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transglutaminase IGA Ab still present, but low


Darcee

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Darcee Newbie

I've been gluten free for 14 years now and recently (last 2 years) did a full elimination and re-introduction following the AIP protocol and am now essentially eating paleo plus rice.  The rest of my household is not gluten free however.  I had my transglutaminase IGA ab tested and it was 3.6.  Greater than 15 is considered positive for Celiac on this lab.  However, the fact that I have had a VERY clean diet for the last 2 years and still have antibodies present makes me concerned.  Do you think I'm getting cross contamination from touching gluten products in my house or does that value of 3.6 mean nothing?  I would just assume if I'm not exposed to any more gluten I should've have any antibodies at all.  Thanks for any advice!


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DonnaNM Rookie

I'm not a doctor.  However, my blood doctor told me because I have Celiac disease the antibodies will always be present.  So don't panic, but discuss it with your doctor.  

Scott Adams Grand Master

For some people there are other conditions that can cause elevated Tissue Transglutaminase IgA Antibodies (tTG-IgA). This article discusses them:

 

 

Raquel2021 Collaborator
21 hours ago, Darcee said:

I've been gluten free for 14 years now and recently (last 2 years) did a full elimination and re-introduction following the AIP protocol and am now essentially eating paleo plus rice.  The rest of my household is not gluten free however.  I had my transglutaminase IGA ab tested and it was 3.6.  Greater than 15 is considered positive for Celiac on this lab.  However, the fact that I have had a VERY clean diet for the last 2 years and still have antibodies present makes me concerned.  Do you think I'm getting cross contamination from touching gluten products in my house or does that value of 3.6 mean nothing?  I would just assume if I'm not exposed to any more gluten I should've have any antibodies at all.  Thanks for any advice!

If greater than 15 is normal then I think is normal to still have a few antibodies.  I recently did mine, being gluten-free for 3 years and follow a similar style diet and mine were 7. My Dr told me that was good.

Jane07 Enthusiast

do you think if it below 15 it not consided postive for celiac in the lab

Darcee Newbie
42 minutes ago, Jane07 said:

do you think if it below 15 it not consided postive for celiac in the lab

I do not understand what you wrote.  I know that greater than 15 from this lab indicates Celiac.  However, I've had my daughter tested (to make sure she doesn't have it) and her value from the lab was <1.  Mine was 3.6 so I was just wondering if it's normal to still have antibodies present regardless of your gluten free diet (14 years) or if having any antibodies present (less than 15) means you are still reacting to gluten from an unknown source then.  

Jane07 Enthusiast
On 2/13/2024 at 11:33 PM, Darcee said:

I've been gluten free for 14 years now and recently (last 2 years) did a full elimination and re-introduction following the AIP protocol and am now essentially eating paleo plus rice.  The rest of my household is not gluten free however.  I had my transglutaminase IGA ab tested and it was 3.6.  Greater than 15 is considered positive for Celiac on this lab.  However, the fact that I have had a VERY clean diet for the last 2 years and still have antibodies present makes me concerned.  Do you think I'm getting cross contamination from touching gluten products in my house or does that value of 3.6 mean nothing?  I would just assume if I'm not exposed to any more gluten I should've have any antibodies at all.  Thanks for any advice!

ok thanks its not in the normal range for me yet. its just been about a year on a gluten free diet it difficult,  

im  hope things improve i get  to the normal range. i will keep trying.

wow you done it for 14 yrs good luck


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Scott Adams Grand Master

If your goal is to get the level near zero you may try a casin/milk-free diet to see if that works, as per the article I shared.

Rogol72 Collaborator

I had a coeliac panel last year to see if any sneaky gluten was getting into my system, the ttg result was 3.1.

I had another done last week, and it came down to 1.7.

flowerpen Newbie
On 2/13/2024 at 11:23 PM, DonnaNM said:

I'm not a doctor.  However, my blood doctor told me because I have Celiac disease the antibodies will always be present.  So don't panic, but discuss it with your doctor.  

I thought it was normal, as in for non- celiac individuals, to have these antibodies. I've been mostly gluten free for years, operating under the assumption I had an intolerance, and I have always landed in the mid-normal range (7-10 with 20 being the cutoff). 

Is it normal for non-celiacs to have none or almost none?

Scott Adams Grand Master

The antibodies used in celiac disease screening are very specific to people who have an autoimmune reaction to gluten, so those without celiac disease or gluten sensitivity normally test at or near zero.

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    • Scott Adams
      The first set of results show two positive results for celiac disease, so at the very least it looks like you could have it, or at the least NCGS.   Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.      
    • Scott Adams
      Elevated tissue transglutaminase IgA (tTG-IgA) levels are highly specific for celiac disease, and they are a key biomarker used in its diagnosis. However, there are some rare instances where elevated tTG-IgA levels have been reported in conditions other than celiac disease. While these cases are not common, they have been documented in the literature. Below are some examples and references to studies or reviews that discuss these scenarios:  1. Non-Celiac Gluten Sensitivity (NCGS)    - NCGS typically does not cause elevated tTG-IgA levels, as it is not an autoimmune condition. However, some individuals with NCGS may have mild elevations in tTG-IgA due to intestinal inflammation or other factors, though this is not well-documented in large studies.    - Reference: Catassi, C., et al. (2013). *Non-Celiac Gluten Sensitivity: The New Frontier of Gluten-Related Disorders*. Nutrients, 5(10), 3839–3853. [DOI:10.3390/nu5103839](https://doi.org/10.3390/nu5103839)  2. Autoimmune Diseases    - Elevated tTG-IgA levels have been reported in other autoimmune conditions, such as type 1 diabetes, autoimmune hepatitis, and systemic lupus erythematosus (SLE). This is thought to be due to cross-reactivity or polyautoimmunity.    - Reference: Sblattero, D., et al. (2000). *The Role of Anti-Tissue Transglutaminase in the Diagnosis and Management of Celiac Disease*. Autoimmunity Reviews, 1(3), 129–135. [DOI:10.1016/S1568-9972(01)00022-3](https://doi.org/10.1016/S1568-9972(01)00022-3)  3. Chronic Liver Disease    - Conditions like chronic hepatitis or cirrhosis can sometimes lead to elevated tTG-IgA levels, possibly due to increased intestinal permeability or immune dysregulation.    - Reference: Vecchi, M., et al. (2003). *High Prevalence of Celiac Disease in Patients with Chronic Liver Disease: A Role for Gluten-Free Diet?* Gastroenterology, 125(5), 1522–1523. [DOI:10.1016/j.gastro.2003.08.031](https://doi.org/10.1016/j.gastro.2003.08.031)  4. Inflammatory Bowel Disease (IBD)    - Some patients with Crohn’s disease or ulcerative colitis may have elevated tTG-IgA levels due to intestinal inflammation and damage, though this is not common.    - Reference: Walker-Smith, J. A., et al. (1990). *Celiac Disease and Inflammatory Bowel Disease*. Journal of Pediatric Gastroenterology and Nutrition, 10(3), 389–391. [DOI:10.1097/00005176-199004000-00020](https://doi.org/10.1097/00005176-199004000-00020)  5. Infections and Parasites    - While infections (e.g., giardiasis) are more commonly associated with false-positive tTG-IgA results, chronic infections or parasitic infestations can sometimes lead to elevated levels due to mucosal damage.    - Reference: Rostami, K., et al. (1999). *The Role of Infections in Celiac Disease*. European Journal of Gastroenterology & Hepatology, 11(11), 1255–1258. [DOI:10.1097/00042737-199911000-00010](https://doi.org/10.1097/00042737-199911000-00010)  6. Cardiac Conditions    - Rarely, heart failure or severe cardiovascular disease has been associated with elevated tTG-IgA levels, possibly due to gut ischemia and increased intestinal permeability.    - Reference: Ludvigsson, J. F., et al. (2007). *Celiac Disease and Risk of Cardiovascular Disease: A Population-Based Cohort Study*. American Heart Journal, 153(6), 972–976. [DOI:10.1016/j.ahj.2007.03.019](https://doi.org/10.1016/j.ahj.2007.03.019)  Key Points: - Elevated tTG-IgA levels are highly specific for celiac disease, and in most cases, a positive result strongly suggests celiac disease. - Other conditions causing elevated tTG-IgA are rare and often accompanied by additional clinical findings. - If celiac disease is suspected, further testing (e.g., endoscopy with biopsy) is typically required for confirmation. If you’re looking for more specific studies, I recommend searching PubMed or other medical databases using terms like "elevated tTG-IgA non-celiac" or "tTG-IgA in non-celiac conditions." Let me know if you’d like help with that!
    • MaryMJ
      I called zero water and they state their filters do not contain gluten or gluten containing ingredients. 
    • trents
      I agree. Doesn't look like you have celiac disease. Your elevated DGP-IGG must be due to something else. And it was within normal at that after your gluten challenge so it is erratic and doesn't seem to be tied to gluten consumption.
    • Jack Common
      Hello! I want to share my situation. I had symptoms like some food intolerance, diarrhea, bloating, belching one year ago. I thought I could have celiac disease so I did the blood tests. The results were ambiguous for me so I saw the doctor and he said I needed to do tests to check whether I had any parasites as well. It turned out I had giardiasis. After treating it my symptoms didn't disappear immediately. And I decided to start a gluten free diet despite my doctor said I didn't have it. After some time symptoms disappeared but that time it wasn't unclear whether I'd had them because of eliminating gluten or that parasite. The symptoms for both are very similar. Giardiasis also damages the small intestine. The only way to check this was to start eating bread again as I thought. Now about my results.   These are my first test results (almost a year ago) when I had symptoms: The Tissue Transglutaminase IgA antibody - 0.5 U/ml (for the lab I did the tests 0.0 - 3.0 is normal) The Tissue Transglutaminase IgG antibody - 6.6 U/ml (for the lab I did the tests 0.0 - 3.0 is normal) Immunoglobulin A - 1.91 g/l (for the lab I did the tests 0.7 to 4 g/l is normal) IgA Endomysial antibody (EMA) - < 1:10 titer (for the lab I did the tests < 1:10 titer is normal) IgG Endomysial antibody (EMA) - < 1:10 titer (for the lab I did the tests < 1:10 titer is normal) Deamidated gliadin peptide IgA - 0.3 U/ml (for the lab I did the tests 0.0 - 6.0 is normal) Deamidated gliadin peptide IgG - 46.1 U/ml (for the lab I did the tests 0.0 - 6.0 is normal)   Then I didn't eat gluten for six months. Symptoms disappeared. And I started a gluten challenge. Before the challenge I did some tests. My results: The Tissue Transglutaminase IgG antibody - 0.5 U/ml (for the lab I did the tests < 20 U/ml is normal)) Deamidated gliadin peptide IgG - 28 U/ml (for the lab I did the tests < 20 U/ml is normal)   During the challenge I ate 6 slices of wheat bread. After the challenge my results are: The Tissue Transglutaminase IgA antibody - 2.0 U/ml (for the lab I did the tests < 20 U/ml is normal) The Tissue Transglutaminase IgG antibody - 2.0 U/ml (for the lab I did the tests < 20 U/ml is normal) Immunoglobulin A - 1.31 g/l (for the lab I did the tests 0.7 to 4 g/l is normal) Deamidated gliadin peptide IgA - 2.0 U/ml (for the lab I did the tests < 20 U/ml is normal) Deamidated gliadin peptide IgG - 2.13 U/ml (for the lab I did the tests < 20 U/ml is normal)   To be sure I continued consuming gluten. I ate a lot each day. Two months after I did the tests again. My results I got today are: The Tissue Transglutaminase IgA antibody - 0.7 U/ml (for the lab I did the tests < 20 U/ml is normal) Immunoglobulin A - 1.62 g/l (for the lab I did the tests 0.7 to 4 g/l is normal) Deamidated gliadin peptide IgG - 25.6 U/ml (for the lab I did the tests < 20 U/ml is normal)   Nowadays I didn't have any symptoms except tiredness but I think it's just work. I think it was this parasite because two years ago, for example, and before I didn't have these symptoms and I always ate gluten food. But I'm still not sure especially because the Deamidated gliadin peptide IgG results are sometimes high. What do you think? @Scott Adams
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