Positive Gliadin Abs & Marsh 1?

[Rebecca Grossfield]

I was recently diagnosed with Hashimoto's disease. My endo also ran a celiac panel due to my symptoms, which was normal (although the internet tells me that perhaps my total IGa was on the low side at 85) except for positive gliadin abs. Cut to 1 month later, I've had a TERRIBLE appt with a very young gastro who was pretty much not helpful AT ALL. It looks like the endoscopy results which are "inconclusive" but "may be consistent with Celiac disease" are at a Marsh 1. I'm trying to find another doc to get a second opinion, but I'm also trying to make sense of all of this. I have cut gluten for a few weeks, but I still want a correct diagnosis either way.... and this seems to be not entirely black/white?

[trents]

Welcome to the forum, Rebecca!

You need to be on regular amounts of gluten until all testing is complete. So, if you anticipate retesting you need to go back on it. The Mayo Clinic guidelines for going back on gluten (so called "gluten challenge") is two slices of wheat bread daily (or the gluten equivalent) up to the day of the blood draw for 6-8 weeks and the same amount for two weeks leading up to the day of the endoscopy/biopsy.

Your antibody serum test results indicate possible celiac disease or NCGS (Non Celiac Gluten Sensitivity). Your Marsh score from the biopsy does not indicate damage. I think Marsh 3 is where they start claiming damage from celiac disease. There is no good test for NCGS. Celiac disease must first be ruled out. Celiac disease and NCGS share many of the same symptoms. Some experts believe NCGS can be a precursor to celiac disease.

Besides having Hashimotos, do you have other symptoms that suggest celiac disease or was the check for celiac disease a statistical precaution?

Edited June 21, 2023 by trents