Test Results-Elevated Anti Gliadin

[suzanne*]

Hi everyone. I am new here and know very little about gluten and celiac, but am learning.

I was just tested for celiac this week. The doctor says my results are inconclusive. Here is what I know-

Transglutaminase was normal

anti-gliadin AB IgA was 23 (they said anything over 17 was considered positive)

anti-gliadin IgG was 5 (which is normal, they said)

I am still waiting on the test result for anti-endomysial antibodies.

The doctor said to "Decrease" gluten in my diet, and if I was still having symptoms after that, they would do an endoscopy.

I really, really wish it was a black and white test..what does this mean? I would think that since my anti-gliadin was elevated, then my Transglutaminase would be too, right?

What else could be wrong with me? Will the anti-endomysial test be more definate?

Thanks!

[Roda]

Yes you can have just some of the tests to be elevated. The tTg was the only test that was done originally for me and it was positive. Six months later my tTg was normal but the antigliadin antibodies were still elevated. A year post diagnosis the tTg is still negative as is the IgA antigliadin but my IgG antigliadin was still elevated. I've made some more changes and am going to have the blood work repeated soon. You possibly just haven't had damage to show an antibody reaction. Or you could have a false negative test which is not all that uncommon. If you are wanting to do the endoscopy I would not go gluten lite. I would do the endo while I was still consuming a full gluten diet to make the biopsy as accurate as possible. If you choose to do the endo make sure they take several samples from different areas at least six.

[suzanne*]

Thanks.

Question-if the endo is done to detect damaged villi, why does it matter if you are on a gluten free diet or not? If you have a gluten intolerance or celiac, wouldn't they already be damaged?

[ksymonds84]

Thanks.

Question-if the endo is done to detect damaged villi, why does it matter if you are on a gluten free diet or not? If you have a gluten intolerance or celiac, wouldn't they already be damaged?

When you go fully gluten free your villa tend to heal very quick. It sometimes can take a month or two to get the endoscopy done and your villa could heal in that time giving you a false negative. This could be why he suggested gluten light to you? Most doctors will say to keep eating gluten (equivalent to two slices of bread a day)until the endoscopy to be sure. Keep us all posted and good luck!

[suzanne*]

Thank you. So what does an elevated anti gliadin IgA mean? Doesn't it mean that my body has made some antibodies to gliadin? If that is true, then the only normal test result would be 0 anti gliadin antibodies, right?

Why would my Transglutaminase be totally normal if I have a gluten intolerance problem?

[Mari]

My test results were the same as yours, only the the alpha gliadin was elevated. Instead of letting the Dr do more tests I ordered the genetic DNA marker test. This test showed that I had inherited genes from both of them which put me at risk for gluten problems, one from autoimmune Celiac Disease and the other for non-celiac sprue (Leaky Gut Syndrome, not an autoimmune problem). Having both put me at high risk for developing gluten problems and making the problems more severe. The Molecular Serology test from Prometheus Labs gives similar information. The DNA results and my symptoms and feeling better on a gluten-free diet convinced me to adopt a gluten-free lifestyle. Even a tiny amount of gluten can set off the autoimmune reaction so if you go back to this DR you can print out some information from one of the celiac websites to correct his ideas about gluten.

[Emilushka]

Thank you. So what does an elevated anti gliadin IgA mean? Doesn't it mean that my body has made some antibodies to gliadin? If that is true, then the only normal test result would be 0 anti gliadin antibodies, right?

Why would my Transglutaminase be totally normal if I have a gluten intolerance problem?

The way these tests work, they bind your blood antibodies to a panel of antibodies that they have in stock. It's possible for your antibodies to bind to their panel a little bit, even if you don't actually have antibodies against gliadin. That's why "normal" isn't only zero. Antibodies aren't perfect, and they can bind a little bit to things they're not designed to fight.

Your transglutaminase could be normal if they didn't catch any antibodies against the transglutaminase in the blood sample they drew. That's within reason, and as has been said before, that's why there are so many tests for Celiac. It's not like you need to be positive on all of them for them to be valid. Celiac is very sneaky. It's not an easy disease to catch in action. If you got a positive result, be glad - lots of people on this forum haven't been as lucky but responded to the diet nonetheless.

Best of luck to you. I hope the gluten-free diet brings you relief and good health. Never hesitate to ask questions here. Lots of people are on here with lots of good information to help you.

[nora-n]

Are you sure it was not the new deamidated gliadin test, which some labs call gliadin antibody test? I have seen that some labs do that now. So the testsw can be confused with the very old gliadin antibldy test, which is not so specific for celiac, and only catches about 60% of biopsy proven celiacs if they send blood to labs. The ttg test is much better, and this one is supposed to be even better.

[suzanne*]

I am going gluten-free. How long before I stop having symptoms? I didn't eat any gluten yesterday (first day without it) and I woke up this morning with diarrhea. I am therefore guessing that it takes a while to get the gluten out of your system (or that I am reacting to something else, like dairy?). How long does it take to get it all out and feel better?

[suzanne*]

Are you sure it was not the new deamidated gliadin test, which some labs call gliadin antibody test? I have seen that some labs do that now. So the testsw can be confused with the very old gliadin antibldy test, which is not so specific for celiac, and only catches about 60% of biopsy proven celiacs if they send blood to labs. The ttg test is much better, and this one is supposed to be even better.

I have not seent the results on paper. All I know is the nurse told me it was -

anti gliadin IgA

and

anti gliadin IgG

And gave me two numbers associated with those two tests (23 and 5, respectively)

I can ask them Monday, when my endo-something test will be in.

[suzanne*]

Hi everyone,

I have an update.

All my other celiac tests were normal except the elevated anti-glidin antibodies IgA.

Other tests reveal that I have prediabetes and gallstones. I am going to see a surgeon soon.

I went gluten-free for a week and then ate glutn and feel fine, but that may not have been enough time gluten-free to know.

1. So how long IS long enough? And if I am gluten-free for say, 90 days and then eat gluten again and feel fine, can I then conclude that I CAN eat gluten?

2. Also, with the elevated anti-gliadin antibodies, does a really high elevation mean some one is REALLY intolerant, while a lower elevation means that the person is just slightly gluten intolerant? Is there a continuim? Or does it not matter, and ANY elevation above 17 mean you are gluten intolerant? (mine was 23)

3. Also, if I DO feel fine eating gluten and I KEEP eating it, and I don't have any symtpoms, could the gluten be hurting me , damaging my villi or causing other health problems?

[suzanne*]

Anyone?

[ravenwoodglass]

1. So how long IS long enough? And if I am gluten-free for say, 90 days and then eat gluten again and feel fine, can I then conclude that I CAN eat gluten?

There are folks that are referred to as silent celiacs. If your body is making antibodies it doesn't want gluten. A couple weeks gluten free is not really long enough to heal and you may actually have some symptoms that you are not aware are a part of the gluten picture.

2. Also, with the elevated anti-gliadin antibodies, does a really high elevation mean some one is REALLY intolerant, while a lower elevation means that the person is just slightly gluten intolerant? Is there a continuim? Or does it not matter, and ANY elevation above 17 mean you are gluten intolerant? (mine was 23)

No. Being GI or celiac is like being preggers. You are or you aren't. Some folks are very ill and still show negative on blood work, some have sky high numbers but are not really feeling all that sick.

3. Also, if I DO feel fine eating gluten and I KEEP eating it, and I don't have any symtpoms, could the gluten be hurting me , damaging my villi or causing other health problems?

Yes it would still be hurting you. The damage may not be evident but it is still going on. The antibodies could be attacking your brain, gallbladder, liver, thyroid, lymph system etc. In some cases you might not know you were being damaged until it is too late. Lymphomas being on example of that.

[suzanne*]

13. Also, if I DO feel fine eating gluten and I KEEP eating it, and I don't have any symtpoms, could the gluten be hurting me , damaging my villi or causing other health problems?

Yes it would still be hurting you. The damage may not be evident but it is still going on. The antibodies could be attacking your brain, gallbladder, liver, thyroid, lymph system etc. In some cases you might not know you were being damaged until it is too late. Lymphomas being on example of that.

Is this true of all antibodies? So if someone is allergic to cats, and is around a cat, and therefore their body makes more antibodies, would the anti-cat antibodies possibly attack that person's brain, gallbladder, liver, thyroid, lymph system, etc?

[Emilushka]

Is this true of all antibodies? So if someone is allergic to cats, and is around a cat, and therefore their body makes more antibodies, would the anti-cat antibodies possibly attack that person's brain, gallbladder, liver, thyroid, lymph system, etc?

No, that's luckily not how antibodies work. Just think of how many people you know who are allergic to cats, and none of them have brain or gallbladder disease inflicted by anti-cat antibodies.

[suzanne*]

No, that's luckily not how antibodies work. Just think of how many people you know who are allergic to cats, and none of them have brain or gallbladder disease inflicted by anti-cat antibodies.

Exactly! Then why do THESE antibodies do that? It does not make sense to me that some antibodies would cause brain, liver, etc damage and others are completely benign.

[ravenwoodglass]

Is this true of all antibodies? So if someone is allergic to cats, and is around a cat, and therefore their body makes more antibodies, would the anti-cat antibodies possibly attack that person's brain, gallbladder, liver, thyroid, lymph system, etc?

Celiac is not an allergy it is an autoimmune disease. The reactions are very different. Autoimmune means the body attacks itself where an allergic reaction is a histamine reaction.

[suzanne*]

Celiac is not an allergy it is an autoimmune disease. The reactions are very different. Autoimmune means the body attacks itself where an allergic reaction is a histamine reaction.

I understand that. I am not talking about celiac. I don't have celiac. I am having an immune response to gluten. So if I went ahead and ate gluten for the rest of my life, would I have negative silent health effects? Would my antibodies attack my other organs?

[sb2178]

Well, the antibodies would cause extra inflammation. Chronic inflammation is generally bad, and how it manifests would depend on your vulnerability. I had a ton of joint pain that faded without the gluten exposure. The "brian fog" aka neuro celiac is a typical representation and also recognized as being best diagnosed with AGA rather the EMA/TTG. And, uh, digestive upsets that interfere with absorption are pretty bad for you too.

Nobody has done sufficient following folks with +AGA but negative biopsies etc to be entirely sure of your path. The risk of continuing to eat gluten would be that you have "latent celiac" where you are in the very early stages of developing it. In that case, you may have the anti-TTG antibodies inside your intestines but they have not yet leaked out into your blood. Limited work has been done in that area, so to be on the very safe side, I'd not eat it. If you do, at the very least, have regular celiac panels run and watch for anemia. You could also elect to have genetic testing and plan to eat it if you don't have the commonly recognized genes but avoid it if you do. NOTE: while most celiac patients have those genes, there are a few who do not. It's a game of statistics.

Meanwhile, gotta tell you, my symptoms make me miserable enough to voluntarily avoid it for relief alone. From what I've read, I do think it is a progressive disease. Maybe not everyone goes into the autoimmune form, but I don't think you go from non-reactive to flat intestines and positive bloodwork in three weeks straight.

Now, you do have the right to push for a biopsy based on partially positive bloodwork. If you search, I believe the Mayo clinic diagnosis guidelines calls for a biopsy given positive AGA even if TTG/EMA are negative. While it is unlikely, it is definitely not impossible.