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



    I think that a diet based on Raw food is the best for everybody. And sure for celiac people. Try it. It's natural and its according to our physiology. Blessings to all.

    Share this comment


    Link to comment
    Share on other sites

    There are 3 stages of injury to the intestinal lining with gluten sensitivity/celiac disease - Marsh 1, Marsh 2, and Marsh 3. Marsh 1 shows inflammation only. Marsh 2 shows tips of the villi missing, and Marsh 3 shows the villi are gone. Only Marsh 3 is diagnostic of celiac disease.

     

    Blood tests correlate with celiac disease (Marsh 3) 90% of the time. With anything less, the blood tests correlate only 30% of the time. Having normal blood tests may mean you don't have celiac disease (defined as total loss of the intestinal villi), but it doesn't rule out gluten sensitivity (anything less than total loss of the villi).

     

    There is a new lab, Cyrex, that does some novel testing for gluten senstivity/celiac disease, but it is new. I haven't had any experience with it.

     

    The best test is an elimination diet and see what happens. If you feel better, you are sensitive to the food, whether it's gluten or something else. If you have been off of gluten for a while, it may not be a good idea to re-challenge. It can take months for the inflammation to calm down again.

    Share this comment


    Link to comment
    Share on other sites
    Guest marylworth@yahoo.com

    Posted

    If you're still having minor symptoms after eliminating wheat, try eliminating soy or soybean oil too. This can be tedious (read labels on everything - jar spaghetti sauces, salad dressings, soups, butter spreads, chips, microwave popcorn, cereal, Worcestershire, etc.) but worth it! An article my sister sent me four years ago saved me because I was still not 100% well until reading it.

    Do you still have the article? Can you post it?

    Share this comment


    Link to comment
    Share on other sites
    If you're still having minor symptoms after eliminating wheat, try eliminating soy or soybean oil too. This can be tedious (read labels on everything - jar spaghetti sauces, salad dressings, soups, butter spreads, chips, microwave popcorn, cereal, Worcestershire, etc.) but worth it! An article my sister sent me four years ago saved me because I was still not 100% well until reading it.

    Not only wheat and soy can cause this type of distress, but also corn. I have the double whammy of no corn, no gluten. This makes eating very difficulty--but far better than ending up bent over in pain.

    Share this comment


    Link to comment
    Share on other sites

    I've been having problems with my stomach for two years now. My doctor thought it was my gallbladder but, i did an ultrasound and they said it was all fine. My doctor said it was my birth control, she took me off and gave me something else, but as always it didn't work. I'm having stomach pains, bloating, extreme gas, and getting nausea. Well, i got the blood test done the other day because, my friend has it and she told me it sounds just like her problems. Well, they both came back negative and I want to get a endoscopy done to see. But, if i go two days without eating gluten products my stomach starts to feel a little better but when i go right into eating again it starts bloating, stomach pains, extreme gas, and nausea.

    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 the morning after I eat gluten.

    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 very itchy nose (externally, like the skin on the end of my nose), bloodshot itchy eyes, nosebleeds, I had erythema nodosum, headaches, acne, and about 20 other symptoms of the approximate 300. This all in addition to the stomach pain, and other gastro issues.

    Share this comment


    Link to comment
    Share on other sites
    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.

    From what I understand, the blood test CAN be sufficient to determine a gluten intolerance, BUT in order to know if you have celiac disease, you need the biopsy. Celiac disease involves the deterioration of the villi which line the small intestine, and this is only confirmed through biopsy. However, you can have a significant gluten intolerance and not have celiac disease. Celiac is just one of the many possible side effects of eating gluten if you are intolerant. the body does not produce antibodies against something unless it is harmful to you. Therefore, the positive blood work could be considered enough to determine your gluten intolerance, and spare yourself or your little ones the expense and trauma of an endoscopy. Unless of course you really want to have the celiac diagnosis, eliminating gluten will provide amazing health benefits either way to the gluten intolerant individual.

    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?

    No, but in my reaction, I get extremely itchy and red and patchy skin particularly on my chest and face and extreme acne flair ups within minutes of consumption among the gastrointestinal effects. I read that "food allergies" particularly cause your symptoms and they can be celiac-related so I would try to avoid completely the foods that cause that reaction in you as this is a sign that your body is not taking to well to it.

    Share this comment


    Link to comment
    Share on other sites

    My total SIgA (saliva) was 6 (depressed- normal is (25-60)) and Gliadin Ab, SIgA (Saliva) was 1 (positive is >15). Which is a negative result. Could my SIgA Gliadin be lower since my SIgA is very low? (I have no other known conditions). Should I try to get a blood test? Is that more accurate than saliva? Where to go from here?

    Share this comment


    Link to comment
    Share on other sites

    Hi everyone. I am recent to this celiac and am from a developing country...so little gluten free diet options here. My igA is 118 on a retest after I was on a gluten free diet for 6 months. Previously it was 284 (normal is less en 10). My igG was 604 but it is normal this time (4). So my doc says I don't need a biopsy. My tests are sufficient. AND now with this repeat test he has put me on steroids for a week...confusing.

    Share this comment


    Link to comment
    Share on other sites
    From what I understand, the blood test CAN be sufficient to determine a gluten intolerance, BUT in order to know if you have celiac disease, you need the biopsy. Celiac disease involves the deterioration of the villi which line the small intestine, and this is only confirmed through biopsy. However, you can have a significant gluten intolerance and not have celiac disease. Celiac is just one of the many possible side effects of eating gluten if you are intolerant. the body does not produce antibodies against something unless it is harmful to you. Therefore, the positive blood work could be considered enough to determine your gluten intolerance, and spare yourself or your little ones the expense and trauma of an endoscopy. Unless of course you really want to have the celiac diagnosis, eliminating gluten will provide amazing health benefits either way to the gluten intolerant individual.

    So my question in my case is if my blood test came back barely positive but my endoscopy came back negative should I stop eating gluten? My doctor told me that if I don't have any symptoms that it is ok to eat it. Your thoughts????

    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.

  • Related Articles

    Scott Adams
    Dermatitis herpetiformis (DH) is a severely itchy skin condition that often starts abruptly, affecting the elbows, knees, buttocks, scalp, and back. It usually starts as little bumps that can become tiny blisters and then are usually scratched off. DH can occur in only one spot, but more often appears in several areas.
    The condition is related to IgA deposits under the...

    Scott Adams
    There are different practices amongst GIs on repeat biopsies vs. serology, and on gluten challenges. My sons g/i, for example, took the position that since my sons symptoms stopped on a gluten-free diet, and his previously sky-high EMA and ARA went back to normal, that it was unnecessary to do either a repeat biopsy or a gluten challenge. From the celiac list correspondence...

    Scott Adams
    For 100 units of whole grain wheat, about 70 units of white flour results from the milling process. The rest is separately sold as wheat bran or wheat germ. Those 70 units of flour are about 10%- 15% protein, thus about 7 to 10 units of protein for 100 units of whole wheat. The protein is about 80% gluten, thus about 6 to 8 units of gluten for 100 units of whole wheat. Since...

    Scott Adams
    The following was posted by Kemp Randolph on the Celiac Listserv news group krand@pipeline.com:
    The difference is that between two immune related reactions, allergy and intolerance. I asked the question of the technical difference between the two some time ago and got no response. Its not based on overt symptoms, thats for sure. Were also not talking about the difference...

  • Forum Discussions

    Thank you knitty kitty and posterboy. I do take my multi that has it in it. I may have to look for a liquid form. thank you for reaching out I very much want to find some stability as I am working now and need to be a good wife, mom,...
    Awol, I saw this earlier...but got busy with life...Knitty Kitty's response triggered my memory...POTS has been associated with low Thiamine Levels...they say as many as 1/4 of those with POTS might improve after taking thiamine supplementation...
    You can try the AIP diet. It is very effective for treating IBS. Migraines are often linked to IBS. https://autoimmunewellness.com/aip-medical-study-results/ Also NAC an antioxidant that can cross the blood brain barrier. http...
×
×
  • Create New...