Got My Lab Results... Can Anyone Help Interpret Them?

[TheBadOtter]

Background: I was having very few true GI issues, although I have always gone back and forth between constipation and loose stools (one or the other over 50% of the time). I went to the doc with depression, anxiety, fatigue, migraines, and really bad joint pain. She ran the gamut of blood tests on me and the Celiac panel came back today. She is recommending I go to a GI, but they can't see me for three weeks! I was hoping you guys could share some advice here, bc I am scouring the internet and not loving what I am finding... that I have to keep eating gluten to make myself sicker or the biopsy could be negative (I had just started a low carb diet >:[ ), that the biopsy could even have a false negative...And to make it worse, it's not my IgA levels that are high, it's my IgG. 

 

Here's my results:

 

(reference range is <20 units for all of them- is that weird?)

 

Glialdin IgG: 48

Glialdin IgA: 3

TTG IgA: 16

TTG IgG: 33

 

Is there anything else that causes IgG levels to be high? Searching the web is not finding much besides celiac...

 

Any advice or help would be appreciated!

[nvsmom]

Welcome to the board.

 

I'm afraid that it is probably celiac disease.  The tTG (tissue transglutaminase) tests indicate an attack on the endomysial linings of the intestines, and the AGA (antigliadin antibodies) shows gluten intolerance... That probably means celiac disease.

 

These reports have some info on the specifity of the tests (what percentage of positives are caused by celiac disease):

Open Original Shared Link

Open Original Shared Link

 

The AGA IgG has a specificity of 80-95%, and the tTG IgG has a specificity of 95%. If you combine the two, I would say it is pretty certain.  AGA tests can indicate non-celiac gluten sensitivity (NCGS) in some of that 20% of the time.  False negatives in the tTG tests (5%) are usually from diseases such as thyroiditis, diabetes (T1), chronic liver disease, crohn's, colitis, or a serious infection, and those are usually weak positives (like a 21). 95% of the time a positive is from celiac disease.

 

You may want to keep eating gluten until you are sure all testing is done.    You could still do these tests:

• DGP IgA and DGP IgG - deaminated gliadin peptides - newer and better tests that have largely replaced the less reliable AGA tests
• EMA IgA or EMA IgG - endomysial antibodies - detect more advanced damage, and is extremely specific to celiac disease.
• total serum IgA - a control test to determine if IgA levels are low, which would cause false negative IgA based test results.
• endoscopic biopsy - 6+ samples taken

All the tests need you to be consuming gluten in the 8-12 weeks prior to testing, so it is probably best not to stop gluten yet.  No need to eat too much though; most doctors suggest somewhere between 1/2 to 4 slices of bread (or equivalent) per day, with 1 or 2 slices being about the average.

 

Good luck with the gastro.  

[TheBadOtter]

Thank you! I will let you know how it goes. The GI my PCP gave me the # for actually has some really bad reviews, so maybe I can find someone to take me sooner...

[nvsmom]

Good idea.  They do sometimes move people up (from what I've heard) if they are having a hard time.