Jump to content

  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.



  • Celiac.com Sponsor (A1):

    Celiac.com Sponsor (A1-M):

  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Question About Anti-Endomysial Antibodies (Ema), Iga Class

Mjay71

Recommended Posts

Mjay71 Newbie
Mjay71
Posted

Hello, everyone, I am a first-time poster to this board. Thanks for considering my question.

I'll provide background on my own gluten-consuming history and problems later if anyone thinks it is necessary, but for now, let me ask a question that should be generally applicable regardless of an individual's particular issues and history:

Is it necessary to be consuming gluten beforehand in order to have an accurate reading in a Anti-Endomysial Antibodies (EMA), IgA class blood test for celiac? I've read and heard anecdotally that consuming gluten for a spell before blood tests is necessary to achieve accurate results, but my doctor ordered this specific test and told me that it is NOT necessary to eat gluten beforehand because once antibodies form, they stay in the body for decades.

Thanks in advance for your help.

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


shadowicewolf Proficient
shadowicewolf
Posted

Yes, gluten consumption is needed.

As for the antibodies staying, they vanish not long afterwords (thus the reason why people need to stay on it during testing). This is why its advised for celiacs to have regular blood tests after diagnosis. :)

kareng Grand Master
kareng
Posted

The blood tests measure if you are currently making antibodies. If you aren't eating gluten, you aren't making any. Read around on the Univ of Chicago website for explanations of the blood tests and print some out for your doctor. Or get another doctor..

Open Original Shared Link

"Which blood tests should I have to screen for celiac disease?

You should have both tTG-IgA and total serum IgA tests to screen for celiac disease. As long as you produce IgA (total serum IgA confirms you do), tTG-IgA is 98% accurate in measuring elevated antibodies. If IgA deficient, or if there is some other equivocating factor to potentially compromise the blood test, then an EMA blood test is also given.

Other gliadin antibody tests are not useful in screening for celiac disease."

Open Original Shared Link

I’ve heard that I don’t necessarily have to endure 12 weeks of eating gluten if I have a severe reaction. Is that true? How does it work?

The gut needs time to mount an antibody response that can be measured in the blood, which is why we recommend 12 weeks of eating gluten. If you experience symptoms immediately, it’s likely that the gut itself has quickly become damaged. In these cases, you and your medical professional could consider a shorter gluten challenge (3-4 days) and then have a biopsy.

Diagnosis is not an exact science, each person responds differently to the presence of gluten in the small intestine and the amount of time it has been there. Be sure to work with your medical professional to adjust your diet, if needed, during your gluten challenge.

Mjay71 Newbie
Mjay71
Posted
  • Author

Your responses are most appreciated, thank you. I was afraid gluten consumption before the test was needed. Predictably, the test results were negative.

I have been relatively gluten-free for over a decade. I say relative because I allow myself to eat non-certified oats daily and drink some beers on the weekends. As others have reported, some beers I seem to handle fine and others not so well. I decided to include a celiac test in my annual physical because I am beginning to fear that if I am legitimately celiac rather than gluten-intolerant, I am doing long-term damage by consuming even the minimal amounts of gluten in non-certified oats and beer.

Unfortunately, it seems the test was a waste of money since I was told eating gluten beforehand was not necessary for an accurate reading. Drag.

Thanks again for your input.

tom Contributor
tom
Posted

Open Original Shared Link

...

"...Other gliadin antibody tests are not useful in screening for celiac disease."

...

Wait, what??

So all the posts here specifying FULL Celiac Panel would all be wrong per UofChi?

No IgG, AGA, DGP??? :huh: what's going ON over there?

Did I read all that wrong? Maybe it explains still doing 12wk challenges? (I hope THAT'S wrong - that'd be ridiculous)

Quincypp Rookie
Quincypp
Posted

Your responses are most appreciated, thank you. I was afraid gluten consumption before the test was needed. Predictably, the test results were negative.

I have been relatively gluten-free for over a decade. I say relative because I allow myself to eat non-certified oats daily and drink some beers on the weekends. As others have reported, some beers I seem to handle fine and others not so well. I decided to include a celiac test in my annual physical because I am beginning to fear that if I am legitimately celiac rather than gluten-intolerant, I am doing long-term damage by consuming even the minimal amounts of gluten in non-certified oats and beer.

Unfortunately, it seems the test was a waste of money since I was told eating gluten beforehand was not necessary for an accurate reading. Drag.

Thanks again for your input.

I just got tested by my dr - waiting for results. While I havne't been on gluten free diet - i have had minimal digestion because I am doing Atkins - so no bread, wheat products consumed. May have digested some in other forms - she was aware of that but didn't say it would impact the results - not until i read hear did i realize hey i probably shoudl have consumed before. I spoke with my family dr and he said I may have to be retested if the results don't come out as they suspect - strongly believe celiac due to malabsorbion of vits.

I'll let you know how my tests come back and if she says I need to consume and then retest.

Mjay71 Newbie
Mjay71
Posted
  • Author

Thanks, Quincypp. I'll look forward to hearing what she says.

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


guest134 Apprentice
guest134
Posted

Wait, what??

So all the posts here specifying FULL Celiac Panel would all be wrong per UofChi?

No IgG, AGA, DGP??? :huh: what's going ON over there?

Did I read all that wrong? Maybe it explains still doing 12wk challenges? (I hope THAT'S wrong - that'd be ridiculous)

I have noticed this not only on the University of Chicago's site but many other medical sites as well that this forum references. Sometimes I get the feeling that there are multiple different people with very different opinions filling out the FAQ at Chicago University's website.

They say that the gliadin antibodies are not useful for CELIAC disease but rather a gluten allergy. The thought for this would be based upon the fact that anti-Gliadin ab's have absolutely no predictive value for intestinal damage which is what celiac is, so to them the only true measurement of celiac is EMA and TTG which to me is also flawed because that only evaluates damage in the intestine that studies have shown can be caused by various reasons (well the TTG at least).

As for the deamidated I am pretty sure they weren't referencing it in that statement but many doctors are still sceptical on it since it is still new and there have been clinical studies that have shown a predictive value of celiac no better than the previous gliadin ab's.

GottaSki Mentor
GottaSki
Posted

What?

I've read many sources that list the gliadin test as tests for gluten intolerance - while many others site as the first celiac antibody to rise/fall in corelation with gluten ingestion, but never (that I recall) gluten allergy.

If incosistancies are found at any celiac center - I'd look to UofMaryland. I know that there have been incosistancies on UCSDs small website so Id imagine UoC could have some too - email them the page for clarification - would hate to have them reduce the amount of helpful info they publish.

Gemini Experienced
Gemini
Posted

They say that the gliadin antibodies are not useful for CELIAC disease but rather a gluten allergy. The thought for this would be based upon the fact that anti-Gliadin ab's have absolutely no predictive value for intestinal damage which is what celiac is, so to them the only true measurement of celiac is EMA and TTG which to me is also flawed because that only evaluates damage in the intestine that studies have shown can be caused by various reasons (well the TTG at least).

The gliadin antibody tests are very useful, along with a full celiac panel. It will tell you whether you are reacting to gluten and is the standard test for dietary compliance, in those who are serio-positive. But it has to be coupled with all the other tests for a more complete picture. There is also the scenario where you could be reacting to gluten but show no intestinal damage on the tTg test. This still could mean you have Celiac....you may just not have acquired enough damage to show in blood work. Never heard of it being used for an allergy test...that would be IgE mediated, not IgA or IgG.

If you don't get the full Celiac panel, you haven't been tested for Celiac Disease.

guest134 Apprentice
guest134
Posted

Intolerance/allergy is what I meant. Yes it can go down in celiac as well as gluten intolerance when gluten is stopped but that does not correlate with celiac in of itself as it does not cause damage, it is simply a negative reaction to gluten that is not specific to celiac. For this reason some doctors are under the impression it is not helpful at all, where in a big picture it is very helpful. You have to remember, many doctors won't entertain the thought of NCGI or going after diagnosis for it.

guest134 Apprentice
guest134
Posted

The gliadin antibody tests are very useful, along with a full celiac panel. It will tell you whether you are reacting to gluten and is the standard test for dietary compliance, in those who are serio-positive. But it has to be coupled with all the other tests for a more complete picture. There is also the scenario where you could be reacting to gluten but show no intestinal damage on the tTg test. This still could mean you have Celiac....you may just not have acquired enough damage to show in blood work. Never heard of it being used for an allergy test...that would be IgE mediated, not IgA or IgG.

If you don't get the full Celiac panel, you haven't been tested for Celiac Disease.

Yes, I completely agree with that but unfortunately a lot of doctors don't. The correct view would be to say in of itself it does not have a high correlation with celiac (remember JUST celiac, nothing about NCGI etc..). It is very useful in a case where someone has an elevated TTG, with an elevated TTG and a negative reaction to gluten (positive AGA) it is very likely to be celiac.

Gemini Experienced
Gemini
Posted

Yes, I completely agree with that but unfortunately a lot of doctors don't. The correct view would be to say in of itself it does not have a high correlation with celiac (remember JUST celiac, nothing about NCGI etc..). It is very useful in a case where someone has an elevated TTG, with an elevated TTG and a negative reaction to gluten (positive AGA) it is very likely to be celiac.

I still don't understand why testing gets so completely screwed up with doctors. Celiac has been in the mainstream for quite awhile now and yet, they still do not do the complete testing.

My sister, who has 2 AI conditions linked to Celiac, and a diagnosed sister (me), told me she doen't have it because her doctor tested her tTg and it was fine. :blink: This is what she wants to hear......

guest134 Apprentice
guest134
Posted

I think the unfortunate reality is many doctors are not willing to do much unless you come in with horrid symptoms, if they would listen to the patient and do appropriate tests to catch early autoimmune I think the diseases in themselves would be of little issue. If treated early there are few AI's that can really hurt you, aside from Lupus, MS and type 1 diabetes I would say most AI's are very easy to manage diseases and wouldn't wreak the havoc that they do if doctors would just stop being so dismissive of early stage symptoms.

It's like my doctors just because I am not reacting to gluten they say I can't have celiac, ok what about all the positive tests I have had? Maybe I caught it early? I don't want to be as sick as you guys before they take me seriously. If I have it I am very happy I caught it before it made me sick, no thanks to my doctors who I have had to fight to be given the endoscopy.

Gemini Experienced
Gemini
Posted

I think the unfortunate reality is many doctors are not willing to do much unless you come in with horrid symptoms, if they would listen to the patient and do appropriate tests to catch early autoimmune I think the diseases in themselves would be of little issue. If treated early there are few AI's that can really hurt you, aside from Lupus, MS and type 1 diabetes I would say most AI's are very easy to manage diseases and wouldn't wreak the havoc that they do if doctors would just stop being so dismissive of early stage symptoms.

It's like my doctors just because I am not reacting to gluten they say I can't have celiac, ok what about all the positive tests I have had? Maybe I caught it early? I don't want to be as sick as you guys before they take me seriously. If I have it I am very happy I caught it before it made me sick, no thanks to my doctors who I have had to fight to be given the endoscopy.

It is very hard to diagnose other AI issues also because not everyone is serio-positive. Plus the overlap of symptoms can fool even the most savvy doctor. AI diseases can wreak a lot of havoc if they go undiagnosed long enough. I have 3 others besides Celiac and I know I would not have developed some of them if I hadn't gone 30 years without the Celiac diagnosis.

Hashi's thyroid disease and Sjogren's Syndrome can hurt you, long term. I have those 2 and they are more of a problem than the Celiac is, although they have gotten better, symptom-wise, since going gluten free.

I think a lot of it is money driven. It's not a money maker for the medical community like other diseases are. Sad but true. Plus, anything to do with food related issues and doctors are automatically baffled. They usually won't address food issues.

tom Contributor
tom
Posted

...

If you don't get the full Celiac panel, you haven't been tested for Celiac Disease.

I agree completely. I don't get how it's possible the oft-quoted U of Chicago skips over half of what we call a full panel.

Open Original Shared Link

You should have both tTG-IgA and total serum IgA tests to screen for celiac disease....

... Other gliadin antibody tests are not useful in screening for celiac disease."

Archived

This topic is now archived and is closed to further replies.

Go to topic listing
  • Celiac.com Sponsor (A19):


  • Member Statistics

    • Total Members
      131,948
    • Most Online (within 30 mins)
      7,748
    Stephanie94
    Newest Member
    Stephanie94
    Joined
  • Celiac.com Sponsor (A20):

  • Forum Statistics

    • Total Topics
      121.5k
    • Total Posts
      1m
  • Celiac.com Sponsor (A22):



  • Celiac.com Sponsor (A21):


  • Upcoming Events

  • Posts

    • Jacki Espo
      Covid caused reoccurrence of DH without eating gluten

      By Jacki Espo · Posted

      This happened to me as well. What’s weirder is that within a couple hours of taking paxlovid it subsided. I thought maybe I got glutened but after reading your post not so sure. 
    • Mari
      New Celiac Mama in My 30s

      By Mari · Posted

      Hi Tiffany. Thank you for writing your dituation and  circumstancesin such detail and so well writte, too. I particularly noticed what you wrote about brain for and feeling like your brain is swelling and I know from my own experiences that's how it feel and your brain really does swell and you get migraines.    Way back when I was in my 20s I read a book by 2 MD allergist and they described their patient who came in complaining that her brain, inside her cranium, was swelling  and it happened when she smelled a certain chemical she used in her home. She kept coming back and insisting her brain actually swelled in her head. The Drs couldn't explain this problem so they, with her permission, performed an operation where they made a small opening through her cranium, exposed her to the chemical then watched as she brain did swell into the opening. The DRs were amazed but then were able to advise her to avoid chemicals that made her brain swell. I remember that because I occasionally had brain fog then but it was not a serious problem. I also realized that I was becoming more sensitive to chemicals I used in my work in medical laboratories. By my mid forties the brain fog and chemicals forced me to leave my  profession and move to a rural area with little pollution. I did not have migraines. I was told a little later that I had a more porous blood brain barrier than other people. Chemicals in the air would go up into my sinused and leak through the blood brain barrier into my brain. We have 2 arteries  in our neck that carry blood with the nutrients and oxygen into the brain. To remove the fluids and used blood from the brain there are only capillaries and no large veins to carry it away so all those fluids ooze out much more slowly than they came in and since the small capillaries can't take care of extra fluid it results in swelling in the face, especially around the eyes. My blood flow into my brain is different from most other people as I have an arterial ischema, adefectiveartery on one side.   I have to go forward about 20 or more years when I learned that I had glaucoma, an eye problem that causes blindness and more years until I learned I had celiac disease.  The eye Dr described my glaucoma as a very slow loss of vision that I wouldn't  notice until had noticeable loss of sight.  I could have my eye pressure checked regularly or it would be best to have the cataracts removed from both eyes. I kept putting off the surgery then just overnight lost most of the vision in my left eye. I thought at the I had been exposed to some chemical and found out a little later the person who livedbehind me was using some chemicals to build kayaks in a shed behind my house. I did not realize the signifance  of this until I started having appointments with a Dr. in a new building. New buildings give me brain fog, loss of balance and other problems I know about this time I experienced visual disturbances very similar to those experienced by people with migraines. I looked further online and read that people with glaucoma can suffer rapid loss of sight if they have silent migraines (no headache). The remedy for migraines is to identify and avoid the triggers. I already know most of my triggers - aromatic chemicals, some cleaning materials, gasoline and exhaust and mold toxins. I am very careful about using cleaning agents using mostly borax and baking powder. Anything that has any fragrance or smell I avoid. There is one brand of dishwashing detergent that I can use and several brands of  scouring powder. I hope you find some of this helpful and useful. I have not seen any evidence that Celiac Disease is involved with migraines or glaucoma. Please come back if you have questions or if what I wrote doesn't make senseto you. We sometimes haveto learn by experience and finding out why we have some problems. Take care.       The report did not mention migraines. 
    • Mari
      My only proof

      By Mari · Posted

      Hi Jmartes71 That is so much like my story! You probably know where Laytonville is and that's where I was living just before my 60th birthday when the new Dr. suggested I could have Celiacs. I didn't go on a gluten challange diet before having the Celiac panel blood test drawn. The results came back as equivical as one antibody level was very high but another, tissue transaminasewas normal. Itdid show I was  allergic to cows milk and I think hot peppers. I immediately went gluten free but did not go in for an endoscopy. I found an online lab online that would do the test to show if I had a main celiac gene (enterolab.com). The report came back that I had inherited a main celiac gene, DQ8, from one parent and a D!6 from the other parent. That combination is knows to sym[tons of celiac worse than just inheriting one main celiac gene. With my version of celiac disease I was mostly constipated but after going gluten-free I would have diarrhea the few times I was glutened either by cross contamination or eating some food containing gluten. I have stayed gluten-free for almost 20 years now and knew within a few days that it was right for me although my recovery has been slow.   When I go to see a  medical provide and tell them I have celiacs they don't believe me. The same when I tell them that I carry a main celiac gene, the DQ8. It is only when I tell them that I get diarrhea after eating gluten that they realize that I might have celiac disease. Then they will order th Vitamin B12 and D3 that I need to monitor as my B12 levels can go down very fast if I'm not taking enough of it. Medical providers haven't been much help in my recovery. They are not well trained in this problem. I really hope this helps ypu. Take care.      
    • knitty kitty
      Does anyone here also have Afib

      By knitty kitty · Posted

      Fascinating.
    • DebJ14
      Does anyone here also have Afib

      By DebJ14 · Posted

×
×
  • Create New...

Important Information

NOTICE: This site places This site places cookies on your device (Cookie settings). on your device. Continued use is acceptance of our Terms of Use, and Privacy Policy.