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Follow Up Testing


*lee-lee*

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*lee-lee* Enthusiast

i recently moved to a new town and have not established with a PCP yet (or any other kind of doctor, for that matter). i am going back home in a few weeks for a follow up with my regular doctor. my insurance will be lapsing shortly after the appointment and it could be months before i have coverage again.

i will be 11 weeks gluten free at that point. is it too soon to re-test for antibodies?


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Puddy Explorer

I think the norm is to be tested at 3 months, 6 months and a year, but my dr. retested me after 1 month. When I questioned her about it, she said that if I was doing everything correctly my antibodies would have begun to drop and if I wasn't, she didn't like to wait 3 months to see, because it would be wasting alot of time. And, yes, there was a marked drop in my numbers. I was well over 100 and I dropped to 60 in 4 weeks time. Hope tihs helps.

ravenwoodglass Mentor

It won't hurt and may be informative. If you did not get a base line for your iron, folic acid and vitamin levels at diagnosis you should have her throw that in also. It can be checked at a year to make sure you are absorbing again normally. Throw in a bone density scan too if that wasn't done at diagnosis. No matter what your age.

happygirl Collaborator

From: Open Original Shared Link

Follow-Up Testing

What does follow up testing do?

Follow-up testing is conducted to ensure that antibody levels are returning to normal, indicating that the intestine is healing on the new diet. For this reason, repeat intestinal biopsies are no longer necessary. These tests also indicate the extent to which a celiac is avoiding gluten, and can detect when hidden gluten has entered the diet

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.

What tests are needed to follow up appointments? How are they interpreted?

New guidelines on the diagnosis and treatment of celiac disease by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition state that tTG-IgA testing should be used for follow-up care. Interpreting this test result is straightforward-a celiac on the gluten-free diet should have a negative test. The numerical value of the test is not important.

Follow Up Test #1

tTG-IgA: This test result should be negative

The numerical value of the test doesn't matter as long as the result is negative.

The University of Chicago Celiac Disease Center recommends additional testing, because the tTG test can sometimes be inaccurate in people with autoimmune disorders like Type 1 diabetes and thyroid disease. In addition, the tTG can sometimes become negative before a celiac has actually experienced significant healing.

For these reasons, Anti-Gliadin Antibodies (AGA) are also important. There are two types that need to be run: AGA-IgA, and AGA-IgG. In this circumstance, the numerical values of the tests are very important. The numbers should be as close to zero as possible, indicating a minimal antibody response to gluten. The additional advantage of these tests is that the blood can be drawn by any physician and sent to any laboratory.

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.

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  • Posts

    • RMJ
      It can take longer than 6 months for antibodies to drop to the normal range,  My DGP IgA took a few years as I got stricter and stricter about being gluten free  But having symptoms again could also mean you’re getting some gluten in your diet.
    • TexasCeliacNewbie
      Hi, I just had my 6 month check after being diagnosed Celiac 6 months ago.  All of my panel numbers were normal except: Deamidated Gliadin Abs, IgA (It is 31 with high being over 30)  I have also been having symptoms again. Am I not actually being as careful as I think I am or does it take longer than 6 months for this particular test to come back down?  I can't get ahold of my doctor this week as she is out.     Thank you!
    • Scott Adams
      That is very strange, because it looks to me like two very different test results, but for the same test! It's definitely time to contact your doctor for clarity on this.
    • Redanafs
      Same day which is strange to me. 
    • JForman
      Scott, thank you SO MUCH for this!! She has been through so much in the last three years as we've tried to track down answers. This language will definitely help me help her to reframe.
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