Test interpretations

[anya22]

Hi, last year i tested for celiac 

my Tissu transglutaminase IgA lev was 20.3 U/ml but my Endomysial antibody IgA level was negative.

I again tested just recently because i have symptoms of fatigue, bloating etc and my Tissu transglutaminase IgA lev was 26.5 but i again tested negative for my Endomysial antibody IgA level 

I have now been referred so are waiting for an appointment where i suppose they’ll do a biopsy?

Wanted to know could this mean i have coeliac, because its only ‘weakly’ negative considering the range is 0.0-14.9 or could it be something else

 

 

 

[trents]

Welcome to the celaic.com community, @anya22!

It is possible that the positive tTG-IGA result is being caused by something besides celiac disease but it is not likely, especially in view of your symptoms.

By the way, you are confusing the terms "negative" and "positive" as they are used in medical testing. "Negative" means the test resulted in no evidence of disease. "Positive" means the test result found evidence of disease. So, your tTG-IGA result was positive and the endomysial  (aka, EMA) was negative. And, by the way, it is not unusual for to get mixed results like that. You can have celiac disease and still find that not all the various tests will show positive results. Many diagnostic protocols work that way. Think about it. If this were not so, why would they have a need for more than one kind of test? I'll include an article outlining the various antibody tests available to diagnose celiac disease.

But let me ask you, have you or had you been experimenting with a reduced gluten diet prior to the testing?

 

Edited March 7 by trents

[anya22]

Thanks for the reply!

I kept my diet the same continued to eat gluten. 

I forgot to mention I have also failed to gain weight even with an high calorie diet since a young age

[knitty kitty]

Welcome, @anya22,

Can you tell us more about your diet?  

How much gluten containing foods did you eat?  What kinds of gluten containing foods did you eat? 

What has your high calorie diet consisted of?  

Some gluten containing foods contain less gluten than others.  Cakes and cookies may have less gluten than something like deep dish pizza.  

Glad you're here!

[trents]

It would seem then that your next step should be a biopsy to check for damage to the villous lining of the small bowel. But you must not reduce gluten intake until that is performed else healing will take place in that area of the intestines and the biopsy results would be invalidated. 

[Dr. Gunn]

As has been pointed out previously, it is not unusual to have mixed tTG and EMA results with active celiac disease. While awaiting your biopsy appointment you could request celiac genetic risk testing. If you don't carry the HLA-DQ2 and/or DQ8 genes, your lifetime risk for celiac disease is < 1%. The celiac risk genes are present in close to 100% of celiac disease cases. If you do carry the genes, biopsy confirmation is essential given your history of symptoms and tTG antibody results.

[knitty kitty]

On 3/7/2026 at 10:57 AM, anya22 said:

Thanks for the reply!

I kept my diet the same continued to eat gluten. 

I forgot to mention I have also failed to gain weight even with an high calorie diet since a young age

Failure to gain weight on a high calorie diet points to nutritional deficiencies in B vitamins, especially Thiamine B 1.  

A person can eat a diet high in calories, but not consume sufficient amounts of the eight B vitamins necessary to turn those calories into fuel for the body and for healthy weight gain.  

Do get checked for nutritional deficiencies.  Talk to your doctors about supplementing with essential vitamins and minerals our bodies need to stay healthy.  

Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet

https://pubmed.ncbi.nlm.nih.gov/19154566/