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Seeing Doctor Tomorrow- What Tests? Cost?

winter.skadi

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winter.skadi Newbie
winter.skadi
Posted

I was sent this site from a friend, who recently has gone gluten-free. After listening to her, and having a longer talk with some extended family members, I am going to see my doctor tomorrow. I certainly can go into symptoms and whatnot, but I am personally convinced I have hypothroid (mom gma, all 3 aunts on one side, and gma and 3 aunts on the other side are already diagnosed), and at least am gluten sensitive (The amount of auto-immune and GI diseases in my family is staggering). I think the tests will help my husband more than me. He still believes doctors know what they are doing. We've already had the talk about false negatives and such, but I am still going to be tested.

All of that said, I am seeing my doctor tomorrow and I will be having a talk with her about both thyroid and gluten. My head is literally spinning with the alphabet soup of antibodies and test names. I can't even keep straight everything I have read. I am wondering if there is a test that screens for a bunch of things? and what that is called? What I should specifically ask my doctor to test me for...

And, I know no one likes to talk about money, but I have absolutely NO idea what a blood test of any type will cost. They cost somewhere between $65-$140 on average for my dog LOL My insurance says this (to follow) does this mean that diagnostic blood tests are covered, or that they are covered after $1000? (The office is of course closed)

Diagnostic Lab 1

A laboratory test of biological samples, used to assist in the diagnosis of a medical condition.

Additional Information

A diagnostic lab can be either free-standing

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winter.skadi Newbie
winter.skadi
  • Author
Posted

Ok... just to let folks know I made it through the alphabet soup, I think... I found something that was posted in April that said this is what I should ask for

Anti-Gliadin (AGA) IgA

Anti-Gliadin (AGA) IgG

Anti-Endomysial (EMA) IgA

Anti-Tissue Transglutaminase (tTG) IgA

Total Serum IgA

and for the Thyroid a T3 and a T4...

We'll see how it goes today, at least I have been duly warned that my doc will most probably think I am off my rocker.

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SaraKat Contributor
SaraKat
Posted

I am not a Dr or anything, but when I was dx'd with celiac they just did the Anti-Tissue Transglutaminase (tTG) IgA and it came back positive (38). Then the Dr told me I needed the endoscopy to confirm, but she told me that the TTG IGA was like 97% or 98% accurate.

So, I made an appt with the GI Dr and he also wanted to run a celiac blood test, but when I got the print out from that test all he tested was the Total Serum IgA- which for me came back normal. I am not sure why he didn't do the TTG IGA, but I already had it done and it was positive and I was on my way to the endoscopy anyway, so I guess it didn't matter in my case.

I am hypothyroid also and had all these tested for:

Free T4

TSH

Free T3

THY PER AB

THYROGLOB AB

Good Luck!

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Skylark Collaborator
Skylark
Posted

It looks to me like your blood tests will be 100% covered. Your doctor should be able to tell you for sure. The $1000 deductible is on scans.

Your celiac list looks good. For thyroid screening, you want TSH, not T3 and T4. TSH changes first and is the most sensitive test. If the TSH is high, your doctor will order additional thryoid tests to see what's going on.

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      Recently Diagnosed Celiac- Need advice

      By Anmol · Posted

      Thanks this is helpful. Couple of follow -ups- that critical point till it stays silent is age dependent or dependent on continuing to eat gluten. In other words if she is on gluten-free diet can she stay on silent celiac disease forever?    what are the most cost effective yet efficient test to track the inflammation/antibodies and see if gluten-free is working . 
    • trents
      Recently Diagnosed Celiac- Need advice

      By trents · Posted

      Welcome to the community forum, @Anmol! There are a number of blood antibody tests that can be administered when diagnosing celiac disease and it is normal that not all of them will be positive. Three out of four that were run for you were positive. It looks pretty conclusive that you have celiac disease. Many physicians will only run the tTG-IGA test so I applaud your doctor for being so thorough. Note, the Immunoglobulin A is not a test for celiac disease per se but a measure of total IGA antibody levels in your blood. If this number is low it can cause false negatives in the individual IGA-based celiac antibody tests. There are many celiacs who are asymptomatic when consuming gluten, at least until damage to the villous lining of the small bowel progresses to a certain critical point. I was one of them. We call them "silent" celiacs".  Unfortunately, being asymptomatic does not equate to no damage being done to the villous lining of the small bowel. No, the fact that your wife is asymptomatic should not be viewed as a license to not practice strict gluten free eating. She is damaging her health by doing so and the continuing high antibody test scores are proof of that. The antibodies are produced by inflammation in the small bowel lining and over time this inflammation destroys the villous lining. Continuing to disregard this will catch up to her. While it may be true that a little gluten does less harm to the villous lining than a lot, why would you even want to tolerate any harm at all to it? Being a "silent" celiac is both a blessing and a curse. It's a blessing in the sense of being able to endure some cross contamination in social settings without embarrassing repercussions. It's a curse in that it slows down the learning curve of avoiding foods where gluten is not an obvious ingredient, yet still may be doing damage to the villous lining of the small bowel. GliadinX is helpful to many celiacs in avoiding illness from cross contamination when eating out but it is not effective when consuming larger amounts of gluten. It was never intended for that purpose. Eating out is the number one sabotager of gluten free eating. You have no control of how food is prepared and handled in restaurant kitchens.  
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    • trents
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      By trents · Posted

      Welcome to the forum community, @ekelsay! Yes, your tTG-IGA score is strongly positive for celiac disease. There are other antibody tests that can be run when diagnosing celiac disease but the tTG-IGA is the most popular with physicians because it combines good sensitivity with good specificity, and it is a relatively inexpensive test to perform. The onset of celiac disease can happen at any stage of life and the size of the score is not necessarily an indicator of the progress of the disease. It is likely that you you experienced onset well before you became aware of symptoms. It often takes 10 years or more to get a diagnosis of celiac disease after the first appearance of symptoms. In my case, the first indicator was mildly elevated liver enzymes that resulted in a rejection of my blood donation by the Red Cross at age 37. There was no GI discomfort at that point, at least none that I noticed. Over time, other lab values began to get out of norm, including decreased iron levels. My PCP was at a complete loss to explain any of this. I finally scheduled an appointment with a GI doc because the liver enzymes concerned me and he tested me right away for celiac disease. I was positive and within three months of gluten free eating my liver enzymes were back to normal. That took 13 years since the rejection of my blood donation by the Red Cross. And my story is typical. Toward the end of that period I had developed some occasional diarrhea and oily stool but no major GI distress. Many celiacs do not have classic GI symptoms and are "silent" celiacs. There are around 200 symptoms that have been associated with celiac disease and many or most of them do not involve conscious GI distress. Via an autoimmune process, gluten ingestion triggers inflammation in the villous lining of the small bowel which damages it over time and inhibits the ability of this organ to absorb the vitamins and minerals in the food we ingest. So, that explains why those with celiac disease often suffer iron deficiency anemia, osteoporosis and a host of other vitamin and mineral deficiency related medical issues. The villous lining of the small bowel is where essentially all of our nutrition is absorbed. So, yes, anemia is one of the classic symptoms of celiac disease. One very important thing you need to be aware of is that your PCP may refer you to a GI doc for an endoscopy/biopsy of the small bowel lining to confirm the results of the blood antibody testing. So, you must not begin gluten free eating until that is done or at least you know they are going to diagnose you with celiac disease without it. If you start gluten free eating now there will be healing in the villous lining that will begin to take place which may compromise the results of the biopsy.
    • Anmol
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      Hello all- my wife was recently diagnosed with Celiac below are her blood results. We are still absorbing this.  I wanted to seek clarity on few things:  1. Her symptoms aren't extreme. She was asked to go on gluten free diet a couple years ago but she did not completely cut off gluten. Partly because she wasn't seeing extreme symptoms. Only bloating and mild diarrhea after a meal full of gluten.  Does this mean that she is asymptomatic but enormous harm is done with every gram of gluten.? in other words is amount gluten directly correlated with harm on the intestines? or few mg of gluten can be really harmful to the villi  2. Why is she asymptomatic?  3. Is Gliadin X safe to take and effective for Cross -contamination or while going out to eat?  4. Since she is asymptomatic, can we sometimes indulge in a gluten diet? ----------------------------------------------------------------------------------------------- Deamidated Gliadin, IgG - 64 (0-19) units tTG IgA -  >100 (0-3) U/ml tTG IgG - 4   (0-5) Why is this in normal range? Endomysial Antibody - Positive  Immunoglobulin A - 352 (87-352) ------------------------------------------------------------------------------------------------ Thanks for help in advance, really appreciate! 
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