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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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    • Thanks for posting this Adrien, it's a great list and I and others will appreciate the effort and the thought behind it. I loved my time in Malaysia and I'm glad I sampled all the food I could whilst I was still on an unrestricted diet. The good thing is that, like you say, some of the nice Malay foods are still ok. As a backpacker I survived on a lot of nasi goreng and laksa, nice to think if I return there I could still do the same Terima kasih!
    • I have posted on here before. DQ2, brother with celiac, DGP iGA was the only mildly elevated test. Was gluten-free so did 6 week challenge last winter. Negative biopsy. I am gluten-free now but do go out to eat. Prior to the challenge my health was good. Since then I have: Chest pain, pain between shoulder blades, periods of shortness of breath, heart palpitations, one instance of a heart arrythmia episode, neck is tender to touch on one side (they kept saying sinuses or TMJ which my dentist vetoed) ear ache, bowels never sink. Numbness and tingling. Blood pressure variations. Could be doing chores and feel dizzy and it might be 84/52.  not super low, but not typical for me if I'm running around the house.While other days I am mildly hypertensive. Recently lost 5 lbs in 8 days without trying. Recently electrolytes were low, alkaline phosphatese was low. Ferritin started dropping so started liquid iron 2-3 times per day 4 months ago. Primary watching that, I am not anemic but we are nowhere near iron overload either.  GI doc was a dick. Did not even know DGP replaced older tests and he was very condescending When I begged him for help recently and told me to get a second opinion which is exactly what I plan on doing.  I now have pain in my upper GI area. It is tender to touch. I had my gallbladder out in 97 along with a stone and infection in my bile duct. It hurts in this area. Pancreatic enzymes look fine, liver enzymes fine. Pancreatic ultrasound fine. I will now be doing a EUS Soon to look at bile duct, pancreas and liver.   so a typical day for me is that I might feel fine for a while and then suddenly feel like I'm going to pass out. really dizzy, numbness in odd places, like my body has been hijacked. I will typically eat a bunch of food something high protein and in about an hour or so I start to feel better. However, then my upper stomach starts to hurt in place of the passing out feeling. blood sugars are also normal. After getting the " it must be panic attacks" and condescending looks a million times my primary finally ordered an ultrasound of my sore neck and there is an abnormality in my thyroid which she says looks like possibly Hashti's. Except for one time, all my serum TSH tests were normal. We have more blood work on Monday. As I have not put on any weight and there are other symptoms that are closer to Graves.  Has anyone else had any thyroid issues that followed doing a gluten challenge?  where is your stomach pain? Do you have it above or below your belly button? Mine feels like it's in the pancreas area, like 2-3 inches above the belly button and when I push on it it's tender, but not all the time. sometimes i feel it in my back. 
    • Thanks for sharing with me.  I really appreciate it.  Honestly, after a glutening last summer (still do not know what glutened me), I did not eat out for a year!  The risk was too great as my healing time took 3 months (for symptoms to subside) and six months to regain lost weight.  Our recent vacation to Europe was worth the risk  as we traveled with our entire extended family, but we were extra cautious and ate only at celiac-approved places.  Otherwise, we "dined" at markets or ate the food we brought from home.  Thankfully, we did not get glutened (at least we don't think so!)  
    • I do not struggle with this and I was brought up the same way as you. I don't struggle because for many years off & on we didn't have a bathtub, only showers as well as this being therapy or medicinal for the skin - heck even for the muscles as I age. I figure I've earned my right to luxuriate or medicate with baths any time I've a mind to. My husband saw just how bad my dh got & NEVER begrudges me a nice long soak in the big soaking tub we now have.
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