliminates certain foods. It's a plan directed mostly at IBS but is well worth looking into if you are suffering any gut health, digestion issues or any ailment you may have which you can't get to the bottom of. Broccoli was one of the foods which I have cut back on and I've eaten HUGE amounts of broccoli so it is a superfood for some but apparently not for others. (I even think I read somewhere it has MSG naturally in it) It's hard to find any bad articles on broccoli so this also really surprised me. It also answered a few other questions I had. Many, many thanks again to you both for your replies. It actually settled me just reading them. I'm glad I found these forums so I don't think i'll be a stranger around here for long.   Richard
    • Confused
      Okay, I get that you are not going to follow the advice from some stranger on the internet, but please read the links that I gave you.  Your doctor is not following the standard level of care.  I am dead serious.  I have Kaiser.  My own GP doesn't have a clue about celiac disease, but my Kaiser GI does.  Please, I urge you to get properly diagnosed.  All celiac testing requires you to be on a gluten diet.  If you go gluten free even for two weeks (it will take time to get the referral and appointment), it will mess up the tests.  Your GI will put you back on a gluten diet (called a gluten challenge) for 8 to 12 weeks.    Chances are (almost 100%) you will feel more miserable!  That will just delay your diagnosis.   Symptoms not bad you say?  I had pretty severe anemia, but no tummy issues.  Two months after my diagnosis, I fractured my back DOING NOTHING!  Yep, I have osteoporosis from undiagnosed celiac disease and I am an athlete!   Please take this seriously!    
    • Silent Celiac or Non-digestive symptoms
      Oh, you might learn how to tell if you had been glutened.  I just had anemia as my main symptom.  I did not have any tummy issues at all.  I was in shock when my doctor even suggested testing me for celiac disease!   Glutenings can vary as we are all different.  For some it is just a few days, others a few weeks and others months (that would be me).  My last official glutening as supported by follow-up antibody testing lasted for three months.  Guess what?  I had vomiting, abdominal pain, the works!  Funny how celiac disease can change and evolve over time.   Welcome to the forum!  Have some patience and learn all that you can.  The good news is that you can feel better and no medications are required!  
    • Confused
      Thank you for the information. I've been not sure if I should eat gluten or not right now. Dr. said I should watch what I eat when I emailed him the question. My symptoms aren't very bad (I understand that doesn't matter for celiac disease), so I can definitley tolerate the food. But I have been starving myself the last few days due to not knowing what the heck is going on. Thanks again.
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