Confusing results

[MariaC]

I was diagnosed with anemia 4 months ago (Iron 3, hemoglobin 88) and had a colonoscopy and endoscopy to look for internal bleeding. Nothing was found in the colonoscopy and the endoscopy showed mild duodenitis. The doctor took some samples of my small intestine to check for celiac disease. The tesults came back and the diagnosis was duodenal mucosa and partial villous atrophy which could indicate celiac disease among other possible diagnosis.

A couple of weeks ago I had bloods taken for a celiac serology and so far just the first part of the results have come back and shows elevated IgA and IgM.

IgA - 4.10 (ref. range 0.8-4.0 g/L)

IgM - 2.38 (ref. range 0.5-2.0 g/L)

My gp has recomended I start a gluten free diet as she believes I am celiac based on those results and that would explain my anemia. The second part of the test should arrive next week.

Should I start a gluten free diet straight away? Or should I wait for the second part of the results? 

I don’t know much about celiac disease, my journey has just started, but would the IgA result being 0.1 above threshold really be positive for celiac disease?

[Russ H]

Those serum tests are for total immunoglobulins in each class (IgA and IgM) and are not specific to coeliac disease. You need the test results for antibodies to tTG2, which is a very sensitive test for coeliac disease. I would follow your doctor's advice.

[trents]

Welcome to the forum @MariaC!

The test terminology you supplied is unfamiliar to me but I will assume Russ H is correct in his interpretation that they are not specific to celiac disease. Were there other celiac specific tests ordered that you did not list, perhaps ones that were negative?

There are blood antibody tests designed to specifically detect celiac disease and I would encourage you to seek a physician who will run these tests. I would recommend a full celiac panel which would include: 

Total IGA

TTG-IGA

DGP-IGA

DG:P-IGG

Here is an article that discusses the various blood tests that can be run for celiac disease: 

Having said that, villous atrophy of the small bowel lining is the hallmark of celiac disease but your physician is correct in asserting that it can be caused by other things besides celiac disease. Other causes can include CMP (Cow's Milk Protein), NSAIDs, a certain blood pressure medication and other bowel diseases. https://www.verywellhealth.com/villous-atrophy-562583

It is important to understand that should you seek to have additional antibody blood testing done for celiac disease you must continue to eat generous amounts of gluten up until the day of the blood draw.

On the other hand, you could trial the gluten free diet and see if your condition improves. Your iron is in the toilet and that needs to come up. Here is an article that gives pointers for getting off on the right foot with eating gluten free: 

 

[Wheatwacked]

Take the diagnosis and run.  In the worst case you can stop eating gluten free after say a six month trial.  Some, like recovering alcoholics never get over the craving.  Resistance is not futile.  Some wait as much as ten years to finally get the diagnosis.  Be sure to monitor your diet for vitamins and minerals.  During recovery you need way more than the minimum to rebuild.

[MariaC]

Thank you for your replies.

I went to see a Gastroentologist and he thinks I am 100% celiac. That not only would explain the anemia but also the fact that my iron levels and haemoglobin are not recovering as fast as they should…

I am still waiting on the final results of the coeliac serology but the consultant said that if they come back negative I’ll need to get them done again 😩