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My Blood Panel Results Are In...


steve-o

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steve-o Apprentice

Well, I finally saw my doctor today to get the results of my blood panel. I'm sure lots of other people have similar confusing results, so I wanted to share my experience and insight:

I had an IGA Anti-Gliadin antibody reading of 53 (over 25 is high), but my TTG was only 3, which is a low/negative number.

My biopsy was also negative, BUT....he only took one tissue sample, so I don't have a lot of faith in the scientific value of this result, given that damage to the villi can be patchy, and all the literature I've read says that you must take multiple tissue samples to avoid sampling error.

The doctor said this means I don't have celiac disease. He said although the Anti-Gliadin AB is high, this doesn't necessarily mean I have celiac. (I didn't think to ask him at the time...but I'm kind of curious, why do they bother doing this test if the results don't mean anything?)

I asked if this means I have a gluten intolerance, that hasn't gotten so bad that it's damaged the villi yet. His reponse was that you either have it, or you don't....there's no degrees of gluten intolerance.

But then he said my symptoms before going gluten free were classic celiac...and the improvements I've seen since being gluten free for the past month, are exactly what he would expect to see from somebody who was recovering/recently started the gluten-free diet. He said there are "subclinical" cases of celiac, and that I may be one of those cases. His recommendation was to stay gluten free for a few more weeks, and then slowly try reintroducing gluten into my diet. If I have reactions to it again, I can probably take this as "evidence" that I need to avoid gluten.

I guess the point (which most of you already know all too well) is that in the end, you need to just listen to your body. Blood tests and biopsies aren't perfect, and if your body is telling you that it doesn't play well with gluten...you should always listen to what your body tells you, regardless of what the tests/doctors say.


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LaurieAnn13 Newbie

When my doctor diagnosed me, it was only with the blood tests. My levels came back indicating celiac, I never had a biopsy. I responded really well to the gluten-free diet and I just went with that, as you said...your body knows best!!

Good luck!

Laurie

rmmadden Contributor

My experience with celiac disease and going to the Doctor is that I have come to learn what an un-exact science medicine is. I always thought with all the technology etc. that medicine was more specific in its diagnosis and treatments....Wrong. This seems especially true when dealing with celiac disease!

Your best bet is to listen to what your body is telling you because nobody knows you like you do.

Best of Luck!

Cleveland Bob B)

celiac3270 Collaborator

I think your physician is about 1/2 right on this one.

An AGA IgA definitely is not enough for a diagnosis. The Anti-Gliadin tests are not very accurate at all. The tTG is the best serological test out there right now, followed by the EMA. A negative biopsy and a negative tTG would be grounds for saying no celiac. However, one sample is not going to work...the biopsy is worthless with only one sample.

What I would suggest is this: get a gene test. This will tell you if you can or cannot have celiac. If you have neither the HLA-DQ2 or HLA-DQ8, you cannot have celiac, and you can rule out celiac altogether. If you have either of the genes, then you should probably have an EMA and another endoscopy, making sure that they take multiple samples.

The part that I think is 1/2 wrong is that you can't have celiac. There is inadequate testing to rule it out altogether, because the tTG, though important, isn't the only way to diagnose or...not diagnose.

Guest nini

I agree that listening to your body is very important...

I also believe that gluten is toxic for way more people than just those predisposed to celiac through genetics.

Listen to your body, if it's telling you gluten is bad for you then by all means stay away from gluten!

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    • trents
      Let me hasten to add that if you will be undergoing an endoscopy/biopsy, it is critical that you do not begin efforts to reduce gluten beforehand. Doing so will render the results invalid as it will allow the small bowel lining to heal and, therefore, obscure the damage done by celiac disease which is what the biopsy is looking for.
    • Scott Adams
      This article, and the comments below it, may be helpful:    
    • Scott Adams
      That’s a really tough situation. A few key points: as mentioned, a gluten challenge does require daily gluten for several weeks to make blood tests meaningful, but negative tests after limited exposure aren’t reliable. Dermatitis herpetiformis can also be tricky to diagnose unless the biopsy is taken from normal-looking skin next to a lesion. Some people with celiac or DH don’t react every time they’re exposed, so lack of symptoms doesn’t rule it out. Given your history and family cancer risk, this is something I’d strongly discuss with a celiac-experienced gastroenterologist or dermatologist before attempting a challenge on your own, so risks and benefits are clearly weighed.
    • Greymo
      https://celiac.org/glutenexposuremarkers/    yes, two hours after accidents ingesting gluten I am vomiting and then diarrhea- then exhaustion and a headache. see the article above- There is research that shows our reactions.
    • trents
      Concerning the EMA positive result, the EMA was the original blood test developed to detect celiac disease and has largely been replaced by the tTG-IGA which has a similar reliability confidence but is much less expensive to run. Yes, a positive EMA is very strong evidence of celiac disease but not foolproof. In the UK, a tTG-IGA score that is 10x normal or greater will often result in foregoing the endoscopy/biopsy. Weaker positives on the tTG-IGA still trigger the endoscopy/biopsy. That protocol is being considered in the US but is not yet in place.
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