Doctor Only Ran One Test?

[targetsgirl]

Hello, I am new here.  I have been "lurking" for about a week, as I waited for my blood test results.  They are in today.  I can view test results online.  From what I understand from my incessant googling and lurking on this site, a full panel should be ordered to diagnose celiac disease.  I see that my doctor only ordered one test.  It is the TTG antibody, IGG.  My result was 1.  I guess this is good, since no one really wants celiac, but I'm afraid to trust the diagnosis if more tests should have been ordered.  Can anyone tell me if I need to press for more testing or if this can send my on my merry bread eating way?

 

A bit of background.  I had the testing done because I have a strong family history of celiac.  Paternal grandmother, two paternal uncles, and a few cousins have been recently diagnosed.  I have been suffering with a lot of hormonal imbalances, frequent periods, tingling hands, anxiety, consitipation/diarrhea, gas and bloating for years. 

 

Thanks in advance for any advice!

 

[GottaSki]

Hello, I am new here.  I have been "lurking" for about a week, as I waited for my blood test results.  They are in today.  I can view test results online.  From what I understand from my incessant googling and lurking on this site, a full panel should be ordered to diagnose celiac disease.  I see that my doctor only ordered one test.  It is the TTG antibody, IGG.  My result was 1.  I guess this is good, since no one really wants celiac, but I'm afraid to trust the diagnosis if more tests should have been ordered.  Can anyone tell me if I need to press for more testing or if this can send my on my merry bread eating way?

 

A bit of background.  I had the testing done because I have a strong family history of celiac.  Paternal grandmother, two paternal uncles, and a few cousins have been recently diagnosed.  I have been suffering with a lot of hormonal imbalances, frequent periods, tingling hands, anxiety, consitipation/diarrhea, gas and bloating for years. 

 

Thanks in advance for any advice!

 

With familial history alone, you should have a complete celiac antibody panel.  Add symptoms and yes - you should absolutely have a complete panel.  If all those are negative, removing ALL gluten for at least three months (six is better) to monitor symptoms would be the next step.

 

That your doctor ordered only a tTG-IgG is strange as it is quite common for docs to order a single tTG-IgA for screening -- which is not sufficient either...but is common.

 

Here are the rest of the tests you need:

 

Total Serum IgA

tTG-IgA

EMA-IgA

DGP-IgA

DGP-IgG

 

and if they haven't been run recently:

 

CBC, CMP and nutrients -- B12, D and Iron (minimally) -- my celiac doc adds more Bs, K and other minerals to the list.

 

Good Luck and do give the diet a strict trial once ALL of your testing is complete

[moosemalibu]

I second what Lisa wrote. Get the full panel done and then trial the diet if those are inconclusive.

[targetsgirl]

Thanks guys.  My gut (no pun intended ) was telling me the same thing.  I kind of have a love/hate relationship with this doc anyway.  I have had problems anytime I initiate testing (as I did for celiac) or when I ask for more conclusive testing (as I have done for hormones and thyroid) in the past.  I know my body, and something is not right.  Would you recommend a specialist, or just find a new GP?  I live in a very rural area, and my options may be limited...

[1desperateladysaved]

Were you eating gluten when the blood was drawn?  Sometimes they have taken more blood than necessary, so that you could request the rest of the panel without drawing more blood.  If you are not eating gluten, the test would be false negative.

 

I hope you get definitive results soon.  You do have some symptoms and family history.

 

If and when you are all done with all the tests.  It would be good to try a gluten free diet and record the changes in your symptoms.

 

D

[targetsgirl]

I had been eating a gluten filled diet for about two weeks when the blood was drawn.  Before that, I had been on a "limited" gluten diet for about a year.  I avoided it as much as I could, due to gastro problems and feeling lethargic when running(I'm a long distance runner),  but I did splurge maybe once or twice a week on pizza or bread for a sandwich.   My doc said that should be enough gluten to run the test.  She ran some other blood tests while I was there and found some hormonal problems, elevated TSH (but not enough to treat?) and iron deficiency.  I don't think she tested any other nutrients. 

 

I'm really beginning to see why so many people are undiagnosed!

[cyclinglady]

What was the TSH value. The range is broad and it is best to be between a 1 and a 3, with closer to 1 being best. Your other thyroid values? Were you tested for antibodies? Anemia (low ferrtin) and higher range TSH levels are always the culprits when my running becomes sluggish.

Mt celiac disease blood tests indicated a mild positive, but my intestinal damage via biopsy showed moderate to severe damage. You might not have been eating enough gluten.

[GottaSki]

Eating gluten once per week or less for nearly a year would require a full gluten challenge of twelve weeks of daily gluten (one slice of glutenous bread is enough).  Two weeks would not be long enough to assure accurate blood results.

[targetsgirl]

My TSH was 3.5.  Free T4 was .99.  She didn't check any others, despite my request.  Ferritin was 10.  I have a history of iron deficiency anemia, so that wasn't a surprise.  She also tested some hormone levels, but those results aren't all in.  Prolactin was quite low, so I'm guessing estrogen will be high...  A cousin recommended her doctor to me, so I will  call and try to get in with someone who is a little more thorough than current doc.

 

Thanks for the advice.  Folks on here have already asked more questions than my doctor did.

[GottaSki]

Thanks for the advice.  Folks on here have already asked more questions than my doctor did.

 

Sad...but not uncommon 

 

Good luck...let us know if we can help with the next doc

[cyclinglady]

Anemia/low ferritin was my only symptom. I went in for a routine colonoscopy and the GI suggested celiac disease. I was shocked! Had all that intestinal damage. Your ferritin is way too low! There is a reason for that iron deficiency and it is not always your period. Good luck and welcome!

[cmc811]

Not to hijack original poster's thread, but what should ferritin be? Mine was labeled as "normal" at 17.8 with a standard range of 12.0-306.0

Should it be closer to mid-range/upper range? Where does transferrin fit in? Mine was actually above the normal range. I've tried googling and just confused myself more and unfortunately my hematologist wasn't much help.

[frieze]

an elevated transferrin may indicate an iron def. anemia....

[cmc811]

an elevated transferrin may indicate an iron def. anemia....

That's what I thought but hematologist said my anemia wasn't iron def.

 

High Transferrin

Very low end of normal ferritin

low hemoglobin

low hematocrit

low red blood cell count

Iron binding capacity 2  points from being high

 

It was my understanding that was all typical for iron def but maybe because my actual iron serum was normal, that is what he was going off of?

[frieze]

did the doc actually say anemia? if so, what kind did he classify it as?  don't forget, low magnesium can produce an anemia as well.

[cmc811]

I got the "unspecified anemia" diagnosis. My PCP referred me to the hematologist to have it further explored but he never figured it out either. He wanted me to keep coming back every 3 months but after the 3rd visit of him saying the exact same things and not reaching any further conclusions I quit going.

 

So, yes I have officially been diagnosed with anemia but I take that with a grain of salt since it can't be pinpointed. Maybe my numbers just naturally run a little outside the ranges, but that is normal for me?

 

Interesting about magnesium.....I can't find in any of my lab reports where magnesium was even checked.

[cyclinglady]

I am not an expert in anemia, but my body was able to use iron, but had a hard time storing it due to the celiac disease. I guess they look at hemoglobin levels below the range. My hemoglobin level has always been slightly below the normal range due to a genetic anemia called Thalassemia (tiny red blood cells, out of range MCV). Luckily, my body has compensated for it.

So I had two anemias (still have the one) but because of heavy periods, the doc would prescribe iron and my ferritin levels would come up from a 2 to let's say a 22, but my next heavy period would hit and it would drop my ferritin levels down again to a 2 or 3. I could never get ahead until my GI diagnosed the celiac disease.

I am now through menopause and am no longer iron deficient. I do think a level of 17 is too low, but there is danger of being too high. Heavy periods and being an athlete can suck up a lot of iron.

[cmc811]

My hemoglobin is always low, as is my hematocrit and rbc. My MCV is slightly high, but B12 and folate are fine. I did notice my b12 is lower with each check though and is now pretty close to the low cutoff. I wonder if I'm becoming b12 deficient?

 

Also, in regards to periods, that is certainly not my problem. I have PCOS and go months between periods if I'm not on bc pills to regulate my cycles. Many of my "anemia" investigations took place during a time when I hadn't started the pill and hadn't had a period in 2-3 months.

 

Thanks for all your info! It's so frustrating because I have many lab values just slightly out of range, but since they don't seem to be getting worse the doctors just shrug and move on. Unfortunately I don't feel well and no one can figure out why And with labs that are close to normal no one seems to think the abnormal values have anything to do with my symptoms.

[cyclinglady]

Even though I was never vit. B-12 deficient, I took a sublingual version as well as magnesium to combat some neuropathy I was experiencing due to celiac disease or diabetes. It seemed to solve this issue, but who knows? It did not hurt me! It might be with investigating in your case.