Is Celiac Disease likely with these results and symptoms?

[kjsimpson27]

Hello! I'm new here to the board. Below are my results from my Celiac Disease Panel along with some other bloodwork results.  I'm curious if these blood results could result in me being diagnosed with Celiac Disease.  An aunt and an uncle of mine have celiac disease and I have multiple symptoms of celiac disease, myself.  Chronic diarrhea, gas, bloating, fatigue, iron deficiency anemia, rash on nape of my neck (red bumps that itch and swell up and down constantly), foot pain, and the list goes on. Since having my gallbladder out 9 months ago, I have started to feel like I'm falling apart.  I was recently diagnosed with Type 2 Diabetes and now NFLD (non-alcoholic fatty liver disease).  I have seen a rheumatologist and x-ray and bloodwork is negative for things like Rheumatoid Arthritis, Lupus and Sarcoidosis, though there are some inflammation markers that I will list below.  My EGD from a few months ago (done before celiac blood panel) was negative for Celiac.  

Celiac Panel

IgA 380 (normal range 81-463)

TtA IgA NEGATIVE <0.5 (normal range <=14.9)

Gliadin (Deaminated) Antibody IgA POSITIVE 18.3 (normal range <=14.9)

Inflamation Markers...

ESR 51 HIGH (normal range <=20)

CRP 9.9 HIGH (normal range <4.9)

Elevated Liver Enzymes...

ALT HIGH 88 (normal range 5-46)

ALP/SGPT HIGH 134 (normal range 37-127)

AST/SGOT HIGH 72 (normal range 11-40)

Thoughts?  Can you be diagnosed with celiac disease with only one antibody being positive and a negative EGD?  

Thank you all for your time! 

 

 

 

 

[trents]

 

Welcome to the forum, kjsimpson27!

The tTG-IGA is the centerpiece of antibody blood work for celiac disease and it is negative. The endoscopy/biopsy, which is the gold standard for diagnosing celiac disease, was also negative.

The symptoms you describe are common to both celiac disease and NCGS (Non Celiac Gluten Sensitivity) which is 10x as common as Celiac Disease. There is no test for NCGS. Celiac disease must first be ruled out. The antidote is the same for both, lifelong abstinence from gluten (found in wheat, barley and rye).

The other inflammation markers you include in your post are not relevant for celiac disease. The elevated liver enzymes I would imagine are tied to the NAFLD.

Elevated liver enzymes are found in about 18% of celiacs but it may also be that NCGS carries that same effect. I don't know about that. As a matter of fact, elevated liver enzymes was what led to my own diagnosis of celiac disease.

At any rate, if I were you I would quit gluten and quit it now. If your symptoms subside you have what you need to know. But there is a real learning curve in arriving at a truly gluten-free lifestyle. Just eating lower amounts of gluten won't cut it.

 

[Wheatwacked]

NALFD has been linked to Choline deficiency. Add to the fact that most Americans don't eat enough choline (4 eggs or 15 oz steak or 10 cups of cooked broccoli a day) choline is absorbed in the small intestine so the effect of Celiac Disease caused malabsorption syndrome added to not enough choline in the diet could cause significant effects to your liver.

Choline, Its Potential Role in Nonalcoholic Fatty Liver Disease, and the Case for Human and Bacterial Genes

Choline Fact Sheet for Health Professionals

[Scott Adams]

I just want mention that you could have celiac disease because you do have one positive blood test:

Gliadin (Deaminated) Antibody IgA POSITIVE 18.3 (normal range <=14.9)

combined with relatives who also have it. All of your symptoms seem consistent and a gluten-free diet may also help your liver issues balance out if it is related to that.

Based on the one positive blood test your doctor may want to schedule an endoscopy to verify it. But either way I would consider a gluten-free diet based on everything you have posted here.

[trents]

Scott, I think she has already had the biopsy and it was negative: "My EGD from a few months ago (done before celiac blood panel) was negative for Celiac."

[Wheatwacked]

It is my understanding that unless looking specifically for Celiac Disease and picking the right spot for a biopsy, it can easily be missed in a standard endoscopy. How many have posted here with "definitely not Celiac" only to be diagnosed 10 years later?

When my son was diagnosed it was finally seen on his third endoscopy.

Just the diagnosis of NAFLD should have them looking for choline malabsorption or severe lack of choline in the diet.

[kjsimpson27]

Thank you ALL so much for your replies and the information you have shared with me.  It is very appreciated. 

My doctor called and told me to go gluten free for 4 weeks before a follow-up appointment in 6 months.  At that time, they will do more bloodwork and see if my numbers change and can be attributed to the gluten free diet.  

Going gluten-free is going to be extremely difficult for me as I have a husband, 3 children and my mother to meal plan for, as well.  Not to mention that gluten-full foods are...life.  😊 Several people in my extended family already live gluten-free lives, so at least I will have some support there.  It will be a serious ramping down process for me and I know I have so much more research to do in order to get it right.  

Thank you again for sharing your knowledge with me and I look forward to exploring this forum more.

[Wheatwacked]

On the other hand, think of all the new unprocessed foods you can try now that you are not bloated by all the "filler" foods made with cheap wheat. It is kind of like moving to a new culture where your old favorites are not available, so you find new favorites. Some people go through a mourning period at the loss of a best friend.

[trents]

4 hours ago, kjsimpson27 said:

Thank you ALL so much for your replies and the information you have shared with me.  It is very appreciated. 

My doctor called and told me to go gluten free for 4 weeks before a follow-up appointment in 6 months.  At that time, they will do more bloodwork and see if my numbers change and can be attributed to the gluten free diet.  

Going gluten-free is going to be extremely difficult for me as I have a husband, 3 children and my mother to meal plan for, as well.  Not to mention that gluten-full foods are...life.  😊 Several people in my extended family already live gluten-free lives, so at least I will have some support there.  It will be a serious ramping down process for me and I know I have so much more research to do in order to get it right.  

Thank you again for sharing your knowledge with me and I look forward to exploring this forum more.

Whoa! Your doctor told you to go gluten free for 4 weeks before a follow-up appointment in 6 months? Did he mean four weeks immediately before the appointment and blood work? If that is what he meant that is absolutely wrong advice. The blood work tests for antibodies produced by inflammation in the small bowel when consuming gluten. If you remove the agent responsible for the inflammation (i.e, gluten) the inflammation will subside and the antibodies will cease to be produced. This will likely produce a false negative on the antibody tests. Can you clarify what your doctor meant by that instruction? If it stands at face value, you need to seek a new doctor. According to guidelines from the Mayo Clinic you should be eating two slices of wheat bread daily (or the gluten equivalent) for 6-8 weeks immediately leading up to the antibody testing. So, if you feel a need to try gluten free eating before the testing, do it now and then go back on gluten two months prior to the test.

[Wheatwacked]

9 hours ago, kjsimpson27 said:

they will do more bloodwork and see if my numbers change and can be attributed to the gluten free diet.

It makes sense. He has bloodwork while on gluten and wants to see the change after a gluten free diet. And maybe he wants to test vitamins in the gluten free state. I think he's giving you time to become gluten free. Dive right in.

[trents]

My bad. I had forgotten what the context was and that your previous testing was done while on gluten. I should have gone back and read the original post. I think I got this thread confused with another one.

[kjsimpson27]

On 3/20/2022 at 12:34 PM, Wheatwacked said:

On the other hand, think of all the new unprocessed foods you can try now that you are not bloated by all the "filler" foods made with cheap wheat. It is kind of like moving to a new culture where your old favorites are not available, so you find new favorites. Some people go through a mourning period at the loss of a best friend.

I will definitely be in mourning.  Gluten and I are tight. I don’t even know who I’ll be without her. 🤪 To gear up I’ve been reading as much as I can about eating gluten free. It’s going to be a complete shift in eating habits for me. I’m hoping I feel so much better physically that it will help me to stay on track. 

[trents]

5 minutes ago, kjsimpson27 said:

I will definitely be in mourning.  Gluten and I are tight. I don’t even know who I’ll be without her. 🤪 To gear up I’ve been reading as much as I can about eating gluten free. It’s going to be a complete shift in eating habits for me. I’m hoping I feel so much better physically that it will help me to stay on track. 

Check for gluten in pills and supplements as well, oral hygiene products, etc.

[kjsimpson27]

On 3/26/2022 at 6:53 PM, trents said:

Check for gluten in pills and supplements as well, oral hygiene products, etc.

Oh, wow, I didn’t realize that was a thing. Good to know. Thank you!!

[trents]

3 minutes ago, kjsimpson27 said:

Oh, wow, I didn’t realize that was a thing. Good to know. Thank you!!

Often times, especially with prescription generic meds and also with those that only give the active ingredient you will need to contact the manufacturer to get the answer about gluten you are looking for. Wheat starch can be used as a "filler", an inactive ingredient. The dispensing pharmacy can give you contact numbers for generics.

Edited March 29, 2022 by trents