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Test Results In, Please Help.
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13 posts in this topic

Hi, I have been having constant D, bloating, and pain so I went to my doctor and had blood tests.

Celiac Disease Panel

IGA Sufficient

Gliadin IgA Ab Out of Range 35

Tis. Transgult.Ab IgA 4

My question is what is a Gliadin IgA test? is 35 an indicator of Cealiac disease?

What should my next step be? I still feel awful.

Edited by somi
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The Gliadin IgA measures your antibodies to gluten. While each lab sets their own reference ranges, nomally the maximum top end for even a mildly positive test is 30, so 35 sounds like a definite positive to the test, especially because you make sufficient IgA. So yes, it is an indicator of celiac disease. Did your doctor not follow up with you on this?? I can't believe it!!!

The next step is normally referral to a gastroenterologist for an upper endoscopy with biopsy, where they will take tissue samples from your duodenum/small intestine and try to confirm the diagnosis through microscopic changes that take place in the tissue. If your doctor did not intend to refer you, you should have been given some instructions on what to do next, like start the gluten free diet / see a nutritionist, but something. Do you have a follow-up appointment scheduled?

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The range for the test i scored 35 on is 0-19.

He circled the Tis. Trasglut Ab IgA (which was only 4) 0-19 range, and drew a line to

"the American GI Asssoc. recommends thaat "in the primary care setting the igA tTga is the most efficient single serologic test for the detection of celiac disease. Evidence indicats at the additional inclusion of IgG antifliadin gastrenteralog 205:131:1977-1980

And then he mailed me the test results...

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In view of that one positive result, I would insist on the full celiac panel being run:

Anti-Gliadin (AGA) IgA

Anti-Gliadin (AGA) IgG

Anti-Endomysial (EMA) IgA

Anti-Tissue Transglutaminase (tTG) IgA

Deamidated Gliadin Peptide (DGP) IgA and IgG

Total Serum IgA

and referral to a GI. That is very incomplete testing. The old school doctors love their tTG testing, but in reality it is not a specific test for celiac disease and the DGP is very specific. It is possible to have intestinal damage on endoscopy with a negative tTG score.

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Ok. Thank you! I have an appointment Wed with a nurse practitioner at a gastro. I will take her the blood tests and see what they think. I started glutton free the second I saw the results.

It is amazing how doctors can be so sure of themselves. I complained about brain fog and stomach issues last march and got put on Adderall... Probably why he didn't request a follow up...

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Get back on the gluten!! You do not want to go gluten free until all testing is finished, I'm afraid, as it can affect the results. The antibodies start to disappear if there is nothing there to attack :)

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my daughter tested negative on the whole panel, except tTG IgG. she was a mild positive (9) after 2 weeks on gluten, and a positive (12) after 6 more weeks on gluten, so the doctor said he thinks she has celiac disease.

i read that 70% of full-blown celiacs will test negative on the panel, but almost 100% test positive on stool testing from EnteroLab. so, we did that. we had the gluten sensitivity panel run (checks for antibodies, ttg- which tests for tissue damage, and malabsorption).

you have gluten antibodies, which means you may or may not have celiac disease. but regardless if you do or don't, you DO have antibodies, which means other organs in your body could be attacked by the antibodies (pancreas, which you could end up with diabetes, joints- rheumatoid arthritis, thyroid, etc.)

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wait! i just looked at my daughter's results and reference ranges, and noticed that you had a 4 on the ttg iga? the reference range is 0-3. ttg is an enzyme found IN your intestinal cells. when gluten antibodies attack your intestines, the ttg comes out, and you form antibodies against it. those ttg antibodies can then go through your blood and attack other organs, like i explained above.

and please remember that if you have the biopsy, and it's negative, that just means that they didn't find it, or it's subclinical (can't see it YET in the microscope!) i would strongly suggest you go on EnteroLab's website and read their info!

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wait! i just looked at my daughter's results and reference ranges, and noticed that you had a 4 on the ttg iga? the reference range is 0-3.

Different labs have different reference ranges. So her 4 could be totally different from a 4 on your test. Their ranges depend, among other things, on the kind of equipment they use, for example.

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i know, but her other results were the same, so i thought it might be the same. but just in case it wasn't, i put the reference range in.

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I read that 70% of full-blown celiacs will test negative on the panel, but almost 100% test positive on stool testing from EnteroLab. so, we did that

From my observation reading here for the past 8+ years, 100% of ALL Enterolab results report positive for gluten intolerance. Send Dr Fine your stool sample; he'll report back that you have an issue with gluten, while happily cashing your check. I don't recall ever seeing a case where Enterolab reported a negative finding with respect to gluten. Fine has never published a study to establish the basis for his tests. Just saying.

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Get back on the gluten!! You do not want to go gluten free until all testing is finished, I'm afraid, as it can affect the results. The antibodies start to disappear if there is nothing there to attack :)

buuttttttt the gluten is nasty I always hated pasta and bread. I think I know why now. I see the gastro tomorrow, I haven't had gluten since Friday. Should I eat it today? I am still bloated after every non gluten meal..

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buuttttttt the gluten is nasty I always hated pasta and bread. I think I know why now. I see the gastro tomorrow, I haven't had gluten since Friday. Should I eat it today? I am still bloated after every non gluten meal..

No, one day isn't going to make any difference at this point. And, it has been less than a week off ......

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    • Now that my initial rage has calmed a tad.... your daughter has to fulfill 4 out of 5 of the diagnostic criteria. Second opinion can do a gene test. If positive, then she will have4 out of 5 of the dx criteria to dx without a positive biopsy. See: http://www.gastro.org/news_items/a-biopsy-should-not-be-required-to-make-the-diagnosis which says in part: The presence of signs and symptoms compatible with celiac disease. Positive serology screening (high serum levels of anti-TTG and/or EMA). Presence of the predisposing genes HLA-DQ2 and/or –DQ8. Histological evidence of auto-insult of jejunal mucosa typical of celiac disease. Resolution of the symptoms and normalization of serology test following the implementation of a gluten-free diet.   Also see: http://www.tenderfoodie.com/blog/2014/5/1/dr-fasano-on-new-gut-autoimmune-research-autism-clearing-up.html She can get a dx after her symptoms resolve on a gluten-free diet!
    • OMG!!!! The doc wants her to get sicker & sicker & do further damage so he can diagnose her? Don't do me any favors doc!!! I'm so spitting med right now I can't even speak! Find a new doc, take the records & get a second opinion. Maybe the next doc will have a freaking brain & dx your daughter. She should be dx'd! This is absurd in the extreme. The very least that should happen is the doc give her a dx now & then in a year or 2 have her do a gluten challenge & do a biopsy all over again but seriously, that would be just as cruel as what he's doing now. He's an ASS!
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