Can Someone Please Help Me Interpret These Results?

[BellaBella]

Hi All.

I am 35 and have had IBS symptoms (and others) for 20 years, at least. After doing a lot of reading about Celiac and going gluten-free I asked my doctor to do a blood test.

I went in two days ago for my follow-up, as soon as she entered the room she said "you have Celiac." She was that definitive. I asked her if I should have a biopsy and she said "that would only confirm what we already know." She said that even some known celiacs won't test positive on a blood test so the fact that I did was pretty definitive that I have it. So, we talked about what I needed to do and off I went - not at all surprised by the diagnosis.

But now that I'm looking over the test results I am very confused. Due to the results and the research I've been doing obsessively over the last few days I'm beginning to doubt the diagnosis just by looking at the numbers - not by symptoms, obviously.

Here are my results:

-Immunoglobulin A, Qn, Serum result: 417 HIGH reference interval: 70-400

-Deamidated Gliadin Abs, IgA result: 8 reference interval: 0-19

-t-Transglutaminase (tTG) IgA result: <2 reference interval: 0-3

negative 0-3

weak positive 4-10

positive >10

-Endomysial Antibody IgA result: negative reference interval: negative

I was diagnosed earlier this year with Hashimoto's Thyroiditis, I had low levels of those antibodies in my blood. This time around I also have high liver enzymes, not sure if that has any bearing at all on the celiac diagnosis.

If I'm reading those numbers correctly the total IgA is the only item of concern, and from what I've read that can be due to just about anything. Am I missing something?

I have started a gluten-free diet but I'm wondering if I should start eating gluten again and request a biopsy. Or does it really matter? I guess I would feel better knowing "for sure" that I have celiac vs. just being gluten intolerant.

Can anyone shed any light on these results? Thanks in advance.

[Skylark]

Looks like a negative celiac panel to me. Weird. Yes, you should start eating gluten again and request a biopsy if you want a definitive diagnosis.

Yes, we sometimes have liver enzyme elevations. Hashi's is common among celiacs too.

[Takala]

after...... going gluten free I asked my doctor to do a blood test.

Stay off of gluten long enough, and the blood test comes out negative.... no surprise. Even comes out negative sometimes on gluten, with symptoms that are obvious. You would have to eat it seriously for months, for the re- tests, and for what purpose, again ? You already have celiac associated disease(s), liver do problems go with this, I'm assuming that you also had celiac symptoms the doctor is going on, such as the "IBS."

Celiac or gluten intolerant, same treatment: gluten free diet.

[Looking for answers]

I had the same exact thing happen to me. I got a firm diagnosis, then I later looked at my bloodwork and started scratching my head. Luckily I have a friend who is a doctor and I had him look at the results, and he confirmed that based on the results, I shouldn't have received the diagnosis. I was so frustrated because I had alread stopped eating gluten by the time I discovered the error, and never want to go back eating it. I'll never have a clear diagnosis now.

[beachbirdie]

Elevated liver enzymes can be related to thyroid issues. And, as another poster stated, Hashimoto's thyroiditis and celiac are common companions.

[The Horticulturalist]

I can't see a +ve test there except the first one, and that's not indicative of celiac as far as I am aware. Your EMA and Ttg were both negative. I think your doctor has got mixed up somewhere, not a gastroenterologist I hope?

As others have said if you want a definitive diagnosis then you need to be eating gluten for 12 weeks prior to testing for your blood work and endoscopy. Even if you had +ve blood work, many doctors will not give you a diagnosis based on that alone. My son had +ve Ttg and EMA, the +ve EMA means it's pretty much 100% sure that he had it, but no one I talked to would give him a diagnosis with the blood tests alone so we has the endoscopy which did confirm it. It you want to know for sure I would seek out an experienced GI doctor to do an endoscopy, if you don't care either way then you could simply go ahead and try the diet and see if you feel better.

Were you eating gluten when you had these bloods taken?

You have hashimotos, along with your IBS issues that's a red flag for celiac, I'd get the endoscopy with or without +ve bloods.

[BellaBella]

Hi everyone, thanks for your responses. I just wanted to make sure I wasn't mis-interpreting something. I was eating gluten when I had the blood draw. I have tried the gluten-free diet before in the past but never made it more than a week. It's been about 2 months since I last tried, I'm not sure if that could have skewed the blood test results.

The sum of all my issues (elevated liver enzymes, Hashimotos, IBS, etc) sure makes me suspect celiac but I'd like to know for sure one way or the other. Maybe she made the diagnosis based on all my symptoms. I intend to start a gluten-free diet regardless but I think it will be helpful for me if I know for sure whether I'm intolerant or true celiac.

Because of the "definitive" diagnosis she gave me I plan to call on Monday and ask her to explain that going step-by-step thru the individual test results. Then I plan to ask for a referral for an endoscopy. The doctor that made the diagnosis is not GI, but there is a GI in town that I have seen before in the past for IBS. I hope they can get me in soon for insurance purposes and also because I'm anxious and motivated to see if I feel any better on gluten-free.

Thanks again for your responses and if anyone has anything to add I'd still welcome opinions!