Jump to content

  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.



  • Celiac.com Sponsor (A1):

    Celiac.com Sponsor (A1-M):

  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Test Results 101: Understanding Normal

gfb1

Recommended Posts

gfb1 Rookie
gfb1
Posted

Everybody gets their blood test results back in a haze of unreadable numbers and words. For all the cost, you'd think that the labs would invest in some decent printers, a legible font and maybe even a decently designed graphic (or two) -- [more on this to follow]. There is no reason that any person who can successfully navigate a newspaper or website should have trouble reading the results of a blood test panel.

To begin: what the hell is 'normal'??

as a good friend always reminds me:

there is no such thing as normal

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


70SS396 Newbie
70SS396
Posted

I'd be interested in hearing more. :)

JennyC Enthusiast
JennyC
Posted

There is a ton of QC done in the lab, and there is not as much variability as one might think. Proficiency tests are frequently done in which samples of unknown concentrations are sent to the lab and the results the lab gets must be within a certain range of the absolute value of the samples. QC is done with each new reagent lot and also with each instrument run. Certain reagents like UA test strips, antibodies, and enzymes have QC performed at the beginning of each shift. Labs are very careful to complete these practices, as they will have many problems with the joint commission, CAP, etc if they fail to comply and they would be at risk of losing their certification/accreditation. There are also defined criteria for tests (like what constitutes a 4+ white blood cell count on a specimen site slide), so they leave very little up for interpretation. Labs work very hard to ensure that their results are accurate and precise.

Serversymptoms Contributor
Serversymptoms
Posted

17 years old

I went on a gluten free diet before my blood test ( I was so far about 2 weeks gluten free). I got a phone call from the doctor ( after my mom question the hospital if results have came back since I've been concern about it) stating that the results were normal. My next appointment, my doctor was absent due to her plane arrival late in New York, the nurse remention the test results after overlooking my profile... when I ask could I review the results, she refused and the nurse and my mom explain that it was normal. I don't understand why I can't see the results, as I've told my mom that your usually allowed to see test results done on your blood. Reasons?

Well I'm about 90% sure I'm gluten intolerance, and I also think there is something wrong with my thyroid. I have all plus more symptoms of thyroid problems, along with coarse hair, skin condition around neck, dehydration, throat clicking (sometimes, but can easily make this clicking noise with my throat), neck pain/ stiffness and more....

Mother of Jibril Enthusiast
Mother of Jibril
Posted

This week I learned that it also pays to know which tests can be a little abnormal and still "no big deal" and which ones are a big deal when they go out of range. For example... if your liver enzymes are elevated a few points, no big deal. Once creatinine and BUN go out of range it means your kidneys are functioning at less than 40% capacity... stage 3 kidney disease (stage 5 means you need dialysis or a transplant). The reason the ranges are so wide is because mild kidney disease is pretty common in this country, thanks to the the high rates of diabetes, high blood pressure, and autoimmune disorders. Just being one or two standard deviations away from the norm doesn't always mean you're safe! Not everything fits into a neat little statistical bell curve where 90% of people are "normal" and the other 10% are not.

gfb1 Rookie
gfb1
Posted
  • Author
There is a ton of QC done in the lab, and there is not as much variability as one might think. Proficiency tests are frequently done in which samples of unknown concentrations are sent to the lab and the results the lab gets must be within a certain range of the absolute value of the samples. QC is done with each new reagent lot and also with each instrument run. Certain reagents like UA test strips, antibodies, and enzymes have QC performed at the beginning of each shift. Labs are very careful to complete these practices, as they will have many problems with the joint commission, CAP, etc if they fail to comply and they would be at risk of losing their certification/accreditation. There are also defined criteria for tests (like what constitutes a 4+ white blood cell count on a specimen site slide), so they leave very little up for interpretation. Labs work very hard to ensure that their results are accurate and precise.

absolutely.

way back; when i was helping to develop an analytical/clinical lab for hoffman-laroche (to assay dinosaur blood samples.... ) the linear portion of the standard curve had to have an R^2 value of 0.9999 (as in 99.99%). techniques have gotten better since the abacus, and using modern QC, the PRECISION of the assays might be 10-100 times better than that. the big 'BUT' in the room (ok, another bad joke i'll leave for another time) is that while the chemistry works, it is the biology that provides the variation.

there is no getting around statistical distributions.

gfb1 Rookie
gfb1
Posted
  • Author
This week I learned that it also pays to know which tests can be a little abnormal and still "no big deal" and which ones are a big deal when they go out of range. For example... if your liver enzymes are elevated a few points, no big deal. Once creatinine and BUN go out of range it means your kidneys are functioning at less than 40% capacity... stage 3 kidney disease (stage 5 means you need dialysis or a transplant). The reason the ranges are so wide is because mild kidney disease is pretty common in this country, thanks to the the high rates of diabetes, high blood pressure, and autoimmune disorders. Just being one or two standard deviations away from the norm doesn't always mean you're safe! Not everything fits into a neat little statistical bell curve where 90% of people are "normal" and the other 10% are not.

yes indeed. the biology is certainly the fun part!

based on my (very loose) plan for these little posts, i hope to discuss your last 2 statements in post #3. clinical labs and diagnosis have a very cozy, yet (imho) uncomfortable relationship. on the one hand, doctors make diagnoses based on the normal curve. yet for the individual being tested they are either sick or not. and, as we've all learned on the 'celiac bus', being sick and misdiagnosed stinks.

i certainly hope your 'learning' experience was not too painful and that you are well.

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


Mother of Jibril Enthusiast
Mother of Jibril
Posted
i certainly hope your 'learning' experience was not too painful and that you are well.

Yes. Thankfully I learned this lesson while my labs were still "normal." In a couple of weeks I'm having some more tests to figure out if the persistent protein and leukocytes in my urine are truly "no big deal" or something to watch carefully. Meanwhile... I'm feeling pretty good :) Doing my best not to end up on the "sick and misdiagnosed" wagon again.

I look forward to your upcoming posts!

Archived

This topic is now archived and is closed to further replies.

Go to topic listing
  • Celiac.com Sponsor (A19):


  • Member Statistics

    • Total Members
      131,680
    • Most Online (within 30 mins)
      7,748
    ashley94261
    Newest Member
    ashley94261
    Joined
  • Celiac.com Sponsor (A20):

  • Forum Statistics

    • Total Topics
      121.4k
    • Total Posts
      1m
  • Celiac.com Sponsor (A22):



  • Celiac.com Sponsor (A21):


  • Upcoming Events

  • Posts

    • Rejoicephd
      Draft gluten-free ciders… can they be trusted ?

      By Rejoicephd · Posted

      That and my nutritionist also said that drinking cider is one of the worst drink choices for me, given that I have candida overgrowth.  She said the combination of the alcohol and sugar would be very likely to worsen my candida problem.  She suggested that if I drink, I go for clear vodka, either neat or with a splash of cranberry.   So in summary, I am giving ciders a rest.  Whether it's a gluten risk or sugars and yeast overgrowth, its just not worth it.
    • Inkie
      Tea Bags and Gluten

      By Inkie · Posted

      Thank you for the information ill will definitely bring it into practice .
    • Scott Adams
      Tea Bags and Gluten

      By Scott Adams · Posted

      While plain, pure tea leaves (black, green, or white) are naturally gluten-free, the issue often lies not with the tea itself but with other ingredients or processing. Many flavored teas use barley malt or other gluten-containing grains as a flavoring agent, which would be clearly listed on the ingredient label. Cross-contamination is another possibility, either in the facility where the tea is processed or, surprisingly, from the tea bag material itself—some tea bags are sealed with a wheat-based glue. Furthermore, it's important to consider that your reaction could be to other substances in tea, such as high levels of tannins, which can be hard on the stomach, or to natural histamines or other compounds that can cause a non-celiac immune response. The best way to investigate is to carefully read labels for hidden ingredients, try switching to a certified gluten-free tea brand that uses whole leaf or pyramid-style bags, and see if the reaction persists.
    • Scott Adams
      Inconclusive results

      By Scott Adams · Posted

      This is a challenging and confusing situation. The combination of a positive EMA—which is a highly specific marker rarely yielding false positives—alongside strongly elevated TTG on two separate occasions, years apart, is profoundly suggestive of celiac disease, even in the absence of biopsy damage. This pattern strongly aligns with what is known as "potential celiac disease," where the immune system is clearly activated, but intestinal damage has not yet become visible under the microscope. Your concern about the long-term risk of continued gluten consumption is valid, especially given your family's experience with the consequences of delayed diagnosis. Since your daughter is now at an age where her buy-in is essential for a gluten-free lifestyle, obtaining a definitive answer is crucial for her long-term adherence and health. Given that she is asymptomatic yet serologically positive, a third biopsy now, after a proper 12-week challenge, offers the best chance to capture any microscopic damage that may have developed, providing the concrete evidence needed to justify the dietary change. This isn't about wanting her to have celiac; it's about wanting to prevent the insidious damage that can occur while waiting for symptoms to appear, and ultimately giving her the unambiguous "why" she needs to accept and commit to the necessary treatment. This article might be helpful. It breaks down each type of test, and what a positive results means in terms of the probability that you might have celiac disease. One test that always needs to be done is the IgA Levels/Deficiency Test (often called "Total IGA") because some people are naturally IGA deficient, and if this is the case, then certain blood tests for celiac disease might be false-negative, and other types of tests need to be done to make an accurate diagnosis. The article includes the "Mayo Clinic Protocol," which is the best overall protocol for results to be ~98% accurate.    
    • Scott Adams
      Medication

      By Scott Adams · Posted

      Welcome to the community! Generally, for a gluten challenge before celiac disease blood tests, Tylenol (acetaminophen) is considered safe and should not interfere with your antibody results. The medications you typically need to avoid are those like ibuprofen (Advil, Motrin) or naproxen (Aleve) that can cause intestinal irritation, which could potentially complicate the interpretation of an endoscopy if you were to have one. However, it is absolutely crucial that you confirm this with either your gastroenterologist or your surgeon before your procedure. They know the specifics of your case and can give you the definitive green light, ensuring your surgery is comfortable and your celiac testing remains accurate. Best of luck with your surgery tomorrow
×
×
  • Create New...

Important Information

NOTICE: This site places This site places cookies on your device (Cookie settings). on your device. Continued use is acceptance of our Terms of Use, and Privacy Policy.