ttg iga high (646 mg/dl) other results are normal

[kpf]

Levels on my celiac panel were within normal range except ttg iga which was tagged as high (646 mg/dl). Is that typical? 

[trents]

Are you asking if it is typical to only have the ttg-iga be high and the other tests being within normal range? Is so, the answer is it is very common. What other tests were included in the celiac panel? Can you list all tests and include not only the scores but the reference ranges? Different labs use different reference ranges so it is difficult to say much by just looking at the scores.

Welcome to the forum, @kpf!

[kpf]

I can’t figure out how to attach a photo here, but thank you so much for your response. And thank you for the welcome. 

[kpf]

Gliadin peptide iga was 0.7 U/mL

Gliadin peptide igg was <0.4 U/mL

IGA TTG was 646 mg/dL (marked high with limits noted as 40-350)

IGG TTG was <0.8 UmL

[kpf]

3 minutes ago, kpf said:

Gliadin peptide iga was 0.7 U/mL

Gliadin peptide igg was <0.4 U/mL

IGA TTG was 646 mg/dL (marked high with limits noted as 40-350)

IGG TTG was <0.8 UmL

peptide iga, peptide igg, and ttg igg were all marked normal with limits noted as <15.0

[kpf]

And of course I get these results (the ttg iga marked high at 646 mg/dL) on a Friday in my portal, my doctor wasn't in, and now we are in the weekend—leaving me to have to try and figure things out on my own until sometime next week. None of the nurses at the office would talk to me. 

[trents]

The IGA TTG (aka, TTG-IGA) is the centerpiece of celiac disease blood antibody testing. A high value in this test indicates probable celiac disease, though there are other reasons (some other diseases, some medications and in some cases, even some non-gluten foods) that can cause it to be elevated. And it is not unusual at all for other celiac antibody tests to be normal when the TTG-IGA is high.

Normally, when the TTG-IGA is elevated, the physician will order an upper GI with biopsy of the small bowel lining to check for the damage characteristic of celiac disease. The biopsy is then sent out for microscopic analysis. This is to confirm the results of the blood testing and is considered the gold standard diagnostic test. You should not begin a gluten free diet until the endoscopy/biopsy is complete. This is very important because otherwise the results will be invalidated. 

This article on celiac disease blood antibody tests might be helpful to you while you are waiting for feedback from the physician:

 

Edited November 23, 2025 by trents

[kpf]

Thanks so much. This is what I thought but really wanted a second opinion. I appreciate this. 

[trents]

What are your symptoms? What has brought you to the point where you sought celiac disease testing?

[kpf]

Abdominal pain and an itchy stomach were the symptoms I asked to see a GI about. Now I’ve learned these other symptoms—that I have but attributed to other issues—could also be related to celiac disease: 

fatigue

joint pain

canker sores

numbness or tingling in hands or feet

difficulty with coordination

anemia

headaches

neutropenia

I never dreamed in a million years she would consider celiac disease. It was a shock to me. It’s definitely not what I went to her for. 

[RMJ]

Are you sure that is the TTG IgA? Based on the units (mg/dL) and having an upper limit to the normal range, it looks like a total IgA result. 

[kpf]

31 minutes ago, RMJ said:

Are you sure that is the TTG IgA? Based on the units (mg/dL) and having an upper limit to the normal range, it looks like a total IgA result. 

I think you may be correct. The way the results are printed makes it appear as though it’s the ttg iga but I think you’re right—the 646 is total iga. So this would be indicative of another issue (another autoimmune condition, infection, cancer, etc.) and my doctor would need to do further testing. Thank you for saying this! 

[Wheatwacked]

So, since total iga 646, was high ,  was tTg iga even tested?

It is not uncommon to test negative for antibodies and even biopsies to still have Celiac Disease.  Many on this forum have gone 10 years testing negative and surviving multiple misdiagnoses before finally being diagnosed as celiac.

If trial GFD after all the negative tests are concluded brings improvement, will you continue to eat gluten and suffering since the doctor says you are not sick?

Your list of symptoms, mostly unrelated to each other, certainly fits the pattern of celiac disease.  Do you really have nine different diseases, all with cause unknown?

 

Edited November 23, 2025 by Wheatwacked

[trents]

Yes, I wondered about the units as well. That large number sure looked more like what we're used to seeing in connection with total IGA scores rather than TTG-IGA. The total IGA test is given to determine if you are IGA deficient. In the case of IGA deficiency, other IGA tests will b skewed and their scores cannot be trusted. Elevated total IGA can point to other health issues, some of them potentially serious, or it can mean nothing. But it doesn't look like you have celiac disease.

[knitty kitty]

@kpf,

Were you eating ten grams or more of gluten daily in the month preceding your antibody blood tests?

TTg IgA antibodies are made in the intestines.  Ten grams of gluten per day for several weeks before testing is required to provoke sufficient antibody production for the antibodies to leave the intestines and enter the blood stream and be measured in blood tests.

If you had already gone gluten free or if you had lowered your consumption of gluten before testing, your results will be inaccurate and inconclusive.   See link below on gluten challenge guidelines.

Have you had any genetic testing done to see if you carry genes for Celiac disease?  If you don't have genes for Celiac, look elsewhere for a diagnosis.  But if you have Celiac genes, you cannot rule out Celiac disease.

You mentioned in another post that you are vegetarian.  Have you been checked for nutritional deficiencies?  The best sources of the eight essential B vitamins are found in meats.  Do you supplement any of the B vitamins as a vegetarian?

Deficiency in Thiamine Vitamin B 1 is strongly associated with anemia which can cause false negatives on antibody tests.  Fatigue, numbness or tingling in extremities, difficulty with coordination, headaches and anemia are strongly associated with thiamine deficiency.  Other B vitamins that contribute to those symptoms are Riboflavin B 2, Pyridoxine B 6, Folate B 9 and B12 Cobalamine.  The eight B vitamins all work together with minerals like magnesium and iron.  So your symptoms are indicative of B vitamin deficiencies.  You can develop vitamin and mineral deficiencies just being a vegetarian and not eating good sources of B vitamins like meat.  B vitamin deficiencies are found in Celiac due to the malabsorption of nutrients because the lining of the intestines gets damaged by the antibodies produced in response to gluten.

 

 

Edited November 23, 2025 by knitty kitty
Typo correction

[trents]

knitty kitty asks a very relevant question. So many people make the mistake of experimenting with the gluten free diet or even a reduced gluten diet soon before getting formally tested.