Help With Lab Results

[mta-464683]

Hi all, noob here, first post. I've been having GI symptoms for about 8 years now, was diagnosed with IBS back then without any testing. However, in the past few months I've been having a lot of fatigue, muscle aches, twitching, tingling in my face, feet and hands in addition to the usual GI symptoms of diarrhea, constipation, bloating, gas, nausea, etc. Just got a lot of blood work done that may indicate I'm celiac. Here are the relevant test results:

 

TTG AB, IGG: 4 (0-19)

GLIADIN PEPTIDE, IGA: 18 (0-19)

GLIADIN PEPTIDE, IGG: 9 (0-19)

TTG AB, IGA: 25 (0-19) (weak positive)

IMMUNOGLOBULIN A: 226 (70-400)

IMMUNOGLOBULIN G: 995 (700-1600)

TSH: 5.070 (0.358-3.740)

 

Does this sound like celiac to you all? I know thyroid issues can cause false positives with TTG IGA but I don't think my high TSH could be the cause all my GI sx. I'm 30/m, so I also think thyroid disease would be rare for my group? I don't even know for sure I have hashi's or anything like that since this is the first time my TSH has been elevated (it was completely normal just 2 months ago!) My doc also thought it was significant that my gliadin IGA was at the high end of normal even though it was still in the range, since that is apparently a very specific celiac test. Does that sound right?

 

I have a biopsy scheduled in 5 days, but I think regardless of the result I'll give the gluten-free diet a try and see how I feel, then follow up with my doc about the thyroid issue. I'm actually kind of hoping gluten has been secretly responsible for all the stomach trouble I've had for years. I wouldn't miss it that much and I would like to feel better!

 

Thanks!

[cyclinglady]

I'm going to defer the celiac lab result questions to some of our experts!  I will say that your TSH is high.  The current range is between 1 - 3.  I feel best personally, being closer to a 1.  Were you tested for thyroid antibodies?  Both my brother and I were diagnosed with Hashimoto's Thyroiditis when we were in our 30's.  So, it's not unusual for men to have thyroid issues.  

 

Keep eating gluten until your endoscopy and make sure they take plenty of samples of the small intestine!  Oh, my celiac blood panel came back as "mildly postive" and I ended up with severe damage!  

 

Welcome ot the forum!  

[NoGlutenCooties]

 

TTG AB, IGA: 25 (0-19) (weak positive)

 

 

There may be a difference between labs, but from my experience a 25 on this test is not a weak positive - it is a most definitely positive, be glad you're getting the endoscopy.  My doctor considers anything over 10 to be a definate positive.  Most nutritionalists that I've talked to consider anything over 3 to be a definite positive.

 

When I had my tests done I had no symptoms yet but requested the test due to family history.  My TTG IGA was 13.  My endoscopy showed visible inflammation - the doctor told me she didn't even need to wait for the biopsy results to come back to know that it was Celiac.  The extent of damage varies greatly from person to person, as do the symptoms.

[nvsmom]

Welcome to the board.

Your tTG IgA is a positive but not a super high results that some celiacs can get - note that I did say "some" - and not necessarily the majority either. In 95% of positive tTG IgA's, the cause of the positive is celiac disease. Because to also have an almost positive gliadin peptide test (DGP IgA I am guessing), I think that would point to celiac disease too. I agree with your doctor.

Thyroiditis and celiac disease often go hand in hand. I agree that your TSH is high; you probably have symptoms of hypothyroidism. I think you should get more tests on that. As cycling lady said, people with thyroid problems often feel best when their TSH is near a 1. More important are your free T3 and free T4 levels; they should be in the 50-75% range of your lab's normal reference range. The free's give you the most info and tell you how much hormone is actually available for your body to use. For example, when my TSH is just above a 1, my free T's are near the bottom of the normal range and I feel hypo. When I get my free T3 to about 70% of my lab's normal range, my TSH plummets to 0.02 -according to my TSH I am hyper but my frees say i am fine, and I do feel fine... That's just me though, everyone is different.

Get your TPO Ab checked too. That's usually elevated in those with hashi's, but not always.

Good luck with the biopsy. If for some reason the doctors miss the damage and call it negative, I hope you will still try the gluten-free diet. Best wishes.

[cyclinglady]

Welcome to the board.

Your tTG IgA is a positive but not a super high results that some celiacs can get - note that I did say "some" - and not necessarily the majority either. In 95% of positive tTG IgA's, the cause of the positive is celiac disease. Because to also have an almost positive gliadin peptide test (DGP IgA I am guessing), I think that would point to celiac disease too. I agree with your doctor.

Thyroiditis and celiac disease often go hand in hand. I agree that your TSH is high; you probably have symptoms of hypothyroidism. I think you should get more tests on that. As cycling lady said, people with thyroid problems often feel best when their TSH is near a 1. More important are your free T3 and free T4 levels; they should be in the 50-75% range of your lab's normal reference range. The free's give you the most info and tell you how much hormone is actually available for your body to use. For example, when my TSH is just above a 1, my free T's are near the bottom of the normal range and I feel hypo. When I get my free T3 to about 70% of my lab's normal range, my TSH plummets to 0.02 -according to my TSH I am hyper but my frees say i am fine, and I do feel fine... That's just me though, everyone is different.

Get your TPO Ab checked too. That's usually elevated in those with hashi's, but not always.

Good luck with the biopsy. If for some reason the doctors miss the damage and call it negative, I hope you will still try the gluten-free diet. Best wishes.

Good catch on the T3 and T4 levels.  For 20 years mine have never been off, so I don't think about it.   Thanks!

[mta-464683]

Thanks everyone for your detailed replies. It sounds like I do probably have celiac with some thyroid issues thrown in for good measure.  Nvsmom, thanks for the thyroid info and I will definitely follow up with my doctor after the endo and get more thyroid testing done. It sounds like these AI diseases tend to travel in packs, so hopefully I'm done with getting new ones now that I've apparently gotten 2 at age 30!

 

NoGlutenCooties, my ttg IGA lab results clearly say that 0-19 is negative, 20-29 is weak positive, and 30+ is moderate/strong positive. Is it typical for labs to have different ranges when measuring the same thing? I'm actually glad I'm high enough for my doc to take it seriously. I've found in the past that docs won't do anything unless you're outside the range, even if you're at the very edge of the range and clearly have a problem going on.

 

I do plan on giving the gluten-free diet a try even with a negative endo. How long does it usually take for most people to get symptom relief? I can see myself questioning whether or not it's the right thing to do if my endo is negative and I don't start to feel better. Fortunately, my wife is very supportive of this whole thing and she won't let me slip up.

 

I also had a question about symptoms. Is it typical for celiac symptoms to present like IBS? I've had IBS like symptoms for years with alternating constipation/diarrhea, although mostly C. I've also had bloating, gas, GERD, constant burping, everything under the sun. My worst symptom right now is actually the constant acid reflux. It seems like constant D/malnutrition is more typical of celiac from what I've read. Also, my joints snap/crack a lot when walking, I get random muscle aches/pains/twitches, I've lost some hair, and feel fatigued all the time. Do these all sound like celiac? I'm just wondering how much of these may be celiac vs. what might be hypothyroidism.

 

Thanks again everyone!

[WinterSong]

 

I also had a question about symptoms. Is it typical for celiac symptoms to present like IBS? I've had IBS like symptoms for years with alternating constipation/diarrhea, although mostly C. I've also had bloating, gas, GERD, constant burping, everything under the sun. My worst symptom right now is actually the constant acid reflux. It seems like constant D/malnutrition is more typical of celiac from what I've read. Also, my joints snap/crack a lot when walking, I get random muscle aches/pains/twitches, I've lost some hair, and feel fatigued all the time. Do these all sound like celiac? I'm just wondering how much of these may be celiac vs. what might be hypothyroidism.

 

Thanks again everyone!

 

I'm not sure about the muscle aches and joint snapping, but the rest are ALL symptoms of Celiac! Most of which are my symptoms, in fact. I had really bad acid reflux that presented itself as awful burping. I was also bloated all the time and very tired.

 

A few more things:

A lot of Celiacs get both C and D.

Malnutrition can cause a lot of problems including hair loss. 

Joint pain is a symptom if you are experiencing that. I have another Celiac friend, and that is his only symptom. 

 

In my opinion, IBS is a BS diagnosis and is just a name that doctors tell you when they can't figure out what's wrong with you. A lot of us on here were diagnosed with IBS which really turned out to be Celiac or a gluten intolerance. 

 

Welcome to the board!

[nvsmom]

Someone around here said IBS is doctor talk for "I Be Stumped".  LOL  A large number of us were told we have IBS,which is not really a diagnosis (in my opinion) but more of a description of how the patient feels - it doesn't get to the "why" of a problem at all.

 

Some symptoms will improve within days whereas others can take months or years. From what I have observed, stomach pain and bloating tends to be one of the first symptoms to improve with improvements beginning within days. Headaches are often quick to improve too. The symptoms that tend to take the longest to improve often involve the nervous system or joint pain... This is just a generalization though., everyone is different.

 

And some people experience withdrawal in the first few weeks and actually feel worse (especially in fatigue) so if you take a sudden turn early on, don't worry. Actually, symptoms can take a turn any time during the healing process; I personally had a lot of joint pain and fatigue after being gluten-free for 3-6 months. Healing is not just linear improvements, and then there are some things that won't heal (my knees have crackled since I was in my early twenties so going gluten-free in my late thirties probably won't help much with that now.  LOL

 

The symptoms you listed could be from thyroid problems or celiac disease; the symptoms are almost the same. Hypothyroidism slows your whole metabolism down by 10-15% (I'm afraid I can't remember where I read that) and causes a great deal of fatigue. Like celiac disease it also thins out hair, and unfortunately I found when I started treatment, it thinnned my hair even more. Pain is a symptoms of both too, and C is pretty classic hypothyroidism. To be honest, malnutrition is not the norm, it's just what doctors THINK is the norm for celiacs. celiac disease can affect absorption of fats but most people eat carb and protein heavy which we don't have issues with - also the reason why many of us have a few extra pounds too.

 

Good luck with the diet! Oh, I should mention too that if you have kids, they should be tested (and retested every few years) as celiac disease has a genetic component to it.  Best wishes.

[NoGlutenCooties]

 

NoGlutenCooties, my ttg IGA lab results clearly say that 0-19 is negative, 20-29 is weak positive, and 30+ is moderate/strong positive. Is it typical for labs to have different ranges when measuring the same thing? I'm actually glad I'm high enough for my doc to take it seriously. I've found in the past that docs won't do anything unless you're outside the range, even if you're at the very edge of the range and clearly have a problem going on.

 

 

My lab results clearly say 0-11 is negative.  I think there are just many differing opinions about how high is too high.  But the nutritionalists I've spoken to, and in the books my mom has read, they believe anything over 3 is cause for concern.  I have an innate distrust of the entire medical profession, but I really think it has more to do with the insurance companies not wanting to pay for further testing.  If your number is "only" 5, then the endoscopy is probably likely to come back negative because you're not sick enough yet.  So the insurance company doesn't want to pay for it.  Like you said, at least your number is high enough that they aren't trying to play the wait-and-see game with you.  For what it's worth, my number was 13 and the biopsy came back in the moderate to severe level of damage range.  So you just never know.