Understanding Labs

[Mich1724]

Hello! New here! I had blood work in January and this is what the results were:

immunogobumn A, un, serum 

 

Mine: 248 mg/dL

Normal Range: 87-352

Deamidated Gliadin Abs, IgA

Mine: 54 units 

Normal Range: 0-19

 

Deamidated Gliadin Abs, IgG

Mine: 4 units

Normal Range: 0-19

1-Transolutaminase (ITG) IgA

Mine: <2

Normal: Range: 0-3

1-Transglutaminase (ITG) IgG

Mine: 5

Normal Range: 0-5

My physician said I probably have Celiac’s but gave me a referral to GI.

 

I did blood work for GI yesterday and my results were as follows:

tTG,IgA

Mine: <0.5

Normal range: 0.0 - 14.9 U/mL

 

tTG,IgG

Mine: <0.8

Normal range: 0.0 - 14.9 U/mL

 

What does this mean? Has anyone seen something like this? I stopped eating gluten for a few weeks because I was in such pain and had so many bathroom problems but resumed eating gluten prior to the blood test yesterday. 
 

help please! 

 

 

 

[Scott Adams]

Welcome to the forum!

Your results are a bit mixed, but not uncommon. Your total IgA level is normal, which means the standard celiac tests (tTG-IgA) should be reliable—and those came back negative both times. However, your elevated deamidated gliadin peptide (DGP) IgA (54, above normal) can sometimes indicate gluten-related immune activity, especially if symptoms are present. The issue is that DGP can be less specific than tTG, so it can be elevated in other conditions too. Also, being gluten-free for even a few weeks before testing can reduce antibody levels and potentially lead to false negatives, even if you resumed gluten shortly before the second test—it may not have been long enough.

At this point, your GI referral is the right next step. They may recommend staying on a consistent gluten-containing diet (often called a “gluten challenge”) for several weeks and possibly doing an endoscopy with biopsy, which is the gold standard for diagnosing celiac disease. In the meantime, your symptoms matter just as much as the labs—so be sure to share the full picture with your specialist. You’re definitely not alone in seeing results like this, and it can take a bit of back-and-forth to get a clear answer.

Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS--but don't go gluten-free until all testing is completed.

Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy:

Quote

"...in order to properly diagnose celiac disease based on serology and duodenal histology, doctors need patients to be on gluten-containing diets, even if they are causing symptoms, and this is called a "gluten challenge."

• Eat gluten prior to celiac disease blood tests: The amount and length of time can vary, but is somewhere between 2 slices of wheat bread daily for 6-8 weeks and 1/2 slice of wheat bread or 1 wheat cracker for 12 weeks 12 weeks;
• Eat gluten prior to the endoscopic biopsy procedure: 2 slices of wheat bread daily for at least 2 weeks;

and this recent study recommends 4-6 slices of wheat bread per day:

 

 

[trents]

Welcome to the celiac.com, @Mich1724! As Scott Adams said, the withdrawal of gluten from your diet prior to testing casts doubt on the reliability of your test scores. It takes time - weeks/months -  after resuming gluten consumption, for antibody levels to build up to the point of detectability by testing after having been on a gluten fast. So, unless you are willing to undergo a "gluten challenge" you cannot be sure whether or not you have celiac disease or NCGS (Non Celiac Gluten Sensitivity). As Scott said, there are not tests yet available for NCGS so celiac disease must first be ruled out. Celiac disease is an autoimmune disorder whereas NCGS is not and we don't have a clear understanding of its mechanism. We do know that when celiac disease is ignored or undiagnosed for a long time it results in damage to body systems and health problems related to nutritional deficiencies since it damages the ability of the small bowel lining to absorb nutrients from our food. The only antidote for either condition is elimination of gluten from the diet.
 

 

Edited Saturday at 06:54 PM by trents