Need Help On My Blood Test Results

[BrewlessInTheBay]

Hi all,

I got blood results recently and it seems like I had one positive test and one negative test. Does anyone know how likely I am to have Celiac based on this info? My doctor wasn't helpful in assessing this. I am getting an Endo next week which I assume will confirm whether I have it?

Here are the test results:

Component Your result Standard range Units

TISSUE TRANSGLUTAMINASE IgG 1.13 < 0.90 - Index

Tissue transglutaminase IgA 0.32 < 0.90 - Index

[mushroom]

Hello, and welcome.

They performed the two versions of the tTG test, the IgA and the IgG versions. IgA and IgG are two types of autoimmune antibodies that your body makes when it is unhappy with gluten. Oftentimes they only run the IgA version and run a test called total serum IgA (as a control) to make sure your body produces 'normal' amounts of IgA (everybody produces some). If the total IgA is insufficient overall they run the IgG version of the tTG test. In your case your doctor just automatically asked for both versions. The fact that your IgG was positive and IgA negative probably means you do not produce normal IgA amounts. Either way, a positive test is a positive test and I believe you can consider that you have celiac disease. Hopefully you will get a definitive answer with the biopsy. Make sure that they take at least six samples because the damage is not uniform throughout the small intestine. And there can still be a false negative on the biopsy. So you should give the gluten free diet a strict three-month trial regardless of whether the biopsy is positive or negative.

[BrewlessInTheBay]

Wow that is such awesome info. Way better than my doctor's explanation! Just a quick follow up, do most Celliacs see postiive tests on both IgA and IgG, or is it possible to get a positive IgG and a negative IgA and stll be a Celiac?

Also with regard to to six samples, I just mention to my doctor before the test?

Thanks so much!

Hello, and welcome.

They performed the two versions of the tTG test, the IgA and the IgG versions. IgA and IgG are two types of autoimmune antibodies that your body makes when it is unhappy with gluten. Oftentimes they only run the IgA version and run a test called total serum IgA (as a control) to make sure your body produces 'normal' amounts of IgA (everybody produces some). If the total IgA is insufficient overall they run the IgG version of the tTG test. In your case your doctor just automatically asked for both versions. The fact that your IgG was positive and IgA negative probably means you do not produce normal IgA amounts. Either way, a positive test is a positive test and I believe you can consider that you have celiac disease. Hopefully you will get a definitive answer with the biopsy. Make sure that they take at least six samples because the damage is not uniform throughout the small intestine. And there can still be a false negative on the biopsy. So you should give the gluten free diet a strict three-month trial regardless of whether the biopsy is positive or negative.

[mushroom]

Yes, it is perfectly possible for one to be positive and the other negative. There are a whole series of tests (the 'panel') that have been developed for celiac disease, and you need only be positive on one of them.

And you don't just 'mention' to the doctor, you "insist" (in a nice way, of course).

[jnh380]

Hi Brewless, I see you have just gotten results from Kaiser, as I just got similar results from then a few weeks ago. The .90 reference range is the giveaway (that and you live in the bay).

The previous posters are correct in that the IGG steps in when you are IGA deficient. For me the numbers were reversed, IGA was 1.56 and IGG was .35. I just had a biopsy endoscopy this monday and am waiting on the results. Have you scheduled one? I dont remember anything about it so its nothing to fear.

I wish Kaiser was a bit more interactive, so far I have only gotten small amounts of information from them. I will let you know what happens with the biopsy results. Welcome to the suspected but not proven Celiac club!

[BrewlessInTheBay]

Hi Brewless, I see you have just gotten results from Kaiser, as I just got similar results from then a few weeks ago. The .90 reference range is the giveaway (that and you live in the bay).

The previous posters are correct in that the IGG steps in when you are IGA deficient. For me the numbers were reversed, IGA was 1.56 and IGG was .35. I just had a biopsy endoscopy this monday and am waiting on the results. Have you scheduled one? I dont remember anything about it so its nothing to fear.

I wish Kaiser was a bit more interactive, so far I have only gotten small amounts of information from them. I will let you know what happens with the biopsy results. Welcome to the suspected but not proven Celiac club!

Hey,

TOTALLY AGREE. I can't get an answer from anyone! From I what understand a positive IGA is more likely to be Celiac than an IGG. I had the biopsy as well and am waiting for results! I will let you know!

[beachbirdie]

Hey,

TOTALLY AGREE. I can't get an answer from anyone! From I what understand a positive IGA is more likely to be Celiac than an IGG. I had the biopsy as well and am waiting for results! I will let you know!

I'm very interested to hear your biopsy results! Like you, I tested positive in the ttg igg, and negative on everything else. It's not common to test this way, I've heard!

Haven't figured out what to do yet. I just sent my result to my doctor (I didn't go through her for testing) and am waiting to hear what she says.

[Ziva]

On Friday, I went with my 21 y/o daughter to her 3 week after endoscopy follow up appt. The doctor totally changed his diagnosis from "classic Celiac" after our initial appt and endoscoy findings to No to Celiac because "the Golden Standard" of biopsy was not met. He now says the ttg IgG result that was 9.3 was not really high. (<6 neg, 6-9 - weak positive and >9 positive) Only test she showed high. Looking back, I don't see where they did the IgA quantity. Can I say we are VERY frustrated! He didn't seem to take into account that she seems to feel better 3 weeks gluten free. No ear infections, decreased bowel problems, more regular bm without added fiber to name a few things. Also had no explaination for her anemia. He is now going with IBS and wants her to take lubiprostone / amitiza and do a stool test for blood. Also said she should "modify" her carbs but doesn't have to eliminate them. It looks like that medication could have some unpleasant side effects! Anyone else take that medication?

Any input?

I'm thinking she is going to skip the medication for now and continue eating gluten free. Right? Do the poop test for blood. Is 2 months eating gluten free long enough to see changes in blood work for anemia?

So frustrating! Good luck to the other posters on this thread regarding your results. Seems like you really have to go with how you react to foods because you may not get confirmation from the doctors.

[mushroom]

On Friday, I went with my 21 y/o daughter to her 3 week after endoscopy follow up appt. The doctor totally changed his diagnosis from "classic Celiac" after our initial appt and endoscoy findings to No to Celiac because "the Golden Standard" of biopsy was not met. He now says the ttg IgG result that was 9.3 was not really high. (<6 neg, 6-9 - weak positive and >9 positive) Only test she showed high. Looking back, I don't see where they did the IgA quantity. Can I say we are VERY frustrated! He didn't seem to take into account that she seems to feel better 3 weeks gluten free. No ear infections, decreased bowel problems, more regular bm without added fiber to name a few things. Also had no explaination for her anemia. He is now going with IBS and wants her to take lubiprostone / amitiza and do a stool test for blood. Also said she should "modify" her carbs but doesn't have to eliminate them. It looks like that medication could have some unpleasant side effects! Anyone else take that medication?

Any input?

I'm thinking she is going to skip the medication for now and continue eating gluten free. Right? Do the poop test for blood. Is 2 months eating gluten free long enough to see changes in blood work for anemia?

So frustrating! Good luck to the other posters on this thread regarding your results. Seems like you really have to go with how you react to foods because you may not get confirmation from the doctors.

You got that one right, Ziva. That is really the final test - does it make her feel better? If it does, then you have your answer - she should not eat gluten. Doesn't matter what the tests say. You tried your best to extract a diagnosis, he chooses to ignore the positive blood result and go with the biopsy which depends on the skill of the GI and the pathologist, and put her on medication!! I am not familiar with those meds but I assume neither one of them is addressing her iron deficiency? It is going to take her quite a while to heal enough to start absorbing iron if it is due to celiac, unfortunately.

I share your frustration. Do do the stool blood test, if only to show him, and do keep her gluten free, steady as she goes

[Bubba's Mom]

A little positive? So...she's supposed to go her merry way and come back when the damage is more?

I hope she stays gluten-free. As she heals her iron levels will come up.

Dr.s make me crazy! When they know a test isn't 100% accurate, and continuing to eat gluten when your body is intolerant of it, can cause more damage, they don't err on the side of caution..they say go ahead and eat it?

I guess that keeps them in business with a steady stream of sick patients?

[Cara in Boston]

Just wanted to add that my son (7) was negative on all the IgA tests (but not total IgA - that was sufficient) but positive on the IgG tests. His biopsy was positive.

I had positive blood tests and negative biopsy. My doctor diagnosed me with "gluten intolerance" instead of celiac because of the negative biopsy. My son's doctor (who seems more knowledgeable) said that was silly. I just didn't have any damage yet . . . no reason to continue eating gluten just to create damage that can be measured. A positive blood test is enough to tell you to stop eating gluten.

Been gluten-free for a year now and feel great . . .

Cara

[nora-n]

I just want to comment that the ttg test is specifically developed to look for total villous atrophy, or lots of tissue damage, so a weak positive does mean there is a lot of tissue damage. Biopsies can miss the celia lesions.

Celiac nowadays is typically the patchy kind, so a negative biopsy does not say much. They just missed the spots.

There was a study recently about biospy practices in the U.S, and the places where they follow guidelines and take more biopsy samples, have double the number of celiac diagnosis compared to those places where they only take one or two samples.

[jnh380]

Hey,

TOTALLY AGREE. I can't get an answer from anyone! From I what understand a positive IGA is more likely to be Celiac than an IGG. I had the biopsy as well and am waiting for results! I will let you know!

Brewless- I got my biopsy results and they came back positive. Looks like I definately have celiac. Hope you get the answer you are looking for.