Confused with lab results

[Greens]

I'm new to the celiac forum and have tried to look up previous posts to find answers I'm looking for.  Apologies if I missed a post that questions the same issue as I'm about to go on about.  I'd be grateful for any input anyone might have.

3 years ago I asked for a serum gliadin IgA and IgG only because it seemed that everyone is suddenly gluten sensitive.  I've never had gastric problems or any other symptoms to indicate sensitivity.  The IgG was negative.  The lab range for a negative IgA was 0-5 and my results on that test was 78.  I don't feel my doctor was able to adequately explain what that meant and whether that indicated that I had a true gluten issue.  Can someone ELI5 what this result means?

In the meantime, I religiously abstained from gluten for 2 years.  I wanted to see if I could reintroduce wheat and had 2 ciabatta sandwiches in a 2 week period.  Soon after I had another IgA and IgG drawn and similar results, but IgA was 84 (higher) this time.  Still, no digestive problems and am back to avoiding gluten.

I just feel unclear what the IgA means if that is the only positive test, especially since I am asymptomatic.  If I understood correctly, people can have negative tests, but still have celiac disease, but can someone have a positive and be negative for sensitivity?  My doctor doesn't want to do a biopsy, just told me to avoid gluten.

The only other lab value that is off is my alkaline phosphatase which has been low at least 12 years (that is as long as I have my lab records).  My levels are 19-22 range and lab range 25-100.  Has anyone heard of any correlation with gluten sensitivity?  I ask because I don't have liver, kidney or bone disease, my diet is not protein deficient.  None of my doctors have made any comment on the low levels - had since my 20s.  Seem it would be unusual for a healthy adult to have chronically low levels.  Was wondering if I do have gluten allergies whether this test could be reflecting a decreased ability in digesting/absorbing protein from intestinal damage.  Until I went gluten free, I didn't realize how much gluten I had been consuming on a daily basis.   

Ok, lastly I do have the vague symptoms that can correlate with many other issues:  sluggishness, fatigue, brain fog, intermittent depression.

Again, I appreciate anyone who can give more info.  I'm just looking to make sense out of something I feel my doctor should have been able to do.

[cyclinglady]

Welcome! 

First, let's make sure you had standard celiac blood tests and these include: 

• Tissue Transglutaminase (tTG) IgA and (tTg) Ig
• Deamindated Gliadin Peptide (DGP) IgA and (DGP) IgG
• EMA IgA
• Total serum IgA and IgG (control tests)
• AGA IgA and AGA IgG -- older less reliable tests largely replaced by the DGP tests
• Finally, Endoscopic biopsy -- 6 samples

I am not sure which test you had, the new DGP or the old AGA tests.  Did your doctor order at least the IgA total serum test?  If the results are below range, then you are IgA deficient and the IgA tests you took for celiac are not valid.

You do sound like you have some symptoms.  You know that celiac disease is an autoimmune disorder that is triggered by gluten and there are no known reputable tests for a sensitivity to gluten.  Science is not there yet.  Celiac disease is not an allergy.  I do not know why your doctor would not refer you to a GI doctor for an endoscopy.  To tell you to go gluten free without completing all  testing was wrong.  Were you seeing a medical doctor? 

Why are your gliadin antibodies levels still high?  It appears that gluten is still in your diet.  It is hidden in so many places.  Cross contamination is a big problem.  Do you live with gluten eaters?  Kiss a gluten eater? 

Your alkaline phosphatase levels?  I am not a doctor, but something is up with your liver and it could be related to celiac disease.  What does your doctor say?

Hope this helps! 

[nvsmom]

Ditto everything Cyclinglady said.

 It's hard to say for sure if it is celiac disease unless you know what test was done.  If it was the antigliadin antibody (AGA IgA) then it probably is celiac disease (such a high result), but if it was the deaminated gliadin peptide (DGP IgA) then you do have celiac disease - it is a very specific test.

I too think you have gluten in your life. Check medications, don't share a toaster or condiments.  cc is a big issue.