Help me understand my Results

[LGillette]

I need some help understanding my results, my follow up isn't until mid June.

Immunoglobulin A Quant 185 mg/dL 87-352 

T-Transglutaminase Iga <2 U/mL 0-3 

Endomys AB Iga Negative Negative 

Here are the comments in the summary:

Negative 0 - 3 Weak Positive 4 - 10 Positive >10 Tissue Transglutaminase (tTG) has been identified as the endomysial antigen. Studies have demonstrated that endomysial IgA antibodies have over 99% specificity for gluten sensitive enteropathy

[trents]

Welcome to the forum, LGillette!

Immunoglobulin A Quant 185 mg/dL 87-352  . . . This is reporting the total IGA count. The importance of this is to make sure you are not getting false negatives on the individual antibody tests. If total IGA is low then it will give lower values, to say, the tTG-IGA test with the possibility of a false negative.

T-Transglutaminase Iga <2 U/mL 0-3 . . . This is the centerpiece of celiac disease antibody testing. It is considered to combine good sensitivity with good specificity for celiac disease.

Endomys AB Iga Negative Negative . . . This is a companion test to the tTG-IGA. It is not as sensitive as the tTG-IGA but is very specific for celiac disease. For whatever reason, some people's immune system responds atypically to gluten such that the tTG-IGA is negative but they actually do have celiac disease. Sometimes the Endomysial AB IGA can catch those folks.

Summary: Your total IGA was not low. Both tTG-IGA and Endomysial AB IGA were negative. It does not appear that you have celiac disease. However, if you know that gluten is causing you problems then you likely have NCGS (Non Celiac Gluten Sensitivity). They share many common symptoms but there is not yet a test for NCGS. Celiac Disease must first be ruled out. NCGS is 10-12x more common than celiac disease and the antidote is the same: Total avoidance of gluten.

But let me ask you something important. Were you already attempting to eat gluten free before your antibody testing? If so, that will invalidate the antibody testing.

I hope what I have shared helps your understanding.

Edited May 9, 2022 by trents

[LGillette]

1 minute ago, trents said:

Welcome to the forum, LGillette!

Immunoglobulin A Quant 185 mg/dL 87-352  . . . This is reporting the total IGA count. The importance of this is to make sure you are not getting false negatives on the individual antibody tests. If total IGA is low then it will give lower values, to say, the tTG-IGA test with the possibility of a false negative.

T-Transglutaminase Iga <2 U/mL 0-3 . . . This is the centerpiece of celiac disease antibody testing. It is considered to combine good sensitivity with good specificity for celiac disease.

Endomys AB Iga Negative Negative . . . This is a companion test to the tTG-IGA. It is not as sensitive as the tTG-IGA but is very specific for celiac disease. For whatever reason, some people's immune system responds atypically to gluten such that the tTG-IGA is negative but they actually do have celiac disease. Sometimes the Endomysial AB IGA can catch those folks.

Summary: Your total IGA was not low. Both tTG-IGA and Endomysial AB IGA were negative. It does not appear that you have celiac disease. However, if you know that gluten is causing you problems then you likely have NCGS (Non Celiac Gluten Sensitivity). They share many common symptoms but there is not yet a test for NCGS. Celiac Disease must first be ruled out. NCGS is 10-12x more common than celiac disease and the antidote is the same: Total avoidance of gluten.

But let me ask you something important. Were you already attempting to eat gluten free before your antibody testing? If so, that will invalidate the antibody testing.

 

I actually hadn't had anything to eat prior to the blood draw.

[trents]

4 minutes ago, LGillette said:

 

I actually hadn't had anything to eat prior to the blood draw.

You misunderstand what I was asking. Whether or not you ate anything immediately before the blood draw is irrelevant. I mean, were you attempting to eat gluten free in the weeks or months before the blood draw?

[LGillette]

My apologies.  I try to eat very little gluten in general.  I have noticed when I eat pasta I get a super upset stomach.

[trents]

15 minutes ago, LGillette said:

My apologies.  I try to eat very little gluten in general.  I have noticed when I eat pasta I get a super upset stomach.

Then I would question whether or not your antibody test scores are reliable. As I see it, you have a choice. You can start eating regular amounts of gluten for about two months and get retested . . . or . . . commit to eating truly gluten free and assume you have either celiac disease or NCGS.

The Mayo Clinic guidelines for a pretest gluten challenge are:

For the antibody test, consume the equivalent of two slices of wheat bread daily for 6-8 week leading up to the blood draw.

For the endoscopy/biopsy, consume the equivalent of two slices of wheat bread daily for two weeks leading up toe the blood draw.

Keep in mind that the antibody test isn't measuring your consumption of gluten. It is measuring the inflammation being produced by gluten consumption. If you cut out the gluten the inflammation disappears and antibodies are not produced. Does this make sense?

[LGillette]

That makes complete sense, I didn't eat gluten for 2 years and then started eating more.  Since then I have noticed left side pain and large amounts of bloating and gas.