Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×

  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.



  • Celiac.com Sponsor (A1):

    Celiac.com Sponsor (A1-M):

  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Questions after blood test results

Rachy265
 Share
Go to solution Solved by trents,

Recommended Posts

Rachy265 Newbie
Rachy265
Posted

Hi. My 16 year old daughter has been suffering with stomach pains, bloating, gas, occasional vomiting, tiredness and loose stools for a number of months. We thought it was a symptom of anxiety as this has also flared up. Her doctor has run some blood tests and found the following abnormalities:

- Iron-deficient anaemia (serum ferritin 5ug/L) and slight folate deficiency

- anti-tissue transglutaminase level of 31.4 U/ml (with a note from the lab to say IgA TTg results to follow)

We are awaiting an appointment to speak to the doctor again but she has been prescribed iron tablets in the meantime. There are no obvious explanations for the anaemia as she's on medication to stop her periods and she eats a good diet, including meat and green leafy veg etc.

She is taking the iron tablets with food but is getting even worse stomach pain than before.

Could anybody please help me to understand the following:

1. Are her anti-tissue transglutaminase levels indicative of Celiac Disease?

2. What is the IgA TTg test that they talk about, and how is it different from the anti-tissue transglutaminase test?

3. Are there any other more stomach-friendly iron supplements we could ask her doctor to prescribe? (We are in the UK so we don't pay for her prescriptions)

Thank you in advance for your help

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


trents Grand Master
trents
Posted

Welcome to the forum, Rachy265!

Not sure how the anti-transglutiminase differs from the tTG-IGA. I have run across the anti-transglutenminase lab recently on this forum and I assumed it to be an alternate way of expressing tTG-IGA. Now I'm not sure. By the way, when you post test numbers make sure you post the reference ranges for negative vs. positive since there are no industry standard ranges for these tests. Each lab uses their own.

Since you didn't specify what kind of iron tablet your daughter is taking now, we cannot off an alternative suggestion except to say that if she is on a non-buffered iron tablet you need to look at a buffered iron product.

Rachy265 Newbie
Rachy265
Posted
  • Author
8 minutes ago, trents said:

Welcome to the forum, Rachy265!

Not sure how the anti-transglutiminase differs from the tTG-IGA. I have run across the anti-transglutenminase lab recently on this forum and I assumed it to be an alternate way of expressing tTG-IGA. Now I'm not sure. By the way, when you post test numbers make sure you post the reference ranges for negative vs. positive since there are no industry standard ranges for these tests. Each lab uses their own.

Since you didn't specify what kind of iron tablet your daughter is taking now, we cannot off an alternative suggestion except to say that if she is on a non-buffered iron tablet you need to look at a buffered iron product.

Thanks for the reply trents. The blood test negative ranges were given as follows:

Anti-tissue transglutaminase levels: <15 U/ml (Result 31.4 U/ml - Abnormal)

Serum ferritin: 30-150 ug/L (Result 5ug/L - Abnormal)

Her iron tablets are Ferrous Fumarate (322mg)

trents Grand Master
trents
Posted
(edited)

It doesn't sound like the iron product she is on is buffered (also known as "slow iron") but you might aske the physician about this. I'll try and get back to you about the anti-transglutiminase vs. tTG-IGA. We have some moderators on this forum that work in medical science fields who would probably know the answer.

Edited by trents
Rachy265 Newbie
Rachy265
Posted
  • Author
6 minutes ago, trents said:

It doesn't sound like the iron product she is on is buffered (also known as "slow iron") but you might aske the physician about this. I'll try and get back to you about the anti-transglutiminase vs. tTG-IGA. We have some moderators on this forum that are work in medical science fields who would probably know the answer.

Thank you!

trents Grand Master
trents
Posted

One thing I will add and that is iron supplements are better assimilated when you take them with acidic food like orange juice or tomato juice. Taking a vitamin C tablet along with the iron supplement would accomplish the same thing. Some commercial forms of iron supplements are actually combined with vitamin C in the tablet.

knitty kitty Grand Master
knitty kitty
Posted
(edited)

If Total serum IgA is deficient (as sometimes is with anemia), the tTg IgA test may register a false negative.  

However, there is another test, the tTg IgG that is used.  

IgG and IgA are different types of Immunoglobulins.  Both types are present in Celiac Disease.  

Perhaps you have the results of the tTg IgG test, with the tTg IgA test to follow.

Did they do a genetic test?  

Related reading....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6816937/

And...

https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/digestive-diseases/celiac-disease-health-care-professionals

Edited by knitty kitty
Add links
Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


Rachy265 Newbie
Rachy265
Posted
  • Author
6 minutes ago, knitty kitty said:

If Total serum IgA is deficient (as sometimes is with anemia), the tTg IgA test may register a false negative.  

However, there is another test, the tTg IgG that is used.  

IgG and IgA are different types of Immunoglobulins.  Both types are present in Celiac Disease.  

Perhaps you have the results of the tTg IgG test, with the tTg IgA test to follow.

Did they do a genetic test?  

OK, that makes sense, thank you. She hasn't had any genetic testing done.

trents Grand Master
trents
Posted

But kk, what is the "anti-tissue transglutaminaise" test? The "anti" part is what's confusing me.

knitty kitty Grand Master
knitty kitty
Posted

Tissue transglutaminase is an enzyme used in the body by cells for growth and repair and is found on cell surfaces as well as inside cells.

Anti-tissue transglutaminase antibodies (immunoglobulins like IgA and IgG) attack the tissue transglutaminase enzymes on cell surfaces.  

Segments of gluten and casein can resemble segments of tissue transglutaminase.  The antibodies cannot distinguish between gluten and tissue transglutaminase, so both get attacked, which means our body cells get attacked.  

So, the test would properly be called anti-tissue transglutaminase immunoglobulin tests or anti-tTg antibody tests.  But things get shortened.  

 

trents Grand Master
trents
Posted
(edited)

So

29 minutes ago, knitty kitty said:

Tissue transglutaminase is an enzyme used in the body by cells for growth and repair and is found on cell surfaces as well as inside cells.

Anti-tissue transglutaminase antibodies (immunoglobulins like IgA and IgG) attack the tissue transglutaminase enzymes on cell surfaces.  

Segments of gluten and casein can resemble segments of tissue transglutaminase.  The antibodies cannot distinguish between gluten and tissue transglutaminase, so both get attacked, which means our body cells get attacked.  

So, the test would properly be called anti-tissue transglutaminase immunoglobulin tests or anti-tTg antibody tests.  But things get shortened.  

 

So, Rachy265's doctor was using "anti-tissue transglutaminase" as the unabbreviated form of tTG-IGA. Correct?

Edited by trents
knitty kitty Grand Master
knitty kitty
Posted

"anti-tissue transglutaminase  antibody test" can be tTg IgA or tTg IgG.

@Rachy265 said... "a note from the lab to say IgA TTg results to follow".

So the results she did receive must be the tTg IgG.   

 

  • Solution
trents Grand Master
trents
Posted
  • Solution
(edited)

What was confusing, however, was that "a note from the lab to say IgA TTg results to follow came after the result for the anti-tissue transglutaminase had already been given.

 

Rachy265, I expect the physician will want to make a referral to a GI doc for an endoscopy with biopsy of the small bowel lining to confirm the positive anti-tissue transglutaminase tTG? IGG? result. Make sure your daughter doesn't begin cutting back on gluten until all testing is done.

Edited by trents
Rachy265 Newbie
Rachy265
Posted
  • Author

Thank you both for all the advice. I'll let you know if we get any further info about the nature of the blood tests.

Rachy265 Newbie
Rachy265
Posted
  • Author

Just a quick update regarding the confusion over the anti-tissue transglutaminase test results. I think the "tTg IgA to follow" must have been a typo as the follow-up test was an IgA endomysial antibody test which came back weakly positive. She's now being referred on to a Gastroenterologist.

trents Grand Master
trents
Posted
2 hours ago, Rachy265 said:

Just a quick update regarding the confusion over the anti-tissue transglutaminase test results. I think the "tTg IgA to follow" must have been a typo as the follow-up test was an IgA endomysial antibody test which came back weakly positive. She's now being referred on to a Gastroenterologist.

Thank you for the update. I don't think I've ever heard of a "weakly" positive EMA. They're usually just positive or negative. But the EMA is very specific for celiac disease.

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
 Share
Go to topic listing
  • Celiac.com Sponsor (A19):


  • Member Statistics

    • Total Members
      131,198
    • Most Online (within 30 mins)
      7,748
    Jamie0230
    Newest Member
    Jamie0230
    Joined
  • Celiac.com Sponsor (A20):

  • Forum Statistics

    • Total Topics
      121.4k
    • Total Posts
      1m
  • Celiac.com Sponsor (A22):



  • Celiac.com Sponsor (A21):


  • Upcoming Events

  • Posts

    • Scott Adams
      Does Dailymed.nlm.nih.gov site have filters for gluten?

      By Scott Adams · Posted

      Clearly from what you've said the info on Dailymed is much more up to date than the other site, which hasn't been updated since 2017. The fact that some companies might be repackaging drugs does not mean the info on the ingredients is not correct.
    • RMJ
      Waiting Gastroenterology review

      By RMJ · Posted

      To evaluate the TTG antibody result we’d need to know the normal range for that lab.  Labs don’t all use the same units.  However, based on any normal ranges that I’ve seen and the listed result being greater than a number rather than a specific number, I’d say yes, that is high! Higher than the range where the test can give a quantitative result. You got good advice not to change your diet yet.  If you went gluten free your intestines would start to heal, confusing any further testing,
    • Bev in Milw
      Does Dailymed.nlm.nih.gov site have filters for gluten?

      By Bev in Milw · Posted

      Scott is correct….Thank you for catching that!      Direct link for info  of fillers.    http://www.glutenfreedrugs.com/Excipients.htm Link is on 2nd page  of www.glutenfreedrugs.com   Site was started by a pharmacist (or 2) maybe 15-20 yrs ago with LAST updated in  2017.  This makes it’s Drug List so old that it’s no longer relevant. Companies & contacts, along with suppliers &  sources would need to be referenced, same amount effort  as starting with current data on DailyMed      That being said, Excipient List is still be relevant since major changes to product labeling occurred prior ’17.           List is the dictionary that sources the ‘foreign-to-us’ terms used on pharmaceutical labels, terms we need to rule out gluten.    Note on DailyMed INFO— When you look for a specific drug on DailyMed, notice that nearly all of companies (brands/labels) are flagged as a ‘Repackager’… This would seem to suggest the actual ‘pills’ are being mass produced by a limited number of wholesaler suppliers (esp for older meds out of  patent protection.).      If so, multiple repackager-get  bulk shipments  from same supplier will all  be selling identical meds —same formula/fillers. Others repackager-could be switching suppliers  frequently based on cost, or runs both gluten-free & non- items on same lines.  No way to know  without contacting company.     While some I know have  searched pharmacies chasing a specific brand, long-term  solution is to find (or teach) pharmacy staff who’s willing help.    When I got 1st Rx ~8 years ago, I went to Walgreens & said I needed gluten-free.  Walked  out when pharmacist said  ‘How am I supposed  to know…’  (ar least he as honest… ). Walmart pharmacists down the block were ‘No problem!’—Once, they wouldn’t release my Rx, still waiting on gluten-free status from a new supplier. Re: Timeliness of DailyMed info?   A serendipitous conversation with cousin in Mi was unexpectedly reassuring.  She works in office of Perrigo, major products of OTC meds (was 1st to add gluten-free labels).  I TOTALLY lucked out when I asked about her job: “TODAY I trained a new full-time employee to make entries to Daily Med.’  Task had grown to hours a day, time she needed for tasks that couldn’t be delegated….We can only hope majorities of companies are as  conscientious!   For the Newbies…. SOLE  purpose of  fillers (possible gluten) in meds is to  hold the active ingredients together in a doseable form.  Drugs  given by injection or as IV are always gluten-free!  (Sometimes drs can do antibiotics w/ one-time injection rather than 7-10 days of  pills .) Liquid meds (typically for kids)—still read labels, but  could be an a simpler option for some products…
    • Ginger38
      Food Allergies

      By Ginger38 · Posted

      So I recently had allergy testing for IGE antibodies in response to foods. My test results came back positive to corn, white potatoes, egg whites. Tomatoes, almonds and peanuts to name a few.  I have had obvious reactions to a few of these - particularly tomatoes and corn- both GI issues. I don’t really understand all this allergy versus celiac stuff. If the food allergies are mild do I have to avoid these foods entirely? I don’t know what I will eat if I can’t  have corn based gluten free products 
    • JForman
      7yo struggling!

      By JForman · Posted

      We have four children (7-14 yo), and our 7 year old was diagnosed with NCGS (though all Celiac labs were positive, her scope at 4 years old was negative so docs in the US won't call it celiac). We have started her on a Gluten Free diet after 3 years of major digestive issues and ruling out just about everything under the sun. Our home and kitchen and myself are all gluten-free. But I have not asked my husband/her dad or her other siblings to go completely gluten-free with us. They are at home, but not out of the home. This has led to situations when we are eating out where she has to consistently see others eating things she can't have and she has begun to say "Well, I can't have <fill in the blank>...stupid gluten."  How have you supported your gluten-free kiddos in the mental health space of this journey, especially young ones like her. I know it's hard for me as an adult sometimes to miss out, so I can't imagine being 7 and dealing with it! Any tips or ideas to help with this? 
×
×
  • Create New...