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High Transglutaminase


trishatrue

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trishatrue Rookie

Help! My daughter was diagnosed with Celiac 6 months ago and had followed a strict diet since. Recent blood results indicate that transglutaminase has increased instead of decreasing. Her doctor insists she has not been honest about her diet. I vehemently disagree, as she and I read everything that goes in her lips and on her body and we are extremely careful concerning cross-contamination. I need help! Has anyone had a similar experience? Is there another disease that could cause hight translutaminase to be present?

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cruelshoes Enthusiast

There are other conditions that can cause an elevated tTg reading, including Type 1 Diabetes, Hashimoto

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trishatrue Rookie
There are other conditions that can cause an elevated tTg reading, including Type 1 Diabetes, Hashimoto
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cruelshoes Enthusiast

I don't know enough about refractory celiac to comment about that. I did find this, however:

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Refractory celiac disease. For the purpose of this review, patients with refractory celiac disease are patients with true celiac disease and villous atrophy (i.e., not a misdiagnosis) who do not, or no longer, respond to a GFD. Although the most common reason for failure to respond to a GFD is dietary indiscretion or unknown exposure to gluten, refractory celiac disease also occurs in patients on a GFD who have developed a complication such as ulcerative-jejunoileitis, or enteropathy-associated lymphoma. Patients with refractory celiac disease do not necessarily have positive serology for celiac disease. Refractory celiac disease was reviewed in the context of the requested objectives.

I know you said you have already done this, but I would go back again and triple check everything that goes on or in her body. This includes food, supplements, OTC and prescription medications, shampoo, hand lotion, etc. Gluten can hide in the darndest places. Do you have any gluten in the home at all? Would you be willing to make your home totally gluten-free for a few months to see if it made any difference? CC is so hard to track down sometimes, and some people are extremely sensitive to it.

I would also ask the doctor to run the Anti Gliadin antibodies. This is another tool in determining dietary compliance. Maybe it would tell a different story than the TtG.

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How often should follow-up testing occur?

New celiacs should receive follow-up testing twice in the first year after their diagnosis. The first appointment should occur three to six months after the diagnosis, and the second should occur after 1 year on the gluten-free diet. After that, a celiac should receive follow-up testing on a yearly basis.

.....

Follow Up Test #1:

tTG-IgA: This test result should be negative

The numerical value of the test doesnt matter as long as the result is negative.

Follow Up Test #2

Anti-gliadin IgA: This result should have a very low negative value

In this case, the numerical value does matter, because a high negative test result still indicates that a patient is eating gluten. A low negative indicates that the diet is working well.

.

I truly hope you get to the bottom of things soon.

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trishatrue Rookie
I don't know enough about refractory celiac to comment about that. I did find this, however:

Open Original Shared Link

I know you said you have already done this, but I would go back again and triple check everything that goes on or in her body. This includes food, supplements, OTC and prescription medications, shampoo, hand lotion, etc. Gluten can hide in the darndest places. Do you have any gluten in the home at all? Would you be willing to make your home totally gluten-free for a few months to see if it made any difference? CC is so hard to track down sometimes, and some people are extremely sensitive to it.

I would also ask the doctor to run the Anti Gliadin antibodies. This is another tool in determining dietary compliance. Maybe it would tell a different story than the TtG.

Open Original Shared Link

I truly hope you get to the bottom of things soon.

Thank you for the advice. I spent my weekend going over everything in my cupboard's (kitchen & bath) that she consumes and I found a hair product she uses with her hair straightener, mascara, and hand lotion she had in her locker at school. My question is: since these products are not digested, can they elevate her TtG? She does not suffer from any rashes or apparent complications from them (actually, she is completely asymptomatic except for extreme osteopenia that has caused bone deformity in her legs; it took 3 years to figure out it was celiac causing this). Regardless, they have gone in the garbage, as will the rest of the products in my home if it compromises my daughters health.

We did have her blood re-drawn yesterday to confirm the previous results. I wish they had suggested the Anti Gliadin test as well! However, if the results are the same we will ask for it.

I am grateful for your help. Thank you.

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    • trents
      But if you have been off of wheat for a period of weeks/months leading up to the testing it will likely turn out to be negative for celiac disease, even if you actually have celiac disease. Given your symptoms when consuming gluten, we certainly understand your reluctance to undergo  the "gluten challenge" before testing but you need to understand that the testing may be a waste of time if you don't. What are you going to do if it is negative for celiac disease? Are you going to go back to merrily eating wheat/barley/rye products while living in pain and destroying your health? You will be in a conundrum. Do I or do I not? And you will likely have a difficult time being consistent with your diet. Celiac disease causes inflammation to the small bowel villous lining when gluten containing grains are consumed. This inflammation produces certain antibodies that can be detected in the blood after they reach a certain level, which takes weeks or months after the onset of the disease. If gluten is stopped or drastically reduced, the inflammation begins to decrease and so do the antibodies. Before long, their low levels are not detectable by testing and the antibody blood tests done for diagnosing celiac disease will be negative. Over time, this inflammation wears down the billions of microscopic, finger-like projections that make up the lining and form the nutrient absorbing layer of the small bowel where all the nutrition in our food is absorbed. As the villi bet worn down, vitamin and mineral deficiencies typically develop because absorption is compromised. An endoscopy with biopsy of the small bowel lining to microscopically examine this damage is usually the second stage of celiac disease diagnosis. However, when people cut out gluten or cut back on it significantly ahead of time before the biopsy is done, the villous lining has already experienced some healing and the microscopic examination may be negative or inconclusive. I'm not trying to tell you what to do I just want you to understand what the consequences of going gluten free ahead of testing are as far as test results go so that you will either not waste your time in having the tests done or will be prepared for negative test results and the impact that will have on your dietary decisions. And, who are these "consultants" you keep talking about and what are their qualifications? You are in the unenviable position that many who joint this forum have found themselves in. Namely, having begun a gluten free diet before getting a proper diagnosis but unwilling to enter into the gluten challenge for valid testing because of the severity of the symptoms it would cause them.
    • Zackery Brian
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    • Fluka66
      Thank you very much for your reply. I hadn't heard of celiac disease but began to notice a pattern of pain. I've been on the floor more than once with agonising pain but this was always put down to another abdominal problem consequently I've been on a roundabout of backwards and forwards with another consultant for many years. I originally questioned this diagnosis but was assured it was the reason for my pain. Many years later the consultant gave up and I had a new GP. I started to cut out certain food types ,reading packets then really started to cut out wheat and went lactose free. After a month I reintroduced these in one meal and ended screaming in agony the tearing and bloating pain. With this info and a swollen lymph node in my neck I went back to the GP.  I have a referral now . I have also found out that acidic food is causing the terrible pain . My thoughts are this is irritating any ulcers. I'm hoping that after a decade the outlook isn't all bad. My blood test came back with a high marker but I didn't catch what it was. My GP and I have agreed that I won't go back on wheat just for the test due to the pain , my swollen lymph node and blood test results.  Trying to remain calm for the referral and perhaps needed to be more forceful all those years ago but I'm not assertive and consultants can be overwhelming. Many thanks for your reply . Wishing you all the best.
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    • knitty kitty
      @Spacepanther, I found these articles about the connection between Celiac and joint pain. Musculoskeletal Complications of Celiac Disease: A Case-Based Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10201087/ And   Intestinal microbiome composition and its relation to joint pain and inflammation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814863/ And The gut microbiome-joint connection: implications in osteoarthritis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6903327/ Sounds like it's time to change the diet to change the microbiome.
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