Blood Test Result

[Berkan]

Hey! I just checked my results now before I go to my doctor appointment again and I just saw my

Anti-Gliadin Ab.IgG is 35. but all the others are low. I had all the symptoms of celiac, that's why

doctor wanted that. All I want to ask to you guys, is 35 something to concern?

[trents]

Berkan, what is the reference range for normal? We cannot comment until we have a scale. Different labs use different scales. There is no industry standard.

[Berkan]

2 minutes ago, trents said:

Berkan, what is the reference range for normal? We cannot comment until we have a scale. Different labs use different scales. There is no industry standard.

It says below 20 is negative, between 20-30 weak positive and above 30 is positive. The doctor did only ttg-iga,igg and anti-gliadin iga,igg tests.

It was only anti-gliadin igg 35 and all the others are normal range. I am having these stomach and gut issues like 8-9 years. 

I was on gluten-free diet for 1 month when the bloodtest is done. I hope this time I can catch something...

[trents]

It is unfortunate that you had begun a gluten-free diet one month prior to the blood draw for testing. That undoubtedly repressed the ttg-iga numbers which is the primary test used to detect celiac disease. The anti-gliadin igg test is a second tier test and not considered as reliable as the ttg-iga but it is helpful in situations where time has elapsed between beginning the gluten-diet and the blood draw. When positive, it likely means you do have celiac disease but is less definitive. Your having begun the gluten-free diet would also likely compromise the endoscopy/biopsy at this point as a diagnostic tool. Unless you are willing to go back to consuming significant amounts of gluten (10 gm. or more daily) for several weeks in order to get retested, your only recourse would be to jump into the gluten-free diet with both feet and see if your symptoms improve in the next few months.

Edited January 5, 2024 by trents

[Scott Adams]

I agree, and talk to your doctor about whether or not you need more testing, or should just start a gluten-free diet.

This article has some detailed information on how to be 100% gluten-free, so it may be helpful (be sure to also read the comments section.):

 

 

[Berkan]

I appreciate for the help. I guess I will go for the endoscopy/biopsy If my doctor lead me to it. Before that I will make sure that I'm eating gluten daily for 1 month. 

But I want to ask, it's been 8-9 years that I'm suffering with this illness, eating gluten all my life and how these tests getting so low with only 1 month glutenfree diet?

Is it possible?

[trents]

2 hours ago, Berkan said:

I appreciate for the help. I guess I will go for the endoscopy/biopsy If my doctor lead me to it. Before that I will make sure that I'm eating gluten daily for 1 month. 

But I want to ask, it's been 8-9 years that I'm suffering with this illness, eating gluten all my life and how these tests getting so low with only 1 month glutenfree diet?

Is it possible?

You could also have NCGS (Non Celiac Gluten Sensitivity) instead of celiac disease. They share many of the same symptoms and NCGS is 10x more common. No test for it yet.

[Scott Adams]

4 hours ago, Berkan said:

I appreciate for the help. I guess I will go for the endoscopy/biopsy If my doctor lead me to it. Before that I will make sure that I'm eating gluten daily for 1 month. 

But I want to ask, it's been 8-9 years that I'm suffering with this illness, eating gluten all my life and how these tests getting so low with only 1 month glutenfree diet?

Is it possible?

I suspect that you have celiac disease, which is why your antibody levels are still high, even after a month gluten-free. If you had been eating gluten daily for 6-8 weeks before the test, then your levels would likely have been much higher. Celiac disease is an interesting autoimmune disease because once you remove the culprit--gluten--normally your symptoms go away, your blood antibody levels return to normal, and your villi heal, so your disease goes into remission. 

Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy:

Quote

"...in order to properly diagnose celiac disease based on serology and duodenal histology, doctors need patients to be on gluten-containing diets, even if they are causing symptoms, and this is called a "gluten challenge."

• Eat gluten prior to celiac disease blood tests: The amount and length of time can vary, but is somewhere between 2 slices of wheat bread daily for 6-8 weeks and 1/2 slice of wheat bread or 1 wheat cracker for 12 weeks 12 weeks;
• Eat gluten prior to the endoscopic biopsy procedure: 2 slices of wheat bread daily for at least 2 weeks;

and this recent study recommends 4-6 slices of wheat bread per day:

 

 

[Russ H]

On 1/5/2024 at 5:44 AM, Berkan said:

Hey! I just checked my results now before I go to my doctor appointment again and I just saw my

Anti-Gliadin Ab.IgG is 35. but all the others are low. I had all the symptoms of celiac, that's why

doctor wanted that. All I want to ask to you guys, is 35 something to concern?

You have isolated positive anti-DGP: in the absence of a person having IgA deficiency, this has poor positive predictive value for coeliac disease -  15.5% (95% CI 8.5–25.0%). This is because it is not unusual for people without coeliac disease to have DGP antibodies.

https://celiacdiseasecenter.columbia.edu/wp-content/uploads/2018/12/Diagnostic-Yield-of-Isolated-Deamidated-Gliadin-Peptide-Antibody-Elevation-for-Celiac-Disease.pdf

[Berkan]

23 minutes ago, Russ H said:

You have isolated positive anti-DGP: in the absence of a person having IgA deficiency, this has poor positive predictive value for coeliac disease -  15.5% (95% CI 8.5–25.0%). This is because it is not unusual for people without coeliac disease to have DGP antibodies.

https://celiacdiseasecenter.columbia.edu/wp-content/uploads/2018/12/Diagnostic-Yield-of-Isolated-Deamidated-Gliadin-Peptide-Antibody-Elevation-for-Celiac-Disease.pdf

I just checked right now the IgA deficiency symptoms and I have them all...

I guess I have %100 celiac, like I said i will go for a biopsy. Wish me luck, thanks yall for the help.

[Russ H]

On 1/5/2024 at 5:44 AM, Berkan said:

Hey! I just checked my results now before I go to my doctor appointment again and I just saw my

Anti-Gliadin Ab.IgG is 35. but all the others are low. I had all the symptoms of celiac, that's why

doctor wanted that. All I want to ask to you guys, is 35 something to concern?

It is certainly worth following up if your have persistent symptoms. Was your total IgA measured as part of the coeliac screening test?

[Berkan]

2 minutes ago, Russ H said:

It is certainly worth following up if your have persistent symptoms. Was your total IgA measured as part of the coeliac screening test?

ttg-IgA 2 ru/ml

ttg-IgG 0,04 ru/ml

Anti-Gliadin IgA 2,27 ru/ml

Anti-Gliadin IgG 35 ru/ml

[trents]

1 hour ago, Berkan said:

ttg-IgA 2 ru/ml

ttg-IgG 0,04 ru/ml

Anti-Gliadin IgA 2,27 ru/ml

Anti-Gliadin IgG 35 ru/ml

Those numbers are meaningless to us without reference rangers since different labs use different reference ranges. There aren't industry standards.

You need to understand how celiac disease works and why going gluten free invalidates testing. With celiac disease the immune system falsely interprets gluten as a threat when it comes in contact with the cells that line the small bowel. The immune system marshals it's invader fighting cells (antibodies) to the area which causes inflammation of the lining of the small bowel, i.e. the "villous lining". The blood tests for celiac disease are designed to measure the levels of these antibodies. Over time, this inflammation also damages the villous lining which, under a microscope, looks like a network of finger-like projectiles. The villi are worn down. The endoscopy with biopsy is designed to visually identify this damage under microscopic inspection. When you quit eating gluten, the immune system quits attacking the villous lining of the small bowel, antibodies are no longer produced and healing of the villous lining begins to take place.