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    How Accurate are Celiac Disease Blood Antibody Tests?

    Scott Adams
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    Reviewed and edited by a celiac disease expert.

      Just how reliable are blood antibody tests for screening celiac disease?


    Celiac disease blood tests are very accurate. Image: CC BY 2.0--tuckerives
    Caption: Celiac disease blood tests are very accurate. Image: CC BY 2.0--tuckerives

    Celiac.com 05/01/2020 - If you have celiac disease symptoms, for example chronic diarrhea, anemia, bloating, abdominal pain, anemia, etc, your doctor may order a blood test for celiac disease. Note that you must be eating gluten daily for at least 4-6 weeks to be accurately tested celiac disease, otherwise you may end up with false negative results.

    For a celiac disease antibody test, a clinician collects a small amount of the patient's blood. The sample is then sent to a lab, where the blood cells are then removed, and the test is conducted.

    Celiac Disease Blood Antibody Screening is ~98% Accurate When Done Using This Protocol 



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    A celiac disease blood panel includes several tests to determine whether someone has celiac disease. These tests are very specific because certain antibodies only appear in those with gluten sensitivity, celiac disease and/or dermatitis herpetiformis. 

    Testing begins with a test called Immunoglobulin A (IgA). If the results are normal, then a Tissue transglutaminase, antibody, IgA test is given. A weak positive should lead to the following tests:

    1. Endomysial antibodies (IgA) and;
    2. Gliadin (deamidated) antibody, IgA.

    If the initial Immunoglobulin A (IgA) test is low, then these two tests should be done:

    1. Tissue transglutaminase antibodies, IgA and IgG profle.
    2. Gliadin (deamidated) antibodies evaluation, IgG and IgA.

    If the initial Immunoglobulin A (IgA) test is deficient then these two tests should be done:

    1. Tissue transglutaminase (tTG) antibody, IgG.
    2. Gliadin (deamidated) antibody, IgG.

    It sounds complicated, but it's pretty standard procedure now, and when blood screening is done this way the results for celiac disease are ~98% accurate.

    Children Should Now be Diagnosed Using Only Blood Tests and No Biopsy

    In most cases, it is no longer necessary to use biopsy to diagnose celiac disease in children

    Biopsy Still Standard in Adult Celiac Diagnosis

    After positive blood tests some doctors still require a biopsy to confirm the diagnosis. However, this is changing, as new techniques allow doctors to accurately detect celiac disease in adults without a biopsy.

    Remember, nearly all tests and screening for celiac disease require the patient to be eating a gluten-containing diet before testing, usually for at least 4-6 weeks before testing. Be sure to check with your doctor for the latest protocol.

    Blood Tests for Follow Up Care

    Blood tests may also be useful in follow up care in those with celiac disease to confirm that their diet is indeed free 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.

    More Celiac Disease Testing Resources

    Blood Test Questions on the Celiac Disease and Gluten-Free Forum

    Edited by Scott Adams

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    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.

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    Guest marylworth@yahoo.com

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    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?

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    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.

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    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.

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    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.

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    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.

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    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.

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    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?

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    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.

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    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????

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  • About Me

    Scott Adams 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. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


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