Test Results

[jpell237]

Hi Everyone, 

I had a celiac screen (and other tests) ordered by my doctor after experiencing about a year of GI symptoms (diarrhea or unformed stool, undigested food in my stool, bloating etc). My ferritin was very normal 66 (normal is about 5-220) , and my B12 while normal was on the lower end of normal (152 - normal range is 138 - 650), which I found surprising given my diet  (I eat very balanced, eat meat, eggs etc) - maybe I am reading into it too much. My other labs were unremarkable (hemoglobin, MCV etc). I know often lab results are more robust in the USA and people suggest a longer list of tests, but I live in Canada and we are very restricted in what screening we can get. Here are the results of my TTG-IgA and IgA: 

My TTG-IgA was 7.4 (normal <12) 

My IGA was ~2.4 which was in the normal range. 

I know my TTG-IgA is "normal" but I have seen a lot of TTG-IgA results though my work done at the same lab, and they are almost always consistently <0.5, I have never seen a result that has some value to it like mine. So my questions are: 

- Could the result of 7.4 be "weakly positive" or is it normal to produce some TTG-IgA antibodies? I know some labs categorize anything over 3 was weakly positive. 

- Could my results be lower because it is "earlier" in a disease course. 

- Does dietary intake / quantity of gluten consumed affect serum results? I eat foods with gluten, but the tests were done over the summer so my diet was primarily fruit, veg, meats and by no means was I consuming several pieces of bread each day which I know is suggested prior to biopsy. Would it be helpful to repeat once on a more gluten heavy diet. 

I am seeing a GI, but not for several more months, I am just wondering if anyone could share their perspective, is Celiac something that should still be on my radar? 

Thanks :) 

[jpell237]

Oh, I also just wanted to add that over this last year I have developed some derm symptoms, I had an isolated incidence of an intensely itchy red rash on my ankle, could this have been DH? 

I also have developed very itchy ears with a lot of dry skin, has this ever happened to anyone else? Or is it likely completely unrelated. 

 

 

[trents]

Welcome to the forum, jpell237!

Your antibody test  scores could definitely have been invalidated by your summer diet. The Mayo Clinic guidelines for an antibody pretest gluten challenge is the daily consumption of 2 slices of wheat bread (or the gluten equivalent) for 6-8 weeks leading up to the blood draw.

As to DH, it has a vert distinct appearance characterized by little blisters or pimples in the center of the bumps. I suggest you google some pictures of it for comparison to what your rash looks like.

I might also suggest you consider genetic testing to determine whether or not you have the genetic potential for celiac disease. Such is available through third party companies like "123 amd me" fo around $200 US I think.

[Wheatwacked]

Welcome to the forum.  Your symptoms could definately be Celiac Disease. One major symptom is malabsorption syndrome will will cause vitamin and mineral deficiencies that otherwise don't make sense. The cool thing about Celiac Disease is if you are gluten free you will test negative for celiac disease, so your summer diet will skew the results. A positive biopsy for DH is definative for Celiac Disease so you might try pursuing that avenue with a dermatologist familiar with the correct biopsy technique for DH.  Only gluten causes DH.

Do you have test results for plasma vitamin D and homocysteine? Low vitamin D is common, especially in the north where you only get enough sun in the summer to store up for the winter, normal is 70-90 ng/ml but anything over 29 ng/ml is considered sufficient. Low vitamin D can let the autoimmune system run amuck. Almost every autoimmune disease studied has low D.  A lifeguard in summer, not using excessive sun protection has 70-90 ng/ml.  Taking 10,000 IU everyday it took from 2015 to 2020 to raise my plasma vitamin D to 80. In 2018 it measured only 47 ng/ml.

Above normal Homocysteine is an independant indicator of cardiovascular inflammation but is not often checked. There are three (thats how important it is) different paths to recycle this toxic sludge from protein metabolism: 1) B12 + folate, 2) choline and 3) B6.  High homocysteine means you are not absorbing enough of all or some of those. In the western world less than 10% eat enough choline. All of them can be low because of Celiac Disease caused malabsorbtion syndrome.

A 30 day trial period of Gluten Free Diet and vitamin replenishment will give an indication but because it is an addictive agent many find that eating gluten for a gluten challenge after being gluten free is worse than ever.

Quote

 

In particular, studies have investigated possible roles of vitamin D as a key modulator of inflammation and immune mechanisms and of the intestinal mucosa barrier. In this regard, vitamin D has been considered as a factor that affects different conditions such as immune-mediated diseases. The new emerging role of vitamin D and its involvement in immune modulation has led it to be considered as a possible key factor involved in celiac disease (celiac disease) onset. Possible Role of Vitamin D in Celiac Disease Onset

 

Quote

In 2011 the EFSA authorised a number of choline-related health claims. It was concluded that a cause and effect relationship had been established between the following: (1) “choline is needed for lipids metabolism”, (2) “maintaining healthy liver functioning” and (3) “reduction in homocysteine levels”...Other work based on the NHANES datasets showed that only around 11% of American adults achieve the IOM AI for choline...In Alberta, Canada one study showed that only 23% of pregnant women and 10% of lactating mothers (n=600) met the choline AI recommendation   Could we be overlooking a potential choline crisis in the United Kingdom?

 

[jpell237]

Thank you both kindly for your replies! 

I am wondering if anyone has thoughts on the TTG IgA? Despite it being negative, is it normal for there to be some TTG IgA within the normal range, what is the cause of that? Hope that question makes sense! 

Thank you 

[Wheatwacked]

t-Transglutaminase (tTG) IgA
Optimal Result: 0 - 3 U/mL, or 0.00 - 100.00 ug/g.

Which format is yours?

Fhis might clarify  from the Mayo Clinic Labs. Read the whole thing.

Mayo Clinic Labs Tissue Transglutaminase Antibody, IgA, Serum

• REFERENCE VALUES 
• <4.0 U/mL (negative)
• 4.0-10.0 U/mL (weak positive)
• >10.0 U/mL (positive)
• Reference values apply to all ages.

[RMJ]

Different labs use different units so one must only compare to the standard range of the lab that did the test. The units are arbitrary, assigned by the manufacturer of the test.  They are NOT a standardized weight per volume unit (such as micrograms per mL).

It is normal for some TTG IgA to be detected in people without celiac disease. And as Trents said, eating gluten light could have affected your results.

Is the IgA value of 2.4 your total IgA?

Some people with celiac disease are only positive on a DGP antibody test (deamidated gliadin peptide IgA or IgG).  

[LCAnacortes]

I have not been officially diagnosed but had problems with a rash around my neck & itchy dry skin behind my years.  This all got much better once I went gluten free.  But I was still having problems - and figured out I was handling our cat's dry food which contained wheat.  I also had lesions on my head caused by a hair conditioner that had wheat in it.  Once I stopped those products things got much better. If you are using a lotion - check to be sure it doesn't have wheat products in it. I hope things clear up for you soon.