Celiac Disease Test results

[minkgurl]

I just received my blood results for celiacs but have no idea how to read them, and I have not hear back from my doctor in about a week. 

While I'm waiting, I thought I would reach out here and see what you guys can make of my test! 

DGA IgA- 32 (high)

DGA IgG- 26 (weak positive) 

TtG IgA- 5 (weak positive)

TtG IgG- 4 (negative)

Endomysial Antibody IgA- negative

Immuniglobulin 319 (normal)

I recently had a trip the ER in sooo much pain, felt like gallbladder pains but, I had that removed years ago. They noticed I had elevates liver enzymes (non alcoholic fatty liver) and mentioned celiacs disease could be a factor for it. 

It runs in my family, so I wouldn't be surprised. 

Thank you all!

[trents]

Welcome to the forum, @minkgurl!

Your normal Immunoglobulin IgA means you are not IGA deficient which means your IGA-based celiac antibody tests should be accurate. The Immunoglobulin IgA is not a test for celiac disease itself.

Three out of the five celiac antibody tests (Three IGA tests and one IGG test) indicate you do have celiac disease. It is normal that not all tests will be positive. Your next step may be an endoscopy with biopsy of the small bowel lining to confirm the results of the antibody testing.

By any chance, had you already started on a gluten free diet or at least cut back on gluten consumption prior to the blood draw for these tests? If so, that would have pushed the scores lower.

Here is a primer for understanding celiac disease antibody testing: 

 

Edited August 1, 2024 by trents

[minkgurl]

I rarely eat gluten, I've noticed it always makes me sick so I tended to avoid it before this, I did eat gluten the day before my test which I don't think was enough time

[trents]

Well then, it's remarkable that any of your tests were positive. For those who have been off gluten for significant periods of time and want to undergo valid testing, a "gluten challenge" is in order. this would involve the daily consumption of at least 10g of gluten (the amount in approximately 4-6 slices of bread) for a minimum of two weeks, and preferably longer. However, this is obviously impractical for some people because it would endanger their health. Having said that, I think you have all the evidence you need to conclude that you have celiac disease. Is there a reason you need a formal diagnosis? My suggestion at this point for you would be to move from "rarely" eating gluten to completely eliminating it from your diet.

Edited August 1, 2024 by trents

[Wheatwacked]

17 hours ago, minkgurl said:

felt like gallbladder pains but, I had that removed years ago. They noticed I had elevates liver enzymes (non alcoholic fatty liver)

Hi minkgurl and welcome.

I totally agree with trents.  Gluten free diet and replenish your vitamin and mineral deficiencies and you'll be amazed at how well you feel; and why didn't some one tell you years ago, before your gallbladder was removed.

Gallbladder surgery in not uncommon with Celiac Desease.  Combined with your NAFLD it would indicate a deficiency in Choline.

Not eating eggs, beef and liver, as part of a "healthy diet",  it is impossible to get choline without supplementing.  4 eggs a day or 15 ounces of top sirloin or 6 ounces of beef liver  or 10 cups of cooked broccoli!

Taking 'supplemental essential nutrients that we need to be healthy is not a cop out.  It simply acknowledges that our food intake is not sufficient alone.

The safe range for choline is 500 mg to 3500 mg a day.  Experts estimate the only 10% of westerner reach that amount.  We do make some,  but not enough.  Choline makes up a majority of the bile salts that are needed to keep bile moving the gallbladder though the pancreas and into the duodenum.  So it gets backed up and surgery is the result.

Choline deficiency is the cause of both Alcoholic Fatty Liver and Non Alcoholic Fatty Liver.  They used to believe only alcoholism caused Fatty Liver and patients with it were lying about drinking.

Low choline has been linked to brain fog, acetylcholine is an important brain neurotransmitter.  Phosphatidyl choline makes up most of the mitochondrial membrane wall.

Choline, Folate and vitamin B6 recycle homocysteine, an independent indicator of cardiovascular disease.  It is toxic waste from The RDA of folate is 400 micrograms while the RDA of choline is 450 milligrams.  We need a thousand times more molecules of choline compared to folate. 

Quote

"High homocysteine levels in the blood can damage the lining of the arteries. High levels may also make the blood clot more easily than it should."  What is homocysteine? 

Choline and folate and B1 are also important to prevent congenital neural tube defects.  It why the US reguires fortification with folic acid in not gluten free processed foods. (despite Folic acid supplementation was associated with increased risk of prostate cancer.  The endometrium and prostate come from the same embronic cells, Though its hasn't been studied, I bet it increases endometrial cancer, too.)  Folic Acid and Risk of Prostate Cancer: Results From a Randomized Clinical Trial.

Homocysteine is a simple blood test, but rarely done.   I get mine every 3 months and by supplementing with Phosphatidyl Choline it is usually around 18 (normal range is 0 to 19.2.  Higher indicates inflammation and may mean deficient choline status.

 

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Compared to inadequate choline intake, optimal choline intake was related to a lower risk of NAFLD... With the latest NHANES data, we found that higher dietary choline was associated with a lower risk of NAFLD in American adults, and such a relationship exists in both females and males.   Dietary choline intake and non-alcoholic fatty liver disease (NAFLD) in U.S. adults: National Health and Nutrition Examination Survey (NHANES) 2017–2018

Quote

"Plasma choline levels do not decline below 50% of normal, even in individuals who have not eaten for more than a week [3]. This may be due to the hydrolysis of membrane phospholipids, a source of choline, to maintain plasma choline concentrations above this minimal level, or to endogenous synthesis"  NIH: Choline Fact Sheet for Health Professionals

In plain English if we don't intake enough from food our body cannabalizes itself to maintain the blood level.

Edited August 1, 2024 by Wheatwacked

[minkgurl]

Thank you for that information!! I'll look into it. Honestly when they told me I had fatty liver, I didn't do the diet, I did keto & gluten free, and it had actually gone away, but recently came back after I started eating normal foods again. 

[Wheatwacked]

While you are eating gluten and waiting on the doctor you could start taking Choline.  It won't affect your your testing for Celiac and may help alleviate your discomfort and keep you out of the ER.  "According to some research, over 90% of Americans don't get enough choline in their diet.

You may notice that the warning that consuming too much choline can be harmful is in almost everything you read. The Federal Nutrition Board says that the Tolerable Upper Intake Level (UL) for adults is 3,500 mg per day.  To reach that upper limit would take eating the equivelant of 24 eggs or 56 cups of broccoli.  Not very likely.

While the FNB does indicate 3500 mg as UL, this article from Harvard,  last reviewed March 2023, says this about that.

Quote

A Tolerable Upper Intake Level (UL) is the maximum daily dose unlikely to cause adverse side effects in the general population. A UL has not been established for choline, because a toxic level has not been observed from food sources or from longer-term intakes of high-dose supplements.  Harvard T. H. Chan School of Public Health: Choline

Then farther down in the same article they say:

Quote

Other symptoms include excessive sweating, fishy body odor, or nausea/vomiting. The Tolerable Upper Intake Level (UL) for choline for adults 19 years and older is 3,500 mg daily and is based on the amount that has been shown to produce these side effects. Reaching this high amount would most likely be caused by taking very high dose supplements rather than from diet alone.

No wonder there is confusion.