Low Iga Serum? And Lab Results For Other Tests

[EmmaFrost]

I have been on a gluten-free diet for a couple months. I am desperate to feel better so I decided the best way to determine if I had an issue with Gluten was to not eat it and see if I feel better. I will admit that I am losing faith in the Drs. I am currently taking B12 injections for B12 deficiency as well as Vitamin D for Vitamin D deficiency. I have been in and out of the Dr's for back pain and hip pain for over 20 years. I am now 43 and I've had horrible lower back pain and hip pain which has gotten progressively worse over time and I have MRI's which show degenerative disc disease. I had surgery last year for a moderately herniated disc in lower back and since the surgery I actually feel worse. It was during the recovery period when I found out that I was deficient in B12 and Vitamin D. I was also diagnosed with iron deficieny many times. I have alot of symptoms that I think may be indicative of Gluten intolerance or Gluten allergies and I was not aware of what exactly Celiacs disease was until I went to see a GI Dr. recently who ran a couple blood tests on me and then I started researching exactly what Celiacs was. Debilitating fatigue, joint pain, mostly my spine and hip, neuropathy hands and feet, foggy brain, infertility for many years, cysts and ovarian tumors, skin rash that no one seems to be able to diagnose why I get it or what exactly it is..b12 seemed to help with neuropathy. The skin rash I get a few times a years looks very similar to DH pictures I've seen. I get itchy bumps that eventually scab over and then leave scars. In any event, I don't think the GI Dr. ran all of the tests needed so I went to my family Dr. and he ran some additional tests and now I am attempting to intepret because they are telling me that it is negative for Gluten intolerance/allergy. I would just like some additional assurance and I know that no one here is a Dr. Can someone please tell me if I should pursue this further by the following results?:

For the first test I was gluten-free for a few weeks:

03/30/10

Tissue Transglutaminase AB IGA <3 u/mL (<5)

Reference range <5 U/mL Negative

IGA, Serum 71 mg/dL*

Reference range (81-463)

Tissue Transglutaminase AB IGG <3 U/mL

Reference range <7 U/mL Negative

I was also gluten-free for this test:

Gliadin AB IGG 5

Normal Range <11

Gliadin AB IGA <3

Normal Range <11

IGA Serum 83 mg/dL Normal Range 81-463

IGG Serum 907 mg/dL Normal Range 694-1618

IGM Serum 257 mg/dL Normal Range 48-271

IGE Serum 21 kU/L Normal Range 0-114

IGD Serum 15 mg/L Normal Range <179

IGG 1 517 mg/dL Normal Range 382-929

IGG 2 223 mg/dL(abn:L) Normal Range 241-700

IGG 3 77 mg/dL Normal Range 22-178

IGG 4 8.9 mg/dL Normal Range 4.0-86.0

IGG Total 870 mg/dL Normal Range 723-1685

He also ran a full blood panel and the only thing off which has showed consistently off in my blood tests is MCH which is 34.5 and range is 27-33. My Red Blood Cell Count is 3.84 Million/uL Normal Range is 3.8-10.8. MCV is 100 fL and Normal is 80-100.

Thanks in advance for anyone who has a chance to look it over. Not sure any of the blood panel work is relevant. Since I've been taking the B12 injectible and D my levels are now within the normal range on the labwork. B12 is above higher range now and Vitamin D is 40 with normal range of 20-100.

[mushroom]

Hi, and welcome to the forum.

Has none of your doctors told you that you need to be consuming gluten for a valid celiac blood test??? Tests run when you are gluten free have no meaning because in order to make the antibodies which the tests measure, you must be consuming the gluten which triggers antibody production. No gluten = no antibodies.

That being said, there is one test result of interest, the first total serum IGA, a test run as a control, was abnormally low. This in and of itself can also invalidate the testing, because if you are a low antibody producer the other results are unreliable. So on both counts you cannot trust these results.

Unfortunately, your test results have not provided you with any information about how you respond to gluten. At this point I don't even know what to suggest. How has the gluten free diet worked for you, symptom wise? And are you sure you have eliminated ALL the gluten, because it is a master of disguise thanks to the food processors and their labelling??

It must be frustrating after all these years to be not farther ahead. Have you had a bone density scan?

I am hoping others will have some more ideas for you.

P.S. If you still have any active DH-type lesions, you could have a biopsy done of the skin adjacent to the lesion, looking for antibodies. Or you could perhaps resume gluten until one appeared that you could have biopsied. Your lesions certainly sound like they could be DH is they leave a scar.

[frieze]

the IgA is certainly suspect....the MCV is still on the high side, i would try methylcobalamin by mouth on top of the shots....the D could be higher also....normal lab values are often skewed low....off topic, but you might want to check out the relationship between low IgG2 and influenza A, at least the swine flu of last year....good luck

[mushroom]

the IgA is certainly suspect....the MCV is still on the high side, i would try methylcobalamin by mouth on top of the shots....the D could be higher also....normal lab values are often skewed low....off topic, but you might want to check out the relationship between low IgG2 and influenza A, at least the swine flu of last year....good luck

I agree with frieze - MCV is often overlooked by doctors if it is just slightly high. Mine went back to normal with B12 and folate. And you need to be mid-range on D to really feel good. The sublingual B12 is a good idea, and although I can't see your post right now, you probably need to up your D. Try taking the folate too, or a good strong B complex.

[EmmaFrost]

I agree with frieze - MCV is often overlooked by doctors if it is just slightly high. Mine went back to normal with B12 and folate. And you need to be mid-range on D to really feel good. The sublingual B12 is a good idea, and although I can't see your post right now, you probably need to up your D. Try taking the folate too, or a good strong B complex.

Thanks soo much for your replies! I've felt slightly better on the gluten-free diet, but I suspect I've unintentionally ate it because as you said it's in everything. I've not been feeling well for years, so perhaps it will take that long to feel better of the Gluten. As for the low IGA serum blood test, I do not understand why the Dr(s) wouldn't see the IGA serum value as a red flg if that is the control. So your saying that besides my not eating gluten then, my IGA serum level in and of itself even if I was not on gluten-free diet can cause a false negative? When the GI Dr. intially mentioned testing for Celiacs, my first thought was I don't have diarreah so it was waste of time. This was before I knew it was not the only symptom and not necessararily always a symptom since as of late I have the opposite issue. While I do not want it to be Celiacs, at this point I want an answer. While eating gluten-free is tough and I commend everyone who can adhere to such a diet with all the gluten in diguise, it's everywhere in everything, changing my diet is small price to pay if that will make me feel better. I'm leaning towards the DNA/Genetics test. While I know that a positve result only means predisposition at least with a negative I will know for sure I don't have it right?

While I also hear the "Gold" standard for diagnosing Celiacs disease is the biopsies, at this point I am not willing to put myself through any sort of procedure that requires anesthisia or going under the knife again anytime soon because I just don't feel healthy enough and it doesn't seem like it's 100% accurate in every case. I've had quite a hard time recovering from the back surgery which I had LAST APRIL 2009 (microdisectomy). I was required to go to Physical Therapy both before and after and I felt soo tired and weak I had a difficult time just making it to the appointments, let alone getting on a treadmill and doing pushup and situps and yoga exercises. In 2006 I had a C-Section and had a son, rough recovery as well and the fertility treatments which resulted in the pregnancy were stressful and exhausting, but he is the best thing that ever happened to me so well worth it I had nauseau and puked my entire pregnancy and was miserable, ironic my staple food was crackers/bread, bread & wheat thins my all time favorite. Prior to that in 2004 I went in for a diagnostic laparascopy, about the 6th laparascopic surgery over the years after being plagued with ovarian cysts, tubal pregnancies and fertility issues. I woke up to find out they had to do a laparatomy and remove one of my ovaries due to a tumor that had enveloped the ovary. I had a super tough time recovering from that surgery . I had other invasive procedures when they were looking at my tubes and uterus, they never found anything to explain the ectopic pregnancies. I suspect I had other early losses. In the end I probably wouldn't haven't minded all the invasive procedures if I had felt healthier and if they actually found something, a reason or firm diagnosis.

I have 4 sisters and a brother, no problems getting pregnant that I know of. My family is not a family that goes to the Dr.'s much but I know for sure at least 3 of my sisters have had B12, vitamin D and iron deficiency at one time or another, one at least with diverticulosis, maybe more. My brother has been sick for years, looks like he is wasting away, plagued with GI issues, hiatel hernia, ulcers and migraines (cluster headaches) and he has asthma. He is now estranged from our family, went through a horrible divorce and from what I understand has been in and out of the ER and hospital for the aforementioned health issues, seems he maybe having some mental health issues based on temper the last couple years. My mom and dad both have arthritis, mom had knee surgery and a knee replacement surgery, high blood pressure and has various allergies and hive reactions to alot of things, but never been tested as she does not like going to the Dr.'s. 2 of her sisters passed recently, one from breast cancer and leukemia the other suddenly from agressive pancreatic cancer, not sure about her brother that passed. Her mother died at 32, mengitis I THINK?? I'm sure there is more I don't know since there were 6 kids and they were raised in orphanage.

Sorry so long, ironic your comment about B12 and D since my Dr. thinks my levels are great now and told me to back off. I'm not inclined to do so since my clinical symptoms don't seem to match what he is saying at all. B12 helped with neuropathy so far, that's it.

I'm wondering if it would be a waste of my money to have the DNA test run for Celiacs. Not sure I can get Dr. to order since I'm sure he or insurance may require biopsy first, which as I said I just can't go through right now until I feel a bit healthier. As for bumps, I had a biopsy in 2003 and I called to see if they still had the lab results and they are somewhere in a box and I suspect they were not specifically looking for DH. I think I figured out that if they are DH what causes them for me, gluten and seafood (shrimp/lobster/crab) because I just started eating the seafood last 8 years and really only eat at the beach which is when I get bumps. From what I undertand, iodine is the catalyst along with gluten. Always thought it was the suntan lotion. $375 for the genetic test from kimball labs.

[EmmaFrost]

I agree with frieze - MCV is often overlooked by doctors if it is just slightly high. Mine went back to normal with B12 and folate. And you need to be mid-range on D to really feel good. The sublingual B12 is a good idea, and although I can't see your post right now, you probably need to up your D. Try taking the folate too, or a good strong B complex.

One more thing is I looked back over blood work from a few years back and MCV is always running on the high end. I had the B12 prescribed after low results and elevated methymalonic acide and Vitamin D was a whopping 15 at the time, 25-OH, D3 15 and 25-OH, D2 <4 was the breakdown. Now it's 10 and 30, total 40 for D so I guess that looks good to my Dr. considering where I started.