Should I get an endoscopy if test results are...

[Teresa8013]

Hi, my doctor said I can take the endoscopy with duodenal to rule out celiac disease since my TTG IgG was positive. But since my IgA was such a low yield she recommends I get other blood works done before considering taking the endoscopy.  Here's a list of my results of the test she wanted me take 

 

• IgA:  0.21     normal range is <= 0.90 (negative)I
• IgG:  1.28     normal range is <= 1.28 (positive)
• Thyroid Stimulating Hormone (TSH)
  4.47  ulU/mL     range 0-4  (slightly above normal)
• Free Thyroxine (T4)    1.1 ng/dl     (Dr. says normal)
• C-Reactive Protein), Serum
  <0.1 mg/dl      (Dr. says normal)
• Erythrocyte Sedimentation Rate (ESR)
  15 mm/hr      range 0-20 mm/hr   (normal)
• Complete Blood Count   (Dr. says everything was normal here)
• White Blood Cell Differential ( Dr. says everything was normal here)
• Screen for Fecal (Stool) Fat   (Everything was normal)

It looks like  based on my results that everything is normal but my IgG antibody was high, and I have slight hypothyroidism which my dr. said they will monitor.  I'm thinking maybe I won't take the endoscopy and just assume I have a non-celiac gluten sensitivity since there's not enough evidence that I have celiac.  My symptoms right now are diarrhea, distension, itchy skin/burning rash on face, bloating, abdominal pains, tinnitus, sinus issues, anxiety, and restless legs at night. I find my symptoms improve when off gluten and wanted to know if I have celiac so I don't make myself even more sick in the future. I want to know if I should be even more strict about avoiding gluten than I am now and not cross containment. 

Thanks for reading my post!

[emma6]

hey that's definitely confusing. i'm assuming the first Iga result ttg iga? i agree with your doctor that you should peruse further blood tests for celiac disease. get your total iga checked to rule out an iga deficiency as that can cause false negatives on the ttg iga. i would also ask for dgp iga and dgp igg or a full celiac panel. i believe it is possible to have false mild positives on the ttg igg caused by other illnesses not sure if hypothyroidism can do that. you could also consider doing the genetic test.

were you eating gluten for a few weeks leading up the blood test?

do you any iron or vitamin deficiencies? that can be another indicator of malabsorbion caused by celiac

i think its definitely worth doing those tests now to find out more info before you are completely gluten free as it will probably be alot harder to do a gluten challenge for them if you decide you want a diagnosis after being gluten free for a while.

[cyclinglady]

If you can get an endoscopy (and you have been on a gluten-containing diet -- go for it.  I personally test positive only to the DGP IgA test.  Never a positive on anything else even on follow-up testing.  Now, my GI only orders the DGP IgA to monitor diet adherence.  Weird, but true.  

You have so many symptoms.  I would find the source.  I would not accept a hypothryoidism diagnosis without a thyroid antibodies panel  to rule out autoimmune thyroiditis (which seems to go hand-in-hand with celiac disease).  

Like Emma said, the other celiac panel tests  (EMA and an IgA deficiency test) should have been ordered.  If you are IgA deficient,  it would tell the doctor that neither the TTG IgA or DGP IgA would be valid.  I do not see those tests listed.  

 

[squirmingitch]

This is the full, current celiac blood panel:

Anti-Gliadin (AGA) IgA
Anti-Gliadin (AGA) IgG
Anti-Endomysial (EMA) IgA
Anti-Tissue Transglutaminase (tTG) IgA
Deamidated Gliadin Peptide (DGP) IgA and IgG
Total Serum IgA 

 

Also can be termed this way:

Endomysial Antibody IgA
Tissue Transglutaminase IgA 
GLIADIN IgG
GLIADIN IgA
Total Serum IgA 
Deamidated Gliadin Peptide (DGP) IgA and IgG

You should have ALL of those tests done. You need to investigate this instead of just taking the attitude you are taking and I don't mean that in a mean way. This is serious stuff & you should pursue a real diagnosis. You need to continue eating gluten all the way through testing including an endoscopy. The endoscopy is easy. You don't eat or drink anything after midnight, go in, they put you to sleep (briefly - like 20 mins.) & you're done. The doc should take 6 biopsies.