Weak positive blood test...

[pressingon]

So I recently received (with tremendous shock) the news that I have been diagnosed with celiac. I did not have any severe symptoms, but the Functional Medicine doc ordered blood tests including Celiac Panel. I had been basically off gluten for about 6 months (however, eating some wheat etc a few weeks before the test) Here were my results:

GLIADIN AB IGA, DEAMIDATED   14

GLIADIN AB IGG, DEAMIDATED   17

TISSUE TRANSGLUTAMINASE AB, IG     30

TISSUE TRANSGLUTAMINASE IgG       4

 IMMUNOGLOBULIN A [IGA]      230

The Lab showed only the Transglutaminase AB, IG should be lower than 20, but I was looking elswhere online where only over 40 indicated a positive result for Celiac. All the rest of the panel fell into the normal range. Any other input here about any testing to confirm Celiac diagnosis? My doc is not inclined to do the endoscopy because of mixed reviews on its accuracy in recent years. I have been avoiding gluten now, but would like to ave more confidence that the Celiac diagnosis is correct. Any thoughts?

[cyclinglady]

Look to your local lab for the ranges and not a national range.  You have a positive.  It only takes one positive on the panel to move forward.   The next step is usually a referral to a GI.   Know that you must be on gluten daily two weeks prior to the biopsies.  This is important.  

What doctor says the endoscopy to obtain biopsies is in accurate?   All leading celiac disease research centers world-wide recommend the blood tests and an endoscopy to diagnose celiac disease.  Some endoscopies are inconclusive, but often it is because the patient went gluten free, the GI did not follow recommended guidelines, etc.  

If you feel good on the diet  and can get a diagnosed on just the antibodies blood tests, then maybe go for it.  But you sound doubtful.  Hard to maintain a gluten free diet when you have doubt.  Consider a second opinion.  Find a celiac- savvy GI.  
 

I am biopsy confirmed.  Not only did my GI look for celiac disease, but he looked for concurrent issues too.  You can have more than one illness.  

 

 

Edited June 17, 2020 by cyclinglady

[Scott Adams]

If you were not eating gluten for 6 months, and then only ate gluten a few days before this test, it's likely that these results are not too accurate. @cyclinglady is right about the one positive results should be enough for you to move to a biopsy, but you need to be eating gluten daily for at least two weeks before the biopsy, and some believe longer:

 

[cyclinglady]

@Scott Adams, @pressingon,

Pressingon was SO.....lucky to have even had a positive on the TTG IgA since he/she indicated that they had been gluten free.  So many members who were gluten free and then tested had negative results leaving them in diagnostic limboland.  
 

[pressingon]

My doc said that the fact that I had eaten so little gluten prior to the blood test more confirmed the diagnosis of Celiac, since it is a test looking for antibodies. So a weak positive in this situation of minimal gluten ingested recently is a stronger confirmation of the diagnosis. Makes sense to me. I'm just trying to understand what a weak positive means. Does it mean that the disease is not very advanced in me? Are my intestines probably still able to absorb nutrients etc because the cilia are still basically intact? What does it mean?

 

[Scott Adams]

In this case it likely means that you were not eating gluten for a long enough time before taking the blood test. The levels build up over time and those who are being tested need to consume gluten daily for 4-6 weeks before being tested for them: