Some questions on my Results

[Paul2016]

I understand that my v high ttg-igA levels infer Celiac.

But i wanted to understand why the tTg igG levels could be so low?  The last time i had my serum immunoglobulins (igA, IgG & IgM) levels checked, i was not deficient in any.

Also although my Deamidated Gliadin igA/igG levels are relatively weak positive, the older (and less specific) Gliadin tests are negative. 

My understanding is that the older Gliadin tests are used to check for gluten sensitivity, however because they are negative it infers that im not sensitive to gluten? This would be unusual for a celiac?

 

 

[Gemini]

I would say that this shows you have Celiac Disease...with a tTg/IgA that high and the corresponding numbers for your DGP, that is more than just a little positive!   

To answer your questions as best I can......the older versions of the testing for dietary reaction to gluten, gliadin IgA and IgG, do not test for gluten sensitivity.  There is no test for that yet.  They are just older and less sensitive versions of the newer DGP set. The fact that the older tests are negative and the newer ones are positive show that difference in sensitivity.  Did you notice that the older tests come close to being a weak positive? But you then tripped the more sensitive tests, which is why they were developed. The older versions may miss people due to that lack of sensitivity.  All of this testing panel just looks for Celiac Disease because there is no reliable testing yet for gluten sensitivity.

Your levels of IgG are not deficient or low.  If they were, you would most likely not have tripped the DGP/IgG test. Since IgA is the one that is produced in the intestinal tract and the tTg looks for intestinal damage, that is the one more common to showing positive in Celiac testing. My testing did the same thing.  The only test that came back in the normal range was the tTg/IgG, however, my Gliadin IgG was very high along with everything else.  IgG antibodies are the most common and plentiful in the human body so I haven't heard of them being low/deficient like IgA can. I would assume they would then have to test for Total IgG like they did for Total IgA when testing for Celiac and they never do.  I am not an expert on antibodies so I hope this hasn't caused more confusion for you. Hopefully, others will chime in.

You do most likely have Celiac though so if you are going to have the biopsy, keep gluten in your diet until all testing is complete!

[Paul2016]

The DGP test, is not yet widely available in England, which could make it difficult for me to track my progress on a gluten-free diet as the old Gliadin tests are -ve.

I guess my confusion stems from this article by Dr Rodney Ford:

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Quote

The old gliadin test. In the 1990s, the gliadin antibody test was developed. Although most celiacs had a positive IgG-gliadin antibody test, high levels of this antibody were found in about 10% of the normal population. Consequently, gliadin testing was considered non-specific” from the point of view of diagnosing celiac disease. Mistakenly, this led to IgG-gliadin being maligned as a useless and non-specific test .

Gluten sensitivity. The reality, however, is that an elevated IgG-gliadin antibody specifically means that the person is immunologically reacting to gluten. International research, including my own, has demonstrated that high gliadin anybody levels are frequently associated with clinical disease without the gut damage of celiac disease. This is now known as non-celiac gluten sensitivity, or the gluten syndrome.

 

Interpretation

This is how to interpret what these gliadin antibodies mean:

    A positive old test (IgG-gliadin antibody) usually means gluten sensitivity.

    A negative old test usually means that gluten is unlikely to be a problem.
 

 

[Jmg]

Has your doctor ordered an endoscopy on the base of those results Paul? 

 

[Gemini]

Dr. Rodney Ford's viewpoint is not accepted by mainstream medical establishments.  I am in no way defending the mainstream guys because they kept me sick for years.  However, there is no test for gluten sensitivity that is specific or sensitive enough to use as a diagnostic tool. People without Celiac but have an obvious reaction to gluten do better figuring it out from a dietary trial......which I have total respect for and support.  It has only been recently that the mainstream people here in the States, and not all of them, will even recognize gluten sensitivity as real.  I hope they develop better testing protocols that will include the NCGI population.  You quoted that the interpretation for the older gliadin IgG testing being positive was for gluten sensitivity is not quite true.....mine was very positive and I have full blown Celiac.  That is important because you do not want to think you have a sensitivity when you in fact have Celiac...big difference!

None of that matters any to you because with your test results, you most probably have actual Celiac.  I would say it's about 95% certain you do so if you have any doubts, please go on to have the biopsy to see what that shows.  I highly doubt anyone with your IgA/tTg levels will not show a lot of damage. 

I should add that I was tested 11 years ago with the older versions of the gliadin tests.  It was all that was available here at the time. I presented with classic Celiac.  Skinny, malnourished with extreme weight loss and dehydration. They came back VERY positive on both accounts...IgA and IgG.  I have still used them ever since for dietary compliance proof and they also now add in the DGP. My gliadin numbers are always between 1 and 2 while the DGP runs around a 4, with a normal range being below 20.  I think that shows how the increased sensitivity works with the DGP.  So, with your large number on the gliadin IgA testing, you absolutely could use it as a screening tool for dietary compliance.  With healing, that should always be in the low normal range to be considered a success.

Good luck with any further testing and please let us know how you do!