Blood Test Results

[Chelsea Smith]

Hello, 

I just recieved my blood test results and I'm having some trouble interpreting them and my doctor's appointment is not for another two weeks. Celiac runs in my family and I have never had any symptoms until about six months ago. If anyone can better interpret these test results I'd greatly appreciate it! 

Endomysial Antibody IgA - Positive

t- Transglutiminase (tTg) IgA - 13 U/mL

Immuniglobulin A, Qn, Serum - 132mg/dL

I've attached the actual test results down below. Thank you!

[trents]

"The finding of tissue transglutaminase (tTG)-IgA antibodies is specific for celiac disease and possibly for dermatitis herpetiformis. For individuals with moderately to strongly positive results, a diagnosis of celiac disease is likely and the patient should undergo biopsy to confirm the diagnosis." https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/82587#:~:text=The finding of tissue transglutaminase,biopsy to confirm the diagnosis.

The immunoglobulin A test is not specific for Celiac Disease but more generally can point to some kind of autoimmune disease, including Celiac Disease but not limited to it. The fact that it is in the normal range may simply indicate that the test was done at an early stage of the disease, before your immune system had a chance to become more dysfunctional.

Edited October 6, 2020 by trents

[Scott Adams]

Some doctors would diagnose you with celiac disease based on these results alone, as biopsy confirmation seems to be falling out of favor, especially for children. In the UK, for example, they would diagnose you based on your current results, which are 95% accurate:

Keep eating gluten and discuss whether or not you need a biopsy, but given your family history it seems like it should not be necessary.

[cyclinglady]

56 minutes ago, Scott Adams said:

Some doctors would diagnose you with celiac disease based on these results alone, as biopsy confirmation seems to be falling out of favor, especially for children. In the UK, for example, they would diagnose you based on your current results, which are 95% accurate:

Keep eating gluten and discuss whether or not you need a biopsy, but given your family history it seems like it should not be necessary.

I disagree.  The article source (Linked in the celiac.com article) stated that the TTG result must be 10x over the top of the range.  Otherwise, an endoscopy is still recommended.  
 

“Those with antibody levels lower than ten times the normal range will still require an endoscopy before the diagnosis can be confirmed.”

For kids, they normally do not have secondary issues (Like SIBO, h.pylori) as adults can.    Europe is including adults Into this new diagnostic factor because of the pandemic.  The backlog for endoscopy procedures is huge in the UK.  
The OP should discuss this with her doctor as to how to proceed.  As a non-medical person, it would seem that two positives on the panel would indicate celiac disease.  The EMA is pretty specific.  But a GI should make the call.  The article cited said that GPS will still need to get a formal diagnosis from a GI in the UK.  Link:
 

https://www.dailymail.co.uk/health/article-8676809/Now-single-blood-test-diagnose-gluten-illness-brings-misery-suspected-sufferers.html

Edited October 6, 2020 by cyclinglady

[Scott Adams]

Sure, but you're still excluding her family history that she already mentioned. Of course she should discuss this with her doctor, including her family history, and the fact that she's now developed symptoms.

[Scott Adams]

If any of your first degree relatives have celiac disease, you might want to look at this Mayo Clinic study where "The team screened 360 out of a total of 477 first-degree relatives, finding a total of 160 first-degree relatives who were diagnosed with celiac disease, 62% of whom were female. All diagnosed first-degree relatives had positive anti-TTG titers.":

 

That is a rate of 44% of first degree relatives who were found to also have CD, and the rate was higher among women.

[cyclinglady]

1 hour ago, Scott Adams said:

Sure, but you're still excluding her family history that she already mentioned. Of course she should discuss this with her doctor, including her family history, and the fact that she's now developed symptoms.

I made the assumption that  might they not be first- degree relatives.  If it were her parents or siblings, she might have asked them first instead of us, but I could be wrong.  

[Chelsea Smith]

To give a better perspective, my aunt was diagnosed about three years ago with Celiac. Upon first going to my GI, she diagnosed me with IBS and prescribed Dicyclomine 2x daily to help with the stomach cramping and then ordered the Celiac blood test as well as six other stool tests. Only the Celiac test has come back so far. During this whole process, I was on a low FODMAP elimination diet which seemed to help somewhat, but I was still having GI issues. I cut out gluten from my diet about four days ago and I am definitely seeing some difference but still once again am having little GI symptoms. At this point, I feel that I am going to have to stick to low FODMAP but integrate a Celiac-friendly diet. Still awaiting a phone call from my doctor which may not come for the next couple weeks until all of my test results have come in. 

To give a better idea of my timeline, this all began in about March when my mother and I did the Keto diet for about two months. If you're unfamiliar, this is a high fat, moderate protein, very low carbohydrate diet. After this period, I immediately went back to eating carbohydrates and starting realizing many GI symptoms. Extreme heartburn, acid reflux, nausea, ongoing periods of diarrhea mixed with constipation, nothing was settling right in my stomach, and I was passing 5-6 bowel movements some days. I experienced random, extreme headaches and stomach pains and was admitted into the hospital in August because of an 8 hour period of constant diarrhea coupled with nausea and bad stomach cramps. After running blood tests, doctor said everything was normal and sent me home saying it was a stomach bug. As time progressed, the heartburn got much worse after eating anything and my stomach was still not able to settle anything properly. I have always eaten a lot of gluten and LOVE pasta so this is definitely something that I was eating on a daily basis during this time. I'm just wondering if these would correlate with a diagnosis of Celiac. 

[Scott Adams]

So keep in mind that if your doctor wants to do any follow up tests you would need to continue eating gluten until they are finished. You mentioned that you are now gluten-free, so you may wish to talk to your doctor before taking that step.

Your symptoms do sound consistent with celiac disease, especial given your positive blood tests, but could also be gall bladder or other things, which is why it's important to finish all testing.

Your aunt would not be a first degree relative, but certainly it would increase your chances that you have CD it she were also diagnosed with it.

Loving pasta is ok, and Barilla makes outstanding gluten-free pastas.

[Ann--Marie]

i read that going gluten free before the blood work can mess it up? I am sure that i have a problem with gluten. I went gluten free for 1 week ( actually complete whole food, vegan) for a colonics appointment. i felt amazing. then after the appointment , i had a piece of bread. I was down for the count for 2 days. then I decided to go gluten free, then i ate creme brûlée and again was down for the count for 2 days. I made an appointment that is 4 days away. I know if i eat gluten or dairy i will be very sick but I don't want to mess up the test results. please advise .

[aiellokrista]

On 10/6/2020 at 1:27 PM, Chelsea Smith said:

Hello, 

I just recieved my blood test results and I'm having some trouble interpreting them and my doctor's appointment is not for another two weeks. Celiac runs in my family and I have never had any symptoms until about six months ago. If anyone can better interpret these test results I'd greatly appreciate it! 

Endomysial Antibody IgA - Positive

t- Transglutiminase (tTg) IgA - 13 U/mL

Immuniglobulin A, Qn, Serum - 132mg/dL

I've attached the actual test results down below. Thank you!

 

On 10/12/2020 at 5:00 PM, Ann_Marie said:

i read that going gluten free before the blood work can mess it up? I am sure that i have a problem with gluten. I went gluten free for 1 week ( actually complete whole food, vegan) for a colonics appointment. i felt amazing. then after the appointment , i had a piece of bread. I was down for the count for 2 days. then I decided to go gluten free, then i ate creme brûlée and again was down for the count for 2 days. I made an appointment that is 4 days away. I know if i eat gluten or dairy i will be very sick but I don't want to mess up the test results. please advise .

To be honest, my blood test was normal & I had flattened villi.  I was diagnosed with celiac disease in 2010.  Unfortunately, the best test for dx is to go through the "gluten challenge" where you would need to load up on gluten for 2 weeks before an endoscopy.  That is the true marker for celiac disease.  That will truly show what's going on in your intestine.  That's not to say that there could also be something going on with your gallbladder, needing to be on a fodmap diet, etc.  celiac disease can also cause food sensitivities, lactose intolerance.  I had difficulties with other foods after I was dx'd and had to cut out other foods and had to do Paleo for quite a while until I felt better.  There is also gluten in medications, if you are taking any, or you could be gluten intolerant.  You may want to check out out www.glutenfreedrugs.com.  It's a great resource.  It's great for over-the-counter medications also.

[Ann--Marie]

14 hours ago, aiellokrista said:

 

To be honest, my blood test was normal & I had flattened villi.  I was diagnosed with celiac disease in 2010.  Unfortunately, the best test for dx is to go through the "gluten challenge" where you would need to load up on gluten for 2 weeks before an endoscopy.  That is the true marker for celiac disease.  That will truly show what's going on in your intestine.  That's not to say that there could also be something going on with your gallbladder, needing to be on a fodmap diet, etc.  celiac disease can also cause food sensitivities, lactose intolerance.  I had difficulties with other foods after I was dx'd and had to cut out other foods and had to do Paleo for quite a while until I felt better.  There is also gluten in medications, if you are taking any, or you could be gluten intolerant.  You may want to check out out www.glutenfreedrugs.com.  It's a great resource.  It's great for over-the-counter medications also.

Thank you so much!