TTG IgA and IGA elevated mildy

[thejayland10]

Hello, 

I have seen numerous doctors and they can't seem to pin point why my ttg iga is still mildly elevated at 16-20 even after being gluten free for over 10 years. I follow a very strict diet and don't eat out. All my other blood tests such as ema, DGP IGA / IGG, vitamin levels, CBC, and dexa scan were normal. 

[Scott Adams]

For people with celiac disease hidden gluten in their diets is the main cause of elevated Tissue Transglutaminase IgA Antibodies (tTG-IgA), but there are other conditions, including cow's milk/casein intolerance, that can also cause this, and here is an article about the other possible causes (you may want to avoid oats):

 

 

[thejayland10]

1 hour ago, Scott Adams said:

For people with celiac disease hidden gluten in their diets is the main cause of elevated Tissue Transglutaminase IgA Antibodies (tTG-IgA), but there are other conditions, including cow's milk/casein intolerance, that can also cause this, and here is an article about the other possible causes (you may want to avoid oats):

 

 

I only eat certifed gluten-free products but a lot of which are processed. Could there be trace gluten in those or is that very unlikely? 

[Scott Adams]

Around 9% of celiacs cannot tolerate any oats, even gluten-free oats. It might be worth eliminating them for a few months, then get re-tested.

[thejayland10]

1 hour ago, Scott Adams said:

Around 9% of celiacs cannot tolerate any oats, even gluten-free oats. It might be worth eliminating them for a few months, then get re-tested.

thank you, i have been doing that the last few weeks and will continue to do so. I had not had my ttg iga checked since I was diagnosed 14 yrs ago so I am not sure if they ever dropped below the 15-20 range. 
 

all my other labs are completely normal but I am concerned that this may be signs of refractor celiac or something else since I'm so careful with gluten-free diet 

[knitty kitty]

Hi, @thejayland10,

Do you still consume dairy?  Dairy can cause increased tTg IgA levels in some people with celiac disease who react to casein, the protein in dairy, just like to gluten.  

You might try cutting out the processed gluten free foods.  Try a whole foods, no carbohydrate Paleo diet instead, like the AIP diet (the Autoimmune Protocol Diet by Dr. Sarah Ballantyne, a Celiac herself).

Processed gluten free foods can be full of excess carbohydrates which can alter your microbiome leading to Small Intestinal Bacterial Overgrowth (SIBO).  SIBO is found in some people who are not responding to a gluten free diet.  SIBO can elevate tTg IgA levels. 

The AIP diet cuts out sources of carbohydrates like rice, potatoes (nightshades), quinoa, peas, lentils, legumes, which starves out the SIBO bacteria.  Better bacteria can then proliferate.  

I followed the AIP diet to get rid of my SIBO.  It's a strict diet, but my digestive tract had time to rest and heal.  I started feeling better within a few days.  Feeling improvement so soon made sticking to the AIP diet much easier.

References:

Small intestinal bacterial overgrowth among patients with celiac disease unresponsive to a gluten free diet

https://pmc.ncbi.nlm.nih.gov/articles/PMC7759221/

 

Luminal antigliadin antibodies in small intestinal bacterial overgrowth

https://pubmed.ncbi.nlm.nih.gov/9260801/#:~:text=Luminal total IgA concentrations (p,response to local bacterial antigens.

 

Potato glycoalkaloids adversely affect intestinal permeability and aggravate inflammatory bowel disease

https://pubmed.ncbi.nlm.nih.gov/12479649/

[thejayland10]

18 hours ago, knitty kitty said:

Hi, @thejayland10,

Do you still consume dairy?  Dairy can cause increased tTg IgA levels in some people with celiac disease who react to casein, the protein in dairy, just like to gluten.  

You might try cutting out the processed gluten free foods.  Try a whole foods, no carbohydrate Paleo diet instead, like the AIP diet (the Autoimmune Protocol Diet by Dr. Sarah Ballantyne, a Celiac herself).

Processed gluten free foods can be full of excess carbohydrates which can alter your microbiome leading to Small Intestinal Bacterial Overgrowth (SIBO).  SIBO is found in some people who are not responding to a gluten free diet.  SIBO can elevate tTg IgA levels. 

The AIP diet cuts out sources of carbohydrates like rice, potatoes (nightshades), quinoa, peas, lentils, legumes, which starves out the SIBO bacteria.  Better bacteria can then proliferate.  

I followed the AIP diet to get rid of my SIBO.  It's a strict diet, but my digestive tract had time to rest and heal.  I started feeling better within a few days.  Feeling improvement so soon made sticking to the AIP diet much easier.

References:

Small intestinal bacterial overgrowth among patients with celiac disease unresponsive to a gluten free diet

https://pmc.ncbi.nlm.nih.gov/articles/PMC7759221/

 

Luminal antigliadin antibodies in small intestinal bacterial overgrowth

https://pubmed.ncbi.nlm.nih.gov/9260801/#:~:text=Luminal total IgA concentrations (p,response to local bacterial antigens.

 

Potato glycoalkaloids adversely affect intestinal permeability and aggravate inflammatory bowel disease

https://pubmed.ncbi.nlm.nih.gov/12479649/

thank yo, i still eat a bit of dairy and a fair amount of processed foods. I wonder if I have sibo... I will look into that 

[jeema]

In addition to cutting out oats, you may want to investigate any medications or supplements you're taking - they can sometimes contain gluten.  You can check medication ingredients online at sites like DailyMed (www.dailymed.nlm.nih.gov).

[thejayland10]

10 hours ago, jeema said:

In addition to cutting out oats, you may want to investigate any medications or supplements you're taking - they can sometimes contain gluten.  You can check medication ingredients online at sites like DailyMed (www.dailymed.nlm.nih.gov).

I do not take medications and my vitamins are certified gluten-free. Is it common for people to have slightly elevated ttg iga even when on gluten-free diet ?> 

On 7/6/2025 at 2:25 AM, knitty kitty said:

Hi, @thejayland10,

Do you still consume dairy?  Dairy can cause increased tTg IgA levels in some people with celiac disease who react to casein, the protein in dairy, just like to gluten.  

You might try cutting out the processed gluten free foods.  Try a whole foods, no carbohydrate Paleo diet instead, like the AIP diet (the Autoimmune Protocol Diet by Dr. Sarah Ballantyne, a Celiac herself).

Processed gluten free foods can be full of excess carbohydrates which can alter your microbiome leading to Small Intestinal Bacterial Overgrowth (SIBO).  SIBO is found in some people who are not responding to a gluten free diet.  SIBO can elevate tTg IgA levels. 

The AIP diet cuts out sources of carbohydrates like rice, potatoes (nightshades), quinoa, peas, lentils, legumes, which starves out the SIBO bacteria.  Better bacteria can then proliferate.  

I followed the AIP diet to get rid of my SIBO.  It's a strict diet, but my digestive tract had time to rest and heal.  I started feeling better within a few days.  Feeling improvement so soon made sticking to the AIP diet much easier.

References:

Small intestinal bacterial overgrowth among patients with celiac disease unresponsive to a gluten free diet

https://pmc.ncbi.nlm.nih.gov/articles/PMC7759221/

 

Luminal antigliadin antibodies in small intestinal bacterial overgrowth

https://pubmed.ncbi.nlm.nih.gov/9260801/#:~:text=Luminal total IgA concentrations (p,response to local bacterial antigens.

 

Potato glycoalkaloids adversely affect intestinal permeability and aggravate inflammatory bowel disease

https://pubmed.ncbi.nlm.nih.gov/12479649/

Is it common for people to have slightly elevated ttg iga even when on gluten-free diet ?

[knitty kitty]

@thejayland10,

The fact that your tTg IgA is slightly elevated after ten years gluten free suggests there's something going on.  We want all the antibodies to go away.  As long as they are around, our body is in a state of inflammation that can have long term deleterious effects outside of the gastrointestinal tract.

Have you had your thyroid checked recently?   Hashimoto's thyroiditis can raise tTg IgA antibodies without gluten.

Maybe you're getting gluten in your diet or from shampoo/toiletries.  Maybe you've developed an intolerance to other foods, like dairy, oats, corn, or yeast.  One my vitamins used brewer's yeast for a B12 source which, of course, made me ill.  One really has to be a bit of a detective.  

Do think about giving the AIP diet a try.  The AIP diet is strict at first, allowing the immune system to calm down.  Later more foods are added back in slowly, checking for possible reactions. 

[thejayland10]

5 minutes ago, knitty kitty said:

@thejayland10,

The fact that your tTg IgA is slightly elevated after ten years gluten free suggests there's something going on.  We want all the antibodies to go away.  As long as they are around, our body is in a state of inflammation that can have long term deleterious effects outside of the gastrointestinal tract.

Have you had your thyroid checked recently?   Hashimoto's thyroiditis can raise tTg IgA antibodies without gluten.

Maybe you're getting gluten in your diet or from shampoo/toiletries.  Maybe you've developed an intolerance to other foods, like dairy, oats, corn, or yeast.  One my vitamins used brewer's yeast for a B12 source which, of course, made me ill.  One really has to be a bit of a detective.  

Do think about giving the AIP diet a try.  The AIP diet is strict at first, allowing the immune system to calm down.  Later more foods are added back in slowly, checking for possible reactions. 

All of my other labs are normal though, CBC, metabolic, dexa scan, vitamin levels, ema, giladin peptide igg iga, etc. 

Could other allergies like corn or yeast raise this? Should I have allergy testing done for other things? 

[knitty kitty]

It's not allergies.  

Segments of the protein in corn, yeast, and dairy resemble segments if the protein gluten.  Our antibodies get triggered on the segments no matter where they are from.  Then the antibodies get really confused and attack our own cells which have segments resembling the  protein gluten in the cell membrane.  Hence, Celiac is an autoimmune disease.

Did you have a test for Thyroid Stimulating Hormone (TSH)?   Symptoms of hypothyroidism can be very subtle in the early stages.  

Edited July 8 by knitty kitty
Typo correction

[Scott Adams]

@thejayland10, did you read this article?