Jump to content
  • Sign Up
  • Join Our Community!

    Get help in our celiac / gluten-free forum.

  • Scott Adams
    Scott Adams

    How accurate are blood-antibody tests?*

    Reviewed and edited by a celiac disease expert.

    There are two classes of antibodies seen in untreated celiac disease. Antibodies directed against a fragment of gluten called gliadin, and antibodies directed against a particular tissue in the body itself. The two main areas in the body which can be attacked by its own antibodies are the aendomysial (the covering of muscle), and the reticulin ( the framework for kidney and liver), but there are others.

    To conduct the test, 5ccs of blood is drawn from the patient, and the blood cells are removed. The gliadin test is usually an automated machine-read test, which means there is little room for interpretor error. However, currently in the USA there is no standard methods for conducting the test, or normal ranges for the results. The endomysial tests are more dependent on the experience and ability of a pathologist who looks at a pattern of staining produced by the patients serum on a slice of monkey esophagus. While this test is done in similar way in most labs, there are many differences in how the results are interpreted.

    How good are these tests?

    If all of the blood test results are positive a celiac disease diagnosis is 90% accurate. However, there are several circumstances in which the tests can be inaccurate. IGA and IGG are two different varieties of antibodies which are produced by most peoples immune systems. There is a different blood test for each of the antibodies. Of the two tests, the IGA gliadin and IGA endomysial tests are the most accurate. However, this test can become negative relatively quickly after going on a gluten-free diet (3-6 months), which can cause a false negative test result. The IGG is less specific, and can sometimes be positive in non-celiacs. Also, about 4% of celiacs have no IgA at all! For these reasons it is very important that both tests are done for an accurate diagnosis. The biopsy is still considered the "standard candle" to confirm a blood diagnosis, and give a 100% sure diagnosis.

    For all tests for celiac disease it is necessary that one is on a gluten-containing diet, or false-negative test results could be given. Blood tests may also be useful in following up a known celiac and confirm that the diet is indeed free of large amounts of gluten. Also, because of the lack of standardization, keep in mind that blood test results may not be directly comparable from one lab to the next.


    User Feedback

    Recommended Comments



    This article was helpful - to a point. My 6 year old daughter has had tummy issues her whole life. To make a short story we had her blood tested & her antibody results were so high-off the chart- that her pediatrician said a biopsy wasn't necessary. She has celiac...period.

    My husband has had the same symptoms nearly his whole life (that's why we ignored our daughter's for so long). He got his blood tested. His antibodies were also off the charts - and again we were told by his doctor that a biopsy isn't necessary. "he has Celiac".

    We were told by 2 different doctors that a biopsy wasn't necessary. But all the research I've read said that the blood tests weren't 100% accurate.

     

    Both my husband & daughter have been gluten free for 2 months now. My husband's digestive issues have all but disappeared. My daughter however, still has very loose stools, but she's only going once a day instead of several times a day. I"m torn between giving her system a little more time, or requesting that biopsy after all.

    Share this comment


    Link to comment
    Share on other sites

    Great website for someone new to celiac disease. I just got my blood test results and think it says I do not have celiac Even though I still think I do and will begin a gluten-free diet. Results were (ttg)ab,iga <3; iga,serum 141. The thing that is throwing me is the iga serum.

    Share this comment


    Link to comment
    Share on other sites

    False negatives and false positives don't bode well for someone with tendencies toward hypochondria. When I do the gluten elimination diet strictly I feel better but it could be a placebo effect. That's why the blood tests are appealing to me; so I can take my double-guessing self out of the loop, but if they aren't accurate enough to provide greater certainty that the elimination diet then what's the point? Well, anyway this article answered several questions for me including the need to go back on gluten prior to the test and your insightful comments provided a ballpark figure for how long to go back on before testing.

    Share this comment


    Link to comment
    Share on other sites
    Does anyone else get rhinitis (stuffy runny nose and sneezing) during their reactions or is it strictly gastro-intestinal for you?

    I have been having terrible gastrointestinal problems. Had an ultrasound and blood work. Nothing turned up. Since, someone mention perhaps gluten is the problem. I cut it out for 3 days, and the tummy troubles are gone. I have had rhinitis all my life, post nasal drip all night long, been on allergy pills of every type. I am hoping with a little more time on the gluten free diet, this will be alleviated. Keep me posted on your end. PS - going today for the blood work for the antibody to gluten. I am hoping 3 days off of gluten will be ok for an accurate reading. Although, prior to my gluten free diet, I could barely eat anything...that lasted more than a month!

    Share this comment


    Link to comment
    Share on other sites

    This article helps a lot. I have gastrointestinal problems, dermatitis rashes that appear on my foot every 3-4 ish months, and geographic tongue. I'm more at risk for celiac b/c I also have Hashimoto's thyroiditis, but the one antibody test(IA-2) came back negative. I'm thinking my autoimmune disease might be affecting the test results, and am going gluten free to be sure.

    Share this comment


    Link to comment
    Share on other sites
    This article helps a lot. I have gastrointestinal problems, dermatitis rashes that appear on my foot every 3-4 ish months, and geographic tongue. I'm more at risk for celiac b/c I also have Hashimoto's thyroiditis, but the one antibody test(IA-2) came back negative. I'm thinking my autoimmune disease might be affecting the test results, and am going gluten free to be sure.

    A biopsy of your rash may be all you need. They say it is 100% sure indicator for celiac. I'd ask your dermatologist about it.

    Share this comment


    Link to comment
    Share on other sites
    This article was helpful - to a point. My 6 year old daughter has had tummy issues her whole life. To make a short story we had her blood tested & her antibody results were so high-off the chart- that her pediatrician said a biopsy wasn't necessary. She has celiac...period.

    My husband has had the same symptoms nearly his whole life (that's why we ignored our daughter's for so long). He got his blood tested. His antibodies were also off the charts - and again we were told by his doctor that a biopsy isn't necessary. "he has Celiac".

    We were told by 2 different doctors that a biopsy wasn't necessary. But all the research I've read said that the blood tests weren't 100% accurate.

     

    Both my husband & daughter have been gluten free for 2 months now. My husband's digestive issues have all but disappeared. My daughter however, still has very loose stools, but she's only going once a day instead of several times a day. I"m torn between giving her system a little more time, or requesting that biopsy after all.

    Paula - I found your comment to mean the most to our situation. My son was diagnosed with Celiac and also has "off the chart" blood tests for all 4 antibodies. The strange thing was that he is asymptomatic. I made the connection myself based on a tooth enamel defect that was found at the dentist office. We have all been tested (my husband, daughter and myself) and are awaiting the results. I am sure that I have it was well. Anyway, our doc was pushing the biopsy even though the blood tests were so compelling. We have chosen not to do that as my son just had his tonsils out and I do not want to put him through that right now. We have chosen to just eliminate the gluten altogether. I hope we have made the right choice. Did you ever have the biopsy done on your daughter?

    Share this comment


    Link to comment
    Share on other sites
    This article was helpful - to a point. My 6 year old daughter has had tummy issues her whole life. To make a short story we had her blood tested & her antibody results were so high-off the chart- that her pediatrician said a biopsy wasn't necessary. She has celiac...period.

    My husband has had the same symptoms nearly his whole life (that's why we ignored our daughter's for so long). He got his blood tested. His antibodies were also off the charts - and again we were told by his doctor that a biopsy isn't necessary. "he has Celiac".

    We were told by 2 different doctors that a biopsy wasn't necessary. But all the research I've read said that the blood tests weren't 100% accurate.

     

    Both my husband & daughter have been gluten free for 2 months now. My husband's digestive issues have all but disappeared. My daughter however, still has very loose stools, but she's only going once a day instead of several times a day. I"m torn between giving her system a little more time, or requesting that biopsy after all.

    My GI doctor told me there is no way to diagnose just on the blood test. My doctor told me the same thing yours did. I was way off the chart as well...she told me I had celiac and to go on a gluten free diet. My GI doctor was very upset that she told me to go on the diet BEFORE I saw him. He said he HAS to do a biopsy to say I have celiacs.

    Share this comment


    Link to comment
    Share on other sites
    Does anyone else get rhinitis (stuffy runny nose and sneezing) during their reactions or is it strictly gastro-intestinal for you?

    I get a runny nose as soon as I eat anything with gluten in it. I went on an elimination diet for 4 weeks because I was suffering from diarrhea, skin rashes, canker sores, gas, etc. The elimination diet cleared all of my symptoms. In trying things afterward, I got an immediate reaction to bread, so now I am off gluten completely.

     

    I don't think you need a doctor to tell you that you are gluten intolerant. They seem to have a protocol for "diagnosing" someone with celiac that includes the biopsy and tests, but the disease is on a continuum. Not everyone will test positive for every test, but if eliminating gluten helps, you should do it!

    Share this comment


    Link to comment
    Share on other sites

    I am 19 and since I was little I have had stomach issues and chronic constipation. Now more recently I am having severe acne issues, and now am missing periods. I had a colonoscopy about a year ago and everything was fine. I went to a gynecologist and she tested my thyroid levels and my general physician said an antibody level was high but the thyroid function was okay. He sent me for blood work to test for celiac because I have a family history on my mom's side. He called with the results today and said "everything was normal". I am so frustrated because all he is doing is giving me medicine to help me go to the bathroom but they either make me sick or don't work at all, the only thing that works is Exlax. I want to push for an upper g.i. but I don't want to waste the time and money if i really don't have it. I don't know what else to do and it seems like since he can't figure out whats wrong he is just giving up. What do I do? Please help.

    Share this comment


    Link to comment
    Share on other sites
    Does anyone else get rhinitis (stuffy runny nose and sneezing) during their reactions or is it strictly gastro-intestinal for you?

    Tim,

    I get a runny nose immediately when eating something with gluten in it- I mean within 2-3 minutes! It is quite amazing and annoying at the same time!

    Share this comment


    Link to comment
    Share on other sites



    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Celiac.com's Founder and CEO, Scott was diagnosed with celiac disease  in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. Scott launched the site that later became Celiac.com in 1995 "To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives."  In 1998 he founded The Gluten-Free Mall which he sold in 2014. He is co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

×
×
  • Create New...