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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
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shadowseek

Please Help Me Understand My Results

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Hi all, I had two blood tests for antibodies and one was positive

Ttg IgA is 34 , weak positive is >10, positive is >20

Antigliadin antibodies IgA were negative 3,4 where positive is >10.

What does this mean?

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The tissue transglutaminase (ttg) is a marker of damage in the small intestine, you are getting in the range were it becomes very specific for celiac. It can be low positive in other cases but your numbers would likely be in the 10-30 range to consider that. Antigliadin is outdated though, you were negative on it.

Going to need some more info on your clinical presentation, can you answer some of these questions:

1- What made you think of celiac, what symptoms do you have?

2- Any autoimmune in the family?

3- Any recent infections, particularly intestinal?

4- Any other stomach problems in the family?

You are going to need to do some more blood testing to see what is going on, here is the recommended and up to date tests:

Total serum IgA- Nothing to do with celiac, but if low your IgA gliadin was likely a false negative as will be with most IgA tests

Deamidated Gliadin IgA- Very specific in reaction to gluten, if this is positive with your TTG celiac is almost guaranteed

Deamidated Gliadin IgG- Accurate to its counterpart of the IgA class and is particularly useful in IgA deficient patients

Endomysial IgA- This is very specific to celiac in appropriate clinical setting, if this is positive you pretty much 100 percent have celiac

Antigliadin is outdated and considered useless to many people of the medical community, deamidated is the new and very specific version of it.

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The tissue transglutaminase (ttg) is a marker of damage in the small intestine, you are getting in the range were it becomes very specific for celiac. It can be low positive in other cases but your numbers would likely be in the 10-30 range to consider that. Antigliadin is outdated though, you were negative on it.

Going to need some more info on your clinical presentation, can you answer some of these questions:

1- What made you think of celiac, what symptoms do you have?

2- Any autoimmune in the family?

3- Any recent infections, particularly intestinal?

4- Any other stomach problems in the family?

You are going to need to do some more blood testing to see what is going on, here is the recommended and up to date tests:

Total serum IgA- Nothing to do with celiac, but if low your IgA gliadin was likely a false negative as will be with most IgA tests

Deamidated Gliadin IgA- Very specific in reaction to gluten, if this is positive with your TTG celiac is almost guaranteed

Deamidated Gliadin IgG- Accurate to its counterpart of the IgA class and is particularly useful in IgA deficient patients

Endomysial IgA- This is very specific to celiac in appropriate clinical setting, if this is positive you pretty much 100 percent have celiac

Antigliadin is outdated and considered useless to many people of the medical community, deamidated is the new and very specific version of it.

First of all thank you on fast your fast answer.

Now to answer to your questions:

1) I had diarrhea very often, two times with blood, and I went to see a specialist. gastroenterologist

2) no

3) no

4) no

Only thing I am not sure about this, cause I am 23 years old, I never had problems before. Its all coming fast.Also I think I have

candida, is their any possibility that it may have caused this problems? Most of my diarrhea are after something sweet.

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It could.

At this point in time i'd insist on getting the rest of the panel ran (someone will post it no doubt) as well as an endoscopy and the genetic test.

Your levels are around what mine were (37), however i had "D" on a daily basis with vomiting happening several times a week among other things.

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I am 22, not actually diagnosed yet (still might not have it) but it can come up at any age. Bloody diarrhea is not typical of celiac (usually no blood).

My suspicion earlier was with a still relatively low positive TTG without gliadin IgA positivity could be indicative of crohns disease. The fact that your diarrhea is bloody makes me lean to this more, low positive TTG is often associated with crohns and ulcerative colitis. Do you receive bad stomach pains after eating?

With these results you need the celiac panel I posted above along with Anti-Saccharomyces cerevisiae antibodies, which is the antibody associated with crohns disease. Depending on these I would recommend both an endoscopy to check for celiac as well as a colonoscopy to check for crohns and ulcerative colitis.

Both forms of IBD commonly hit at age 20-30.

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That is correct, make sure you get the deamidated versions too.

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Hi all, I had two blood tests for antibodies and one was positive

Ttg IgA is 34 , weak positive is >10, positive is >20

Antigliadin antibodies IgA were negative 3,4 where positive is >10.

What does this mean?

You most likely have celiac disease with a positive ttg IgA, and your test is beyond what the lab considers to be a weak positive. :( EMA is a good test to confirm celiac disease with, but it could end up with a negative result. Not all celiacs test positive for all blood tests. In fact, some celiacs test negative on all blood tests but show upper intestinal damage on biopsy.

Celiacs are often low in B12, D, calcium, ferritin and potassium... there are others that I can't remember. You might want to get your nutrient levels checked when you see the doctor. A TSH test might be a good idea too as thyroid problems are often liked to celiac disease.

I think I read somewhere that candida shows up a bit more frequently in celiacs because of our leaky guts but I can't remember the source of that for the life of me. Sorry.

Blood in bowel movements can often be caused by internal hemorrhoids that get irritated with D or C. Hemorrhoids are fairly common in people with GI issues, although they give scary symptoms. That would be my guess for your circumstance.

Best wishes.

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I forgot to ask that actually, exactly how bloody is the diarrhea? Is it a bit on top of the stool and on the toilet paper or are we talking a significant amount here? I just assumed with bloody diarrhea you meant a significant amount.

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Welcome ShadowSeek-

Your tTG IgA is a clear positive - a very strong indicator of Celiac Disease.

I would suggest you request the rest of the panel to be run and then decide if endoscopy is appropriate with your doctor.

Total Serum IgA

Endomysial IgA

Deamidated Gliadin Peptide - IgA and IgG

My gut always goes with a strong positive plus symptoms = Celiac Disease, but don't remove gluten until ALL testing is complete.

Let us know how you fare with further testing or if you have more questions :)

PS...forgot to ask if you have had nutrient testing - this is important as low nutrients is another clear indicator of malabsorption caused by Celiac Disease.

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Antigliadin is outdated and considered useless to many people of the medical community, deamidated is the new and very specific version of it.

Actually, the AGA IgA/IgG tests are not outdated or useless. They are just less sensitive than the newer DGP ones. Many docs still use them and many people are diagnosed this way. I would ask for the DGP anyway as there was a positive tTg. Gene testing would be very helpful also.

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Actually, the AGA IgA/IgG tests are not outdated or useless. They are just less sensitive than the newer DGP ones. Many docs still use them and many people are diagnosed this way. I would ask for the DGP anyway as there was a positive tTg. Gene testing would be very helpful also.

This is accurate -- and with all things Celiac - the AGA is useful in some cases - my celiac doc still runs both DGP and AGA on me annually. If a doctor is refusing to run all the tests, I would opt for DGP.

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This is accurate -- and with all things Celiac - the AGA is useful in some cases - my celiac doc still runs both DGP and AGA on me annually. If a doctor is refusing to run all the tests, I would opt for DGP.

You know, when I have blood work done every 2-3 years just to make sure I am being as compliant as I can, they never run the DGP.

It's always the AGA IgA/IgG. I was diagnosed via blood work and failed all the tests so I can use any test because there is something to compare it to but no one runs the DGP. Maybe because it wasn't around when I was diagnosed but I always find it amusing that I have to remind them there is a newer test. I have my thyroid doctor run them because she is easier to talk to.....my PCP generally just runs the tTg, which annoys me to no end because that doesn't check for dietary compliance, just damage. So many doctors still don't get it right. It's a wonder anyone is diagnosed........

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Thanks for posting this thread. I also got similar results last week...but over the phone, no numbers, and just a two-minute conversation. I don't get my biopsy results for another two weeks, so I went gluten-free on the assumption that my (low? high?) tTg is a diagnosis. I have Hashimoto's and responded well to a gluten-free diet (before going back on gluten for the biopsy).

Strangely, when I searched over at the Crohn's boards on tTg results, having read the studies about it sometimes indicating Crohn's, they all talked about it as an indication of a double diagnosis, adding Celiac to their existing diagnosis.

Anyway, I'm still not sure if I should begin acting like I have a diagnosis myself. My family all has weird, unexplained issues (migraines, fibromyalgia, mini-strokes at a young age, severe acid refux) and my grandmother had severe and mysterious ataxia for years before her death (she became paralyzed and unable to speak).

I'm worried my biopsy will be negative, and then my family will continue to have problems, while if it's positive maybe they can get tested and start to feel better -- and the younger ones can avoid damage altogether. I know a negative biopsy doesn't conclusively prove anything, since the damage can be patchy, so I'm eager for a diagnosis based on blood work, so I can move onto healing my system and notifying my family.

The scary thing is that a friend of mine is eating gluten although it runs in his family because he doesn't have any symptoms yet. This is the kind of attitude that freaks me out. So of course no matter what I can't guarantee my family would take it seriously either.

At least now I think I know why I don't like the taste of waffles...! Everyone always thought that was weird of me growing up.

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the thing about the biopsy is they're trying to find damage in an area that's about the size of a tennis court. It is very possible for them to miss it. Most cases, unless severe, damage is not seen with the naked eye.

Get the genetic test done, that would help your family out more as celiac is a genetic condition.

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I'll try to convince my doctor to do it (US military doctor) -- thanks for the advice!

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Hi Amelia-

A military doctor - as well as many other docs respond well to preparation. When is your appointment?

List of symptoms.

List of necessary tests - both celiac and nutrient

If needed a few print outs from top Celiac Centers.

Never hurt.

Let us know if you would like a few items to bring along to your appointment.

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Hi Lisa -- thanks! It's my GI doctor, who is the only one for the Asia-Pacific region, and a really good guy. All the others I've seen immediately said I need to see a mental health professional (for anorexia and body image issues of all things), and only ordered tests after I begged them. He just heard me out and said -- why aren't you on any medication for all this?

Anyway, I gave him my notes and lists of symptoms and whatnot and he just handed it back to me without reading it and fired a bunch of questions at me. But I figure he knows what he's doing, since he did my endo like a pro.

At this point, I'm just getting my biopsy test back. If it's negative, I figure I'm "latent" celiac (i.e., they missed the bad patches); if it's positive, then I'm "celiac." But either way, I'm asking for a genetic test, testing for SIBO, and some good probiotics (no gluten-free ones in Japan I can find, and Amazon's freeze-dried ones are coming on the slow boat).

Does that sound like a good game plan? Or should I be doing something else?

(One doctor said my preparation...like measuring my distended belly...would make the other doctors think I was crazy, so I shouldn't mention it to them. This is what I'm dealing with. Argh.)

Anyway, thanks very much for the help. :)

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I think that is a great plan -- I never hand docs anything but medical journal papers :P

The reason I have lists of symptoms, questions and tests in hand during appointments is to make sure I don't forget details or to ask questions. I let them know I had pictures when I started taking pics of rashes and they did want to see those...you just never know.

Regardless of your results, remove ALL gluten for at least three months (six is better) -- this is the only test for Non-Celiac Gluten Intolerance.

If only we could get our money back from dismissive doctors ;)

Hang in there - keep documenting - I waited too long to document. This information may be of help with your future doctors. Also, if you ever decide to get a genetic test - no gluten challange is required :D

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Thanks for the advice!

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