Questions On Test Results

[Collette]

Hello Everyone!

A year ago I took my son (7 years old) to an alternative doctor and she diagnosed him as gluten intolerant. We put him on a gluten free diet and saw a mild improvement with his behavior (he has very strong reactions and problems with anger), and he was sick less often.

After 7 months on the gluten free diet my husband wanted our son tested by a main stream medical test. I asked his pediatrician to test him for celiac disease, which he did.

These are the tests he did and the results:

Gliadin AB IgA <3

IgA Serum 29

tTG Ab, IgA <3

He also did various CBC tests which looked at WBC, RBC, hemoglobin, etc. All of these are within the normal range. I don't know what a lot of these mean.

The pediatrician says that he is not Celiac, but at the same time he says that his numbers are so low that the test is not really accurate. Perhaps I misunderstood him and he meant part of the IgA test. He also said that 5-10% of the population has low IgA numbers and often it means they have higher incidences of sinus infections or ear infections. This is not the case with our son so he is not concerned. The illnesses that he had were frequent colds/ and a recurring unexplained cough.

I have read that low IgA numbers can be connected with autoimmune diseases.

Can anyone help explain to me whether these numbers show he does or doesn't have celiac disease? Any other information about low IgA would be helpful.

Thank you so much. Collette

[AndreaB]

I would have been surprised if his numbers showed positive for celiac after being gluten free for 7 months. At this time unless you want to do a gluten challenge I would recommend Open Original Shared Link for a stool test. They also test for ttg, malabsorption and gene test on the gluten panel. Other tests can include dairy/soy/egg/yeast. If you decide to do a gluten challenge and have him retested than you would need to have him eating the equivalent to 3 or 4 slices of bread a day for three months from what I've read.

[tarnalberry]

1. Blood tests for celiac disease are COMPLETELY useless if you've been gluten free. The test looks for the body's reaction to gluten. If you haven't been consuming gluten, your body won't be reacting to it, and the test won't have a reaction to find, of course. He'd need to consume three slices of bread a day for three months for an accurate blood test at this point.

2. Your doctor was referring to the low total IgA. Basically, what he was saying is that the anti-gliantin and tTg IgA tests that showed low results don't mean anything because your son doesn't produce much of any IgA in the first place, so it would never produce much of those specific ones either. (Again, a moot point since he was gluten free.) A number of celiacs are IgA deficient, however, so this is actually indicative that he could have it.

3. You've seen improvement on the gluten free diet. This is a positive diagnostic result, and one of the most important ones! The question here is whether or not to do a gluten challenge (put him back on gluten for long enough to do the blood work again), or not.

[Collette]

Andrea and Tiffany,

I am so sorry- I forgot to mention that. I put him back on gluten for about 2 1/2 months before the test. I can't say that he ate 3 slices of bread every day however.

So, maybe it isn't accurate?

If he did have enough gluten for the test, what do you all think of the IgA serum results?

My husband and I disagree about whether being gluten free helped him. He does agree that he got sick less often, but perhaps he was just outgrowing his propensity for colds. When he went off gluten I felt his behavior improved slightly, but when he started eating gluten again I'm not sure I noticed that his behavior got worse again.

This is so confusing.

Collette

[AndreaB]

Colette,

I can see how you would be so confused. From what I've read you need to be eating the equivalent of 3-4 slices of bread a day for 3 months for biopsies. If you can swing the money I would highly recommend enterolab (referenced above) to have him tested. You would have a definate answer as to whether he is intolerant or not. The stool tests are very accurate. It could be that he had an allergy that got better with the time he was gluten free, but you won't know that for sure without further testing. The full gluten panel at enterolab is $369, which includes the gene test, IgA, ttg and malabsorption. They were also offering dairy with that panel for no additional charge when we had ours done in May. It would give you something concrete to go off of and put your mind at rest as to whether he was ever intolerant to begin with. The intolerance to gluten starts in the intestines and is quite a bit worse by the time it hits the blood stream. It could be his levels are too low to be detected by the blood draw but he that he still has an active intolerance. My husband, myself and two oldest children got tested by enterolab. All but my husband had active intolerance to gluten with no symptoms. Now, if my daughter gets glutened, she gets a tummy ache; my son doesn't mention anything hurting. My son was just over the intolerance level so that could be why, but he was also the only one with malabsorption. Just something to think about.