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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 FREE Celiac.com email alerts   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) 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 Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

Questions About Cyrex
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As some of you know I've been doing a gluten challenge after being gluten free for a year (on GAPS for most of it). My doctor did order a standard panel for me, but now I'm considering getting the cyrex array 3 instead.

My doctor ordered:

Total IgA

Anti Gliadin IgA

Anti Gliadin IgG

Anti tTG IgA

Anti EMA IgA

She couldn't order the Deamidated Gliadin Peptide test.

Looking at the cyrex array, I see that there is

Deamidated Alpha Gliadin 33 MER IgG ( CPT CODE : 86001-59 )

Deamidated Alpha Gliadin 33 MER IgA ( CPT CODE : 83516-59 )

Are these the same as a Deamidated Gliadin Peptide test? The array also offers other tests which I would find interesting as part of the array - the gluteomorphin, for example. However, the Anti-endomysial Antibody test and the total IgA do not seem to be included.

I KNOW that gluten is a problem for me. The main reason I want the celiac screening is so that I can be aware of whether I have autoimmune gut damage going on as a part of my intolerance, for family reasons and emotional reasons. A smaller side-note... if I don't have indications of autoimmune issues, I may be ok with eventually basing my level of allowable cross-contamination on symptoms rather than absolute avoidance, as I do for my son.

I am leaning toward going with the cyrex array 3 and then if all my IgA numbers are low, getting the total IgA tested, if Deamidated Alpha Gliadin is the same as the Deamidated gliadin peptide test.

But I did want the EMA test. I have a call out to my doctor to find out the cost of the tests ordered, since I have to pay for everything out of pocket. Doing the tests in a phased approach is not possible because I need to stop eating gluten ASAP!!!

What do you think?

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Skylark    935

The Cyrex array does look interesting. The Deamidated Alpha Gliadin 33 MER is the test you're wanting, the one often called DGP.

You might also look at the panels this company offers. They have a celiac panel with total IgA, EMA, TTG, and DGP. There is also DGP IgG and IgA available alone if you just want to supplement what your Dr. has ordered.

http://www.ineedlabs.com/Celiac-Disease-Comprehensive-Antibody-Profile.html

http://www.ineedlabs.com/Gliadin-Antibody-Profile-IgG-IgA-EIA.html

EMA is going to be relatively expensive. It is a hand-read histological test that checks whether your antibodies bind to monkey esophagus so it's much more labor-intensive than an ELISA like TTG or DGP. Cyrex looks to be only running ELISAs which is why they are not offering it. I'm not sure I would order EMA if I were paying out of pocket. DGP is more sensitive, and TTG has been identified as the main antigen in endomysium.

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Yeah, I've looked at all their panels! They also have a panel for assessing cross-reactive foods, and another to determine the specific causes of leaky gut... but funds are limited.

Since the Cyrex test does include DGP (thanks for clarifying), I am very much leaning toward it. I think this whole panel is only about $360. My dr's office still hasn't called me back about costs or ordering from Cyrex (which I'm sure will require a bunch of extra paperwork) but I am thinking that's the direction I'm going to go, rather than with the EMA.

Do you think the idea of only ordering the total IgA if IgA numbers come back low is a good idea? I'm assuming it doesn't matter whether I'm eating gluten or not for that one.

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Skylark    935

Do you think the idea of only ordering the total IgA if IgA numbers come back low is a good idea? I'm assuming it doesn't matter whether I'm eating gluten or not for that one.

I think it's fine if you don't mind being stuck twice. Personally I'd be on pins and needles wondering about IgA if everything came back low so I'd get the total IgA at the same time. :lol: Gluten won't matter for total IgA.

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Yeah, I've looked at all their panels! They also have a panel for assessing cross-reactive foods, and another to determine the specific causes of leaky gut... but funds are limited.

Since the Cyrex test does include DGP (thanks for clarifying), I am very much leaning toward it. I think this whole panel is only about $360. My dr's office still hasn't called me back about costs or ordering from Cyrex (which I'm sure will require a bunch of extra paperwork) but I am thinking that's the direction I'm going to go, rather than with the EMA.

Do you think the idea of only ordering the total IgA if IgA numbers come back low is a good idea? I'm assuming it doesn't matter whether I'm eating gluten or not for that one.

I ordered the Celiac Panel from ineedlabs.com and it was 200 dollars for the panel which included EMA. AND I didn't need a doctor to order it. They use LabCorp.

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I see! I've been scared to use these kinds of services. I found another one that offered the cyrex labs without a doctor, but they had typos and grammar errors all over and were trying to sell some digestive enzyme to deal with being glutened, so I just couldn't trust them.

I'm glad to hear you had a positive experience with i need labs. They don't have all the tests cyrex does, but they do have total iga, ttg, ema, dgp, antigliadin igg and iga. I wish my partner would come home and discuss it with me already!

My doctor's office still hasn't gotten back to me... but it finally occurred to me that my (new) naturopath could also order these tests for me just as easily, and I can get her on the phone or by email, no problem!

I'll be happy to be thinking straight again.

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Yay! I just got a call back from my dr office. I can get the panel listed at the top for $169.36 + a 15.96 fee. Blood draw scheduled for 11:10 AM.

I found the deamidated gliadin peptide test available for $89 online. I'm considering ordering it.

OR, I could order this celiac panel for $177.25 but It doesn't inlcude the anti gliadin IgA or Igg, but does include the EMA, DGP, tTG, and total IgA.

I could get a blood draw with that tomorrow if I want to.

Which would you do?

The cyrex test did have more things listed and I've heard (but not confirmed) that it's about $360. I'm now thinking I'll skip it, since it would be more hassle to order and I'm not convinced of the value added.

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Skylark    935

Great!

That's a tough call what to get. Since you know you're gluten intolerant and it's autoimmunity you are concerned with, how would you even interpret the old anti-gliadin? It's not very specific for celiac autoimmunity.

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Good news! I called the lab at my doctor's office and asked if they could now order the DGP or just let me order some of the tests in their panel so I could order the rest online. It turns out that since my celiac panel was ordered 2 months ago they have changed what's in it. Now their standard screening includes the DGP test! Progress :)

As for interpreting the old anti gliadin - I guess it's just one more piece of validation I might be able to get to help me with my hypochondria about having hypochondria rather than anything physically wrong with me. :rolleyes:

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Skylark    935

That is good news. I hope you get the positive test you're looking for. Good luck!

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