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Blood Test Positive...100% Accurate?


amcouch

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amcouch Newbie

Hello, last week I had a blood test for celiacs and got a letter today stating that "according to the blood work you do have celiac disease". It also said they scheduled a follow up appt with a GI specialist for a treatment plan.

I have 2 questions: is it possible to have a false blood test? Or does this confirm I have the disease? Second, I've been on a gluten free diet for 1 week. It seems like from what I've read that the GI doctor will want to do a biopsy? Am I correct that this is the next step or is the blood work enough to confirm? My appointment isn't until the end of November. Should I go back to eating gluten in case more testing is needed? Thank you!


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psawyer Proficient

False negatives are common. False positives are rare.

If a biopsy is planned, you need to continue to eat gluten on a daily basis until after the procedure.

Some doctors will now diagnose based on positive blood results alone; others won't until a biopsy shows damage to the villi.

It seems that in the early stages of the disease, the blood will show the antibodies before the damage to the small intestine shows up.

amcouch Newbie

Thank you! I'm so glad I found this forum! Of course I get the blood results in the mail on a Saturday morning and have no idea what they mean. Anyone know how to interpret this?

T-Transglutaminase IGA AB >100.0 (H)

Help!

Roda Rising Star

Thank you! I'm so glad I found this forum! Of course I get the blood results in the mail on a Saturday morning and have no idea what they mean. Anyone know how to interpret this?

T-Transglutaminase IGA AB >100.0 (H)

Help!

The reference range would help, but given that it is flagged "H" means it is high. You got a positive blood test. What you need to decide now is if you want to have a scope and biopsy next. If you are then keep on eating gluten until you finish all your testing.

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    • par18
      Thanks for the reply. 
    • Scott Adams
      What you’re describing is actually very common, and unfortunately the timing of the biopsy likely explains the confusion. Yes, it is absolutely possible for the small intestine to heal enough in three months on a strict gluten-free diet to produce a normal or near-normal biopsy, especially when damage was mild to begin with. In contrast, celiac antibodies can stay elevated for many months or even years after gluten removal, so persistently high antibody levels alongside the celiac genes and clear nutrient deficiencies strongly point to celiac disease, even if you don’t feel symptoms. Many people with celiac are asymptomatic but still develop iron and vitamin deficiencies and silent intestinal damage. The lack of immediate symptoms makes it harder emotionally, but it doesn’t mean gluten isn’t harming you. Most specialists would consider this a case of celiac disease with a false-negative biopsy due to early healing rather than “something else,” and staying consistently gluten-free is what protects you long-term—even when your body doesn’t protest right away.
    • Scott Adams
      Yes, I meant if you had celiac disease but went gluten-free before screening, your results would end up false-negative. As @trents mentioned, this can also happen when a total IGA test isn't done.
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