New Here... Would Love Some Help Understanding My Bloodwork

[Gingi]

Hi. Brief history.

In November I tried a new gastroenterologist after years of being told I had IBS. He suspected celiac but my tests came back negative. Had surgery for a relatively rare type of inflammatory polyp. Sometimes the condition is referred to as Solitary Rectal Ulcer Syndrome (just as much fun as it sounds). I am feeling better in some ways but still having significant symptoms.

Because my Transglutaminase IgA Autolabs were borderline (14.36/15), my nutritionist suggested I go gluten-free and thought that I must be gluten intolerant. I've reduced my consumption quite bit but I still do have some slip ups every now and then.

I just redid the celiac panel (10 months later) and once again the test is mostly negative but my "Immunoglobulin A, Qn, Serum" (which wasn't on the last panel) is now positive. What does this mean? I'm honestly unsure as to whether or not I need to be gluten free since my endosmysial Antibody IgA and tTG are both negative. I also have an elevated sedimentation rate. Any suggestions?

Thanks in advance for all of your help.

[cassP]

Hi. Brief history.

In November I tried a new gastroenterologist after years of being told I had IBS. He suspected celiac but my tests came back negative. Had surgery for a relatively rare type of inflammatory polyp. Sometimes the condition is referred to as Solitary Rectal Ulcer Syndrome. I am feeling better in some ways but still having significant symptoms.

Because my Transglutaminase IgA Autolabs were borderline (14.36/15), my nutritionist suggested I go gluten-free and thought that I must be gluten intolerant. I've reduced my consumption quite bit but I still do have some slip ups every now and then.

I just redid the celiac panel (10 months later) and once again the test is mostly negative but my "Immunoglobulin A, Qn, Serum" (which wasn't on the last panel) is now positive. What does this mean? I'm honestly unsure as to whether or not I need to be gluten free since my endosmysial Antibody IgA and tTG and both negative. I also have an elevated sedimentation rate. Any suggestions?

Thanks in advance for all of your help.

14 is NOT a negative or a normal for your Ttg. according to my PCP & GI's ranges- anything about 10 is a positive. and a >4- <10 is a weak positive.

your Iga Serum should be a number within a range- as long as your Iga is between the range- it just means your immune system is normal and your blood panel can be more accurate.

there's other tests as well (Antigliadin Iga/Igg & of course the Biopsies of the Small Intestine)

your Ttg positive could be related to Celiac, or Gluten Sensitivity, or Autoimmune Liver Disease... and im not sure what else.

and i *THINK* i hear that high sedimentation rates have something to do with autoimmune diseases ??? but i might be guessing.

??? if you really want answers- you may want to go back on the gluten for more blood tests & endoscopy.

? OR you may want to try out a gluten free diet- and make sure your doc is ruling out any other possible illnesses.

?? hope my rambling made sense- im sure other members can help too.

[sherrylynn]

14 is NOT a negative or a normal for your Ttg. according to my PCP & GI's ranges- anything about 10 is a positive. and a >4- <10 is a weak positive.

your Iga Serum should be a number within a range- as long as your Iga is between the range- it just means your immune system is normal and your blood panel can be more accurate.

there's other tests as well (Antigliadin Iga/Igg & of course the Biopsies of the Small Intestine)

your Ttg positive could be related to Celiac, or Gluten Sensitivity, or Autoimmune Liver Disease... and im not sure what else.

and i *THINK* i hear that high sedimentation rates have something to do with autoimmune diseases ??? but i might be guessing.

??? if you really want answers- you may want to go back on the gluten for more blood tests & endoscopy.

? OR you may want to try out a gluten free diet- and make sure your doc is ruling out any other possible illnesses.

?? hope my rambling made sense- im sure other members can help too.

A high sed rate shows there is some inflamation somewhere in your body.

I don't know anything about the other stuff. hope that helps.

[Gingi]

Thanks so much for the quick replies. I actually have copies of the labs. Between my GP, GI doc and colo-rectal surgeon I've been needing my records on hand.

The first test showed Transglutaminase IgA Autolabs at 14.36. Normal was considered anything under 15. The nutritionist thought 15 was a rather high cutoff. The most recent test (I've been gluten free for almost a year) was done through a different lab with a range up to 10. This time it was 1. Would going gluten free affect this figure?

I believe you guys are right that sed rate is a general test for inflammation. Back in October I had an endoscopy and sigmoid. My duodenum biopsy didn't suggest celiac (the doc was actually surprised) but other biopsies suggested reflux esophagitis and of course the colon ulceration. The Immunoglobulin A, Qn, Serum (listed as part of the Celiac Panel) did list a range of 70-400 but I was above that range.

Cass-P you were right on about the liver and autoimmune issues. You could have ordered my labs

Because of autoimmune disorders in my family I was tested for autoimmune hepatitis at the same time as the last celiac panel. It was negative. I was also tested for Anti-IgE Receptor Ab because of a history of hives and this was elevated. 36.8 with a range of 0-5. I was told that it means I'm prone to autoimmune hives. Not sure if this has anything to do with celiac or gluten issues or not.

I honestly don't know where to go from here. I'm relatively young and live a healthy lifestyle. Still dealing with significant gastro symptoms and though my symptoms have improved since cutting out gluten I'm still not feeling anywhere near symptom free. I'm just not sure what to do next. Can you guys suggest possible next steps? At what point can I rule out celiac? I'm so ready for a definitive diagnosis that's not IBS.

[Skylark]

Hard to say what the tests mean when your TTG is moving around the normal range of the test. Reference ranges are set by the labs, and partly defined by the variability of the test. A reference range in arbitrary units is not "low" or "high" as you have no way to compare between labs.

Immunoglobulin A, Qn, Serum is total IgA. It means you are not IgA deficient. I don't know what it means if you're above the normal range.

If eating gluten-free helps, why are you trying to get off the diet?

[Gingi]

Skylark- I suppose I'd rather just not eat gluten free if I can get away with it. It's just so much more convenient. Plus I'm one of those lucky people who put on some weight after going gluten-free (and I rarely eat gluten-free specific foods like breads, cookies etc.)

It's hard to tell if I'm feeling better because of the gluten-free diet or just healing post surgery. My main concern though is that I'm still having frustrating gastro symptoms.

BTW you sig lists that you had canker sores. That's so interesting. I used to get the absolute worst ones and have rarely had any since changing my diet.

[ravenwoodglass]

I would stick with the diet strictly if I were you. You have not only had symptom relief but have also seen your TTG go down. I know the diet is inconvient but it seems to have helped you a great deal.

Your continued GI issues could be related to cross contamination if you are not being careful to avoid it. You could also have something else going on so if your continued issues are not traceable to CC in processed foods, restaurants, occasional slipups, sharing cooking equipment or condiments, nut butter, jelly etc do make sure that you have your doctor check things out.

[Looking for answers]

If your GI issues continue, I would also suggest eliminating Soy and Dairy for a while and see how you feel. Those were the two missing pieces for me.

An elevated IGA can mean that you are ingesting other foods you are allergic to as well. I recently had mine tested and it was very high despite my gluten-free and DF diet. The doc ran some allergy tests and turns out I also can't have eggs, highly allergic. I was eating them prior to the test like they were going out of style. Although I didn't really feel the symptoms at the time, since eliminating them, I feel like my immune system is SUPER strong. I can't explain it, just all around I feel very good.

[cassP]

Skylark- I suppose I'd rather just not eat gluten free if I can get away with it. It's just so much more convenient. Plus I'm one of those lucky people who put on some weight after going gluten-free (and I rarely eat gluten-free specific foods like breads, cookies etc.)

It's hard to tell if I'm feeling better because of the gluten-free diet or just healing post surgery. My main concern though is that I'm still having frustrating gastro symptoms.

BTW you sig lists that you had canker sores. That's so interesting. I used to get the absolute worst ones and have rarely had any since changing my diet.

i understand, i toyed around with gluten for years because i never got an official dx.... but i had too many symptoms, and some i'd rather not gross you out with. after i got my gene test back- i was like, ok cassie- you'd have to be stupid to just assume that you can eat gluten for the rest of your life.

your canker sores also suggest celiac or gluten intolerance.

i was gonna say- EVEN IF you never get an official celiac dx- you need to know that Gluten has been a suggested link to IBS, Crohns, Colitis... acid reflux, etc... also Wheat Germ Agglutin can sometimes cause Barret's esophagus.

if you feel better on the diet- you should do it. Celiac is an official dx concerning the autoimmune reaction in the small intestine.... gluten could destroy your colon or stomach without having celiac.... so dont dismiss it yet.

good luck with your journey

[Skylark]

Skylark- I suppose I'd rather just not eat gluten free if I can get away with it. It's just so much more convenient. Plus I'm one of those lucky people who put on some weight after going gluten-free (and I rarely eat gluten-free specific foods like breads, cookies etc.)

It's hard to tell if I'm feeling better because of the gluten-free diet or just healing post surgery. My main concern though is that I'm still having frustrating gastro symptoms.

BTW you sig lists that you had canker sores. That's so interesting. I used to get the absolute worst ones and have rarely had any since changing my diet.

The canker sores do suggest you're gluten intolerant. I always am surprised now when I bite the inside of my mouth and it heals normally. Between that and the slightly elevated TTG it's certainly worth asking a GI about an endoscopy/biopsy. Also, celiac is a process. The high normal TTG and wheat gives you may be signs that you are in the process of developing it. It's so hard to say as the tests are so limited.

If the rest of your trouble is IBS type symptoms you might do well on the Specific Carbohydrate Diet. If it's bloating, reflux, and D, you might be fructose intolerant. It's also not uncommon to have trouble with soy or casein if you have trouble with gluten.