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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes

Celiac Blood Tests

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Does anyone know...

If TTG is the best indicator for Celiac Disease, why are gliadin IGG and gliadin IGA tested also?

My 7-year-old son has gliadin IGG of 126.2 units (strong positive), gliadin IGA 22.2 (weak positive) but his TTG is 17.9 (negative).

Does this mean he is:

- gluten intolerant?

- gluten sensitive?

- has a potential to develop celiac?

The doctor advised me that my son is not celiac and there is no reason to remove wheat from his diet.

Another blood test was IgE to casein - 19.6 (score III). We were advised to remove all forms of milk from his diet but not to strictly eliminate other foods he has trouble with (soy, eggs). Does this sound right??



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It sounds right from the stand point of an uninformed doctor. You are correct that the main celiac disease blood test came back negative, but that is probably only because the antibodies haven't gotten into the blood stream yet. The positive IgG and IgA do mean that your son is atleast sensitive to Gluten.

My blood tests came back postive only for IgG and when I had a stool test done through enterolab all of the antibodies came back positive, including TtG which was negative on the blood tests.

Think of it this way. When a person has an autoimmune reaction to gluten, the war is taking place in the intestines. Thus when the intestines are still realatively healthy the war is contained there. But as the war damages the intestines then the antibodies move to the blood stream where they are then picked up by the blood tests your doctor performs. So a negative for celiac disease in the way of TtG is good, because basically it means his intestines are not as damaged as they could be. However, to say he does not need to eliminate gluten, it pretty risky because his body is reacting to gluten, which over time will probably only get worse.

My personal opinion would be to eliminate gluten for atleast six weeks and see if it makes a difference.

To read more detailed info about what I have wrote read this article http://www.enterolab.com/Essay/

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Are there other factors (besides Celiac) that could cause IgG and IgA to gliadin to be elevated?

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I am not sure, but I don't believe so. The gliadin antibody is specific to gluten I believe. May be someone can correct me if I am wrong.

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with regard to why several blood tests are run, it is a case of the more the merrier. None of the tests catches 100% of celiac cases, so by using several tests that analyze different aspects of the disease there is an increased likelihood of detecting something if it is there to be detected. Although TTG is specific to celiac because it measures the damage to the intestine that results from gluten ingestion, not all celiacs will have enough of this damage for it to show up. That's why the antigliadin tests are important.

Anyway, there is a good overview of the tests on this site, here:




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Jo -

Your son's results are very similar to mine - my IgA was a weak positive of 24, my IgG was a high positive of 127, but my tTG was negative. The lab that did my stuff, also did some reticulin antibody tests and 1 was positive and 1 was negative. The interesting thing in all this was that the two that the results say are most specific for Celiac (tTG and one of the reticulin ones) were both negative. When I received the results, I was in the process of having an ERCP scheduled to clear out a stone in my common bile duct. I asked them to do the small intestine biopsy at the same time. Those results did show damaged, blunted villi and excess epithelial (sp?) lymphocytes that they said were consistent with celiac sprue. I called a pediatric gastro office to check about having my kids tested, and the nurse said they should have the IgA and tTG tests as well as the genetic marker tests for HLADQ2 and HLADQ8. I told her my results and she was a bit puzzled and said that other things (like Crohn's and salmonella to name two) can also cause the villi to be damaged. That had me questioning my diagnosis, even though I had the positive biopsy. Since then, my Dad has tested positive for Celiac via bloodwork, so now I'm feeling that I do indeed have it and that just not all the bloodwork shows every test as positive. There is interesting info at the Prometheus Labs website that explains what blood work should be done to try to not miss any false negatives. I am going to try to have my kids tests done through that Lab instead of the one used for me (LabCorp), but I don't know how easy that will be. I hope some of this info is helpful to you. Danna Korn also has a website that is very good and talks about the testing which is www.glutenfreedom.net. Good luck!

LISA in Wilkesboro, NC

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Thanks for the information. Your results do sound very similar. I have decided to follow up with a visit to a gastoenterologist to make sure the pediatrician's diagnosis was accurate (we have an appointment 6/11 at the University of Michigan with a pediatric gastroenterologist). Your story makes me more confident that I'm doing the right thing. While my son's symptoms have improved significantly by just eliminating milk in all its forms, something is still not quite right. I'm at least going to ask for the genetic tests you wrote about (before I agree to the biopsy for him).

What made your father get tested? What blood test results were positive for him? Did he have the biopsy also? Were other family members tested?

Are your kids having symptoms or are you getting them tested as a precautionary measure?


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Hi, Jo -

I definitely think you are doing the right thing by following up with the gastroenterologist. It is amazing how everyone interprets these tests differently.

My Dad has always been burpy and had been told in years past that he had GERD. He said he was once tested for an ulcer, but it turned out he didn't have one. He only got tested because I tested positive by the biopsy. I'm don't remember exactly what blood work they did on him, but it seemed like only 1 test was different, but he did not have all the ones listed on that Prometheus Labs info. My Mom, brother, and my brother's 3 kids were all tested by blood work and were all negative. I am not confident in the testing, though, after what I have learned about the false negatives and since they had the same panel as my Dad. None of us have had the genetic test, because, of course, none of the doctors we have seen have even mentioned it. It would have been much better to have routinely done that with the other bloodwork - especially for my relatives since they did not have the biopsy. Then they would know if they have the genes and are susceptible to getting Celiac later in life. I think right now, my brother just thinks they are home-free. My sister is ignoring all of this because she just doesn't want to deal with it. I think it is a shame that she is not getting tested (she already has Type 2 Diabetes) and that she is denying her children the chance to do something for their own health. She lives in England and she uses the excuse that it is harder to get drs appts there, but Celiac is more recognized in England, so I think if she put forth a little effort, they would test her, especially with a 1st degree relative biopsy-proven Celiac.

Although I am mostly getting my children tested as a precautionary thing, my youngest has always complained of tummy troubles. She also had lots of ear infections when she was younger and was on lots of antibiotics. She has been able to burp like a truck driver since she was born. She also had trouble with milk and was on soy till almost 3 (my oldest also had to have soy formula, but was able to switch to milk at 1). They both have some skin troubles - not too bad, but it makes me wonder about the DH part of Celiac. Also - regarding your son and milk, I read that the part of your intestines that is damaged first is the part that enables you to digest milk products. I have not been able to drink milk for over a year. I did go back to eating cheese for a little bit after my gallbladder was removed (at the time, that is what they thought was wrong with me), but when I had another "attack" in Jan 2004, I stopped eating that, too, and have not had any since then.

I think it is very wise for you to request the genetic test before agreeing to the biopsy. I am afraid if either of mine are positive that they're going to want to do a biopsy on them and I really don't want to do that. Kids are calling me, so I better go! Hope I have answered all your questions and let me know if you have any more!


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