Does This Look Like A "weak Positive"?

[dimdem]

I started to type a very long post with tons of background information, but I'll try to keep it short. In a nutshell, I recently asked my doctor to run the Celiac panel and he did. I obviously had some symptoms that made it seem to me like it was worth eliminating it (constipation, some bloating, mildly elevated ALT liver enzymes) but even I thought it was kind of a long shot. I got the results back electronically last week with a little note saying they were normal, and looking at the numbers it all looked okay to me. My plan was to try a few gluten-free weeks in August before getting my ALT checked again in September, and unless that number dropped sharply or my constipation really cleared up to let it drop. Then my doctor's office called this morning to tell me to follow up with my GI guy because my results were a "weak positive." So I can't complain that my doctor isn't taking the Celiac possibility seriously, but I'm confused because I don't see how to read the results as any kind of positive and I'm hoping for some insight here. Here are my results (with the normal range in parentheses):

GLIADIN IGA 2.0 (0-19)

GLIADIN IGG 2.0 (0-19)

T-TRANS IGA <2 (< 4)

RETICULIN IGA NEGATIVE (< 1:2.5)

I'll probably end up making an appointment with my GI doc anyway, but I'm hoping that someone can tell me whether it makes sense to call these results a weak positive versus a negative. By the way, I know I'm lucky to have a doc who takes stuff like this seriously, but he is sending me conflicting signals on this one.

[beachbirdie]

I started to type a very long post with tons of background information, but I'll try to keep it short. In a nutshell, I recently asked my doctor to run the Celiac panel and he did. I obviously had some symptoms that made it seem to me like it was worth eliminating it (constipation, some bloating, mildly elevated ALT liver enzymes) but even I thought it was kind of a long shot. I got the results back electronically last week with a little note saying they were normal, and looking at the numbers it all looked okay to me. My plan was to try a few gluten-free weeks in August before getting my ALT checked again in September, and unless that number dropped sharply or my constipation really cleared up to let it drop. Then my doctor's office called this morning to tell me to follow up with my GI guy because my results were a "weak positive." So I can't complain that my doctor isn't taking the Celiac possibility seriously, but I'm confused because I don't see how to read the results as any kind of positive and I'm hoping for some insight here. Here are my results (with the normal range in parentheses):

GLIADIN IGA 2.0 (0-19)

GLIADIN IGG 2.0 (0-19)

T-TRANS IGA <2 (< 4)

RETICULIN IGA NEGATIVE (< 1:2.5)

I'll probably end up making an appointment with my GI doc anyway, but I'm hoping that someone can tell me whether it makes sense to call these results a weak positive versus a negative. By the way, I know I'm lucky to have a doc who takes stuff like this seriously, but he is sending me conflicting signals on this one.

The problem here is that almost all of your tests are IgA tests, and they didn't do a total serum IgA. On the surface, they are negative tests, nothing even "weak positive" here. But without that missing piece, they are suspect. If you are IgA deficient (and many celiacs are) the negative IgA levels are false.

On top of that, 20% of celiac testing comes back with false negatives. So, if you have symptoms, I think it's great to follow up with the GI. Don't quit on gluten though, unless you are going to try diet without diagnosis. You need gluten going through your system, or the test results will ALL be skewed. Antibody levels can drop very quickly when you quit eating gluten.

[Skylark]

Looks negative to me. As Beachbirdie says, it would be nice to see your total IgA and a TTG IgG if you happen to be IgA deficient.

[dimdem]

Thanks. I'm due to have my ALT checked again in September, and my plan had been to go gluten free a few weeks before that to see if that number really plunged. If it did, then I was going to follow up with the GI. Maybe I better go ahead and see him, though; I can't imagine that he would want to scope me based on this, but maybe he would want to run the total IGA test and I guess I should do that before going off gluten.

It's really amazing that ordering a gluten panel wouldn't include all of the standard necessary tests.

[dimdem]

P.S. Is there any test that would be useful in eliminating non-Celiac gluten intolerance?

[Skylark]

P.S. Is there any test that would be useful in eliminating non-Celiac gluten intolerance?

There is no such test and anyone who tells you otherwise is probably trying to sell you something. NCGI is diagnosed by ruling out celiac as thoroughly as possible and then trying the diet.

You probably want both total IgA and TTG IgG. Then you've got all the possible tests done and can try the diet.