Need help understanding my result

[Jessica J]

I had a recent blood and stool test done for celiac disease antibodies. My doctor hasn’t got back to me yet about the results. I admit I’m being impatient but I overthink everything and get anxiety. 
 

My CRP test result is 6.3mg/L with a normal range being <3.0mg/L

With my stool test everything was in normal range except my IGG level.

Tissue Transglut AB IGG is 7 U/ml when normal range is 0-5 U/L

But my IGA is <2U/ml which normal is between 0-3 and it says my Endomysial IGA is negative.

I tried googling it but I just don’t understand what it means. 

[trents]

Welcome to the forum @Jessica J!

The Endomysial IGA is the centerpiece of the testing you had done and was negative. It is the most specific test available for celiac disease but may not be the most sensitive test that can be run for celiac disease. 

The IGA is probably what we normally refer to as "total IGA" and is not a celiac antibody test per se but a measure of total IGA antibodies present in the blood, including celiac antibodies. If total IGA is low, it can skew the celiac antibody tests scores downward and create false negatives. Your total IGA was in the normal range.

IGG is not as specific as some other tests for celiac disease. Elevated IGG levels can be caused by a number of other things.

CRP is a very general, non-specific measure of inflammation and cannot be tied to celiac disease with any degree of confidence.

The one test that is most commonly run because it has both a high degree of specificity and sensitivity for celiac disease but was not run in your case is the tTG-IGA. It has largely replaced the Endomysial IGA. I find that very curious. What kind of a doctor ran these tests on you? What symptoms do you have that prompted this testing?

Edited February 24, 2024 by trents

[Jessica J]

It was my primary care doctor but he also gave me a referral to go see a gastroenterologist. Which of course the earliest appointment I could get was the end of March. 
 

I started having weird bowel movements about 2 months ago where I would go a lot and there was very noticeable mucus in it. The consistency of my BM were very different from usual. Sometimes I noticed a little blood and also at times that’s all that would come out is mucus. Of course a lot of discomfort in my stomach to where I always feel bloated. 

[trents]

Your symptoms are consistent with celiac disease but the testing you had done by your primary care doc was not as helpful as it might have been. The good news is that the GI doc will likely do more targeted testing for celiac disease. It will be very important for you to eat plenty of wheat products between now and when you see the GI doc. He/she will likely do more thorough celiac antibody blood testing and, depending on the results of that, may follow up with an endoscopy and biopsy of the small bowel lining. Celiac disease damages the villous lining of the small bowel. Keep us posted.

[Jessica J]

Thank you for the information. I was going to go out today and buy gluten free food but I guess I should hold off on that. I can’t wait to get this figured out. 

[trents]

Once you begin eating gluten free, antibody numbers begin to decline and so that would sabotage testing. Unfortunately, many have made that mistake. And they were not warned about it by their doctors. The amount of ignorance in the medical community, and even the indifference, with regard to gluten disorders, is disturbing. It is slowly improving, however. 

 

[Wheatwacked]

Hi Jessica,  When my son was weaned in 1976 he had similar stool.  I made it to 63 years old before I had it.

C-reactive protein (CRP) is a blood marker for inflammation produced by the liver.

Low serum TMAO induced by choline-deficits diets is associated with non-alcoholic steatohepatitis (NASH),

"Decreased synthesis of IgA is observed in acquired and congenital immunodeficiency diseases such as Bruton type agammaglobulinemia. Reduced levels of IgA can be caused by protein‑losing gastroenteropathies and loss through skin from burns."

Reading it this way, you have high tTg IGG and normal IgA, but you have severe gastroenteritis which would could cause you to lose IgA and account for the "normal" level measured.

Keep eating at least 3 slices of bread a day until you and your doctors are through with testing, as trents said, once you stop gluten contamination you will begin to heal.

In the meantime you likely have deficient vitamin D and are either not eating enough Choline (liver, eggs, beef) or not absorbing because of Celiac caused malabsorption syndrome.  You need the equivelant of 4 eggs a day worth of choline.  Or the equivalent of 10 cups of brocolli every day.   Choline - Health Professional Fact Sheet

Get tested for blood levels of vitamin D and homocysteine, B12 and B6 and Folate.  There is no good test for Choline but 90% of us do not eat enough of it thanks to the recommendations to avoid Eggs and Red Meat.  Homocysteine is another indicator of inflammation.  Homocysteine is neutralized by Choline, Folate and Vitamin B6. B12 assists the Folate. If your homocysteine is high (above 19) you are deficient in one or all of the above.

Thiamine and the other B vitamins is also likely in you at this point.

 

8 hours ago, Jessica J said:

Tissue Transglut AB IGG is 7 U/ml when normal range is 0-5 U/L

But my IGA is <2U/ml which normal is between 0-3 and it says my Endomysial IGA is negative.

Hi Jessica.  Could your check your results again.  The units don't match.  I think it should be micromoles/L but there is no µ on the keyboard. (For the micro symbol (µ) the numeric is 0181. So holding down the Alt key and typing 0181 on the numeric keypad will type the micro symbol.)

6 hours ago, Jessica J said:

I started having weird bowel movements about 2 months ago where I would go a lot and there was very noticeable mucus in it.

[Jessica J]

Ok, my bad. Those two tests were blood tests. I just got the other test result today. I wish I knew how to just send a pic of my results. 

The celiac antibody blood test everything was normal except for my TT IGG which is 7 U/mL. Which normal is 0-5. And it does say “U/mL”, I’m assuming it means units per milliliter??

My Calprotectin test is 157 ug/g which normal range is 0-120. So definitely high. That’s all my doctor said was, “There’s definitely inflammation and keep my appointment with the GI doctor.” Well, duh 🙄 I could’ve figured that out on my own. 
 

So, have to wait till my appointment to get any more details. At least I can go to that and have these tests already done and she can do more specific ones.