• Ads by Google:
     




    Get email alerts Subscribe to Celiac.com's FREE weekly eNewsletter

    Ads by Google:



       Get email alertsSubscribe to Celiac.com's FREE weekly eNewsletter

  • Announcements

    • admin

      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? - 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

Blood Test Received -- Endoscopy Or Not?
0

Rate this topic

15 posts in this topic

Recommended Posts

Hi everyone,

I am new to the forum, although I'm not completely new to Celiac/Gluten Intolerance. My mother is Celiac/DH, and was diagnosed about 4 years ago. She has been pushing for all of her children to get tested (2 down, 1 to go) since she is a first-degree relative. (FWIW, Mum is 70, I am 40, female, married).

I had my blood work done a few weeks ago, and I received the results. My family practitioner ordered the tests, even though I am not currently exhibiting any debilitating or outward symptoms -- as far as I can tell. The labs were done through Prometheus, and my printout has the following information:

DGP IgG = Positive (5.9 EU/ml, reference <4.9)

DGP IgA = Negative (4.6 EU/ml, reference <6.1)

TTG IgA = Negative (6.5 U/ml, reference <10.3)

EMA IgA = Positive

Total IgA = 143 mg/dl (reference >44-441 mg/dl)

Prometheus report adds that "Results support a diagnosis of celiac disease," and "Serological markers for celiac disease detected."

My FP was honest enough to tell me he wasn't sure how to interpret the results, and that he would be happy to refer me to a specialist.

I know that a biopsy/endoscopy is generally used to confirm findings, but since I have a first-degree relative with Celiac, and my EMA is positive, do I really need the endo?

Really, I'm in denial. Big time.

Thank you in advance for any advice or support you may be able to offer.

Best,

Cathy

Share this post


Link to post
Share on other sites
Ads by Google:
Ads by Google:


Welcome Cathy!

Your results are a bit confusing - the positive DGP is enough to know something is going on related to gluten ingestion. The positive EMA means there is damage to your small intestine. With family history and two positive antibody tests - that is celiac - in my opinion.

Your total IgA is within normal range, but interestingly in the lower end of normal which is quite similar to everyone in my family - we all test higher on IgG. You are missing the tTG-IgG. I highly suggest getting it run along with nutrient testing if you have not had it done as the malabsorption caused by celiac can be another important piece of the diagnostic puzzle.

The endo is up to you - I vote get it. The reason is this...you have no gastro symptoms - I would guess you may have some other symptoms that you never would think are caused by celiac. If your endoscopic biopsy reveals clear damage it makes it much easier to be fully compliant about removing ALL gluten - at least this was the case in the early days for me as some digestive problems resolved yet my autoimmune symtoms all got worse for a time which could have left me wondering if gluten was really the cause of my symptoms - for me the endo was far worse than my bloodwork. We are all different so read as much as you can and then decide if endoscopy is the next best step for you.

Hang in there :)

  • Upvote 1

Share this post


Link to post
Share on other sites

Welcome Cathy!

Your results are a bit confusing - the positive DGP is enough to know something is going on related to gluten ingestion. The positive EMA means there is damage to your small intestine. With family history and two positive antibody tests - that is celiac - in my opinion.

Your total IgA is within normal range, but interestingly in the lower end of normal which is quite similar to everyone in my family - we all test higher on IgG. You are missing the tTG-IgG. I highly suggest getting it run along with nutrient testing if you have not had it done as the malabsorption caused by celiac can be another important piece of the diagnostic puzzle.

The endo is up to you - I vote get it. The reason is this...you have no gastro symptoms - I would guess you may have some other symptoms that you never would think are caused by celiac. If your endoscopic biopsy reveals clear damage it makes it much easier to be fully compliant about removing ALL gluten - at least this was the case in the early days for me as some digestive problems resolved yet my autoimmune symtoms all got worse for a time which could have left me wondering if gluten was really the cause of my symptoms - for me the endo was far worse than my bloodwork. We are all different so read as much as you can and then decide if endoscopy is the next best step for you.

Hang in there :)

Thanks so much, Lisa. I will have my family doctor refer me to a specialist, and we'll proceed from there. I think you are spot-on with the non-digestive symptoms; my mother feels she has traced the majority of her "other" issues throughout her life (infertility/miscarriage, dental issues, osteoporosis, ad infinitum) to celiac. Worse, she suspects her own father had silent celiac, which ultimately took his life through intestinal cancer. I was 5 when he passed away. Celiac wasn't even a blip on the map in 1977, at least in our neck of the woods (suburban Midwest).

Thanks again. Glad to have found such a welcoming community!

Cathy

Share this post


Link to post
Share on other sites

interesting - i had labs done by Prometheus too and mine are almost the opposite of yours. Prometheus said I probably did not have celiac disease, but i'm certain i have it.

They showed my TTG IgA of 1.3u/ml, which is in the less than 10,3u/ml reference range.

however, the exact same blood sample was also tested by PeaceHealth Labs by accident (long story) and the TTG IgA came in at 29. their reference range was <20 none, 20-30 weak positive and >30eu was positive. I have the gene and my doc said with the TTG of 29, that was high enough to be sure. yours is much higher than mine.

i am still wondering if i should get the biopsy done but i've been gluten-free for 2 months and i don't know how quickly you heal.

i wish you the best figuring it all out! like you, i think my family has it on my mom's side, and i am nearly certain that my mom died from complications from it. it's better to know so we can, hopefully, avoid complications from it.

Share this post


Link to post
Share on other sites

interesting - i had labs done by Prometheus too and mine are almost the opposite of yours. Prometheus said I probably did not have celiac disease, but i'm certain i have it.

They showed my TTG IgA of 1.3u/ml, which is in the less than 10,3u/ml reference range.

however, the exact same blood sample was also tested by PeaceHealth Labs by accident (long story) and the TTG IgA came in at 29. their reference range was <20 none, 20-30 weak positive and >30eu was positive. I have the gene and my doc said with the TTG of 29, that was high enough to be sure. yours is much higher than mine.

i am still wondering if i should get the biopsy done but i've been gluten-free for 2 months and i don't know how quickly you heal.

i wish you the best figuring it all out! like you, i think my family has it on my mom's side, and i am nearly certain that my mom died from complications from it. it's better to know so we can, hopefully, avoid complications from it.

Thanks so much! I really appreciate your input. Best of health for you, too!

~Cathy

Share this post


Link to post
Share on other sites
Ads by Google:


I would say if the endoscopy will help with your denial, then get it done but be aware that there is a chance that they will miss damaged areas if your intestinal damage is not yet excessive. The intestines have a really large surface area so if the damage is patchy, and the endo doesn't take enough samples (or isn't lucky) there is a chance that you'll end up with a negative biopsy.

I had two positive blood tests too, but that was enough for me since I did not want to undergo minor surgery for my own personal reasons. Like Lisa, my intestinal issues resolved fairly quickly on the gluten-free diet, but I ended up with more autoimmune problems after starting the diet; I found out those issues were actually related to other AI issues so I didn't waiver in my resolve to stay gluten-free either.

It really is a personal choice unless you need to do the biopsy to get an "official diagnosis" for health concessions at work or school. Best of luck to you in whatever you decide to do. :)

Share this post


Link to post
Share on other sites

The positive EMA is virtually 100% specific for Celiac. You also have a positive DGP, which is also very specific for Celiac. I would not bother with a biopsy if I were you (but that is just me). Because your mom is Celiac, I would consider yourself diagnosed.

Share this post


Link to post
Share on other sites


Ads by Google:


The positive EMA is virtually 100% specific for Celiac. You also have a positive DGP, which is also very specific for Celiac. I would not bother with a biopsy if I were you (but that is just me). Because your mom is Celiac, I would consider yourself diagnosed.

Thank you, thank you, to everyone. I am grateful for everyone's input.

Share this post


Link to post
Share on other sites

Haven't seen anyone mention that it can be good, just in general, to let a specialist take a look under the hood, so to speak, since we already know things haven't been well.

I feel better knowing I've got a baseline eval available for future comparison.

  • Upvote 2

Share this post


Link to post
Share on other sites

It is a lot easier to be on a gluten free diet all the time, as more people discover that they need to be. B) Humans have existed for tens of thousands of years (or hundreds of thousands... not going to get into the anthropology wars ;) ) in their current form, without ingesting wheat, which is an extremely new foodstuff on the human timeline. By switching over to a more traditional human menu now, "omnivore" or eating what you need, not what the wheatwashed keep pushing as "healthy," you can probably avoid damaging yourself. So worth it. :)

  • Upvote 1

Share this post


Link to post
Share on other sites


Ads by Google:


Your blood tests very clearly indicate that you have celiac. Being a first degree relative makes it even more certain. Our doctor talked us into getting the endoscopy because it would give them a "baseline" to measure future healing. However, be aware that a negative biopsy does NOT mean you don't have celiac - it just means damage was not found (could be too early, could be missed by the doctor taking samples, could be interpreted incorrectly by lab technician, etc.) Do not take a negative endoscopy as a signal to continue eating gluten. Your blood tests are enough to know you should be gluten free. Some doctors "require" a positive biopsy to give you a diagnosis. My son's biopsy was positive, mine was negative. My blood tests were positive, my symptoms were classic (and all resolved on the gluten free diet) but my diagnosis is "gluten intolerance." It is so obvious that I also have celiac - but no matter, treatment is the same. Gluten free for life.

  • Upvote 1

Share this post


Link to post
Share on other sites

I agree with what everyone else here has said; you definitely have Celiac and you at this point do have intestinal damage (the EMA result). You don't need an endoscopy to confirm these results.

Share this post


Link to post
Share on other sites

interesting - i had labs done by Prometheus

They showed my TTG IgA of 1.3u/ml, which is in the less than 10,3u/ml reference range.

however, the exact same blood sample was also tested by PeaceHealth Labs by accident (long story) and the TTG IgA came in at 29. their reference range was <20 none, 20-30 weak positive and >30eu was positive.

How in the world does this level of a mistake happen? How can one lab get such a radically different reading from the same blood sample than another lab? My goodness!

Share this post


Link to post
Share on other sites

Do look into an endo exam, as was mentioned earlier. With a family history and personal history of digestive disorders/discomfort, it's always good , in the least, get an "inside look" to insure that there are no, more serious issues...or as a baseline test. imho ;)

  • Upvote 1

Share this post


Link to post
Share on other sites

Wow, I am really so very humbled and grateful for all of your responses. I think I'm going to avoid the expense and just go gluten free. I am truly blessed, because my husband insists that once we eliminate the gluten currently in the house (throwing out, donating, etc.), we will go gluten-free. Very curious to see how my kids react: 6 year old boy (with a handful of attention "issues") and 2.5 year old girl.

It hasn't been very difficult. We enjoy natural and whole foods, and we do most of our own cooking anyways. I survived my first post-diagnosis grocery shopping trip, but was a little panicked by the end. We don't eat out very often, but that still concerns me.

On the plus side, I think my mom is happy to have a partner in health. She's not happy I have celiac, but she's relieved that I know and that I can reverse/prevent damage. And now she won't feel quite so left out at family functions -- we'll bring out own stuff, or make things that everyone can eat. My dad, on the other hand, is resistant to the house being totally gluten-free, so we all worry about cross-contamination. She's working on him...

Thanks again, and know that your words have helped me segue into a healthier lifestyle with a minimum of stress!

Cathy

Share this post


Link to post
Share on other sites


Ads by Google:


Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

0

  • Forum Statistics

    • Total Topics
      108,146
    • Total Posts
      939,917
  • Member Statistics

    • Total Members
      66,132
    • Most Online
      3,093

    Newest Member
    Whhyyy
    Joined
  • Popular Now

  • Topics

  • Posts

    • Please check the date on post, you just responded and tried talking to a person from 7 years ago. On consideration to the subject Poatoes are a huge flare factor for my UC and cause my blood sugar to sky rocket...I am not even diabetic but for some reason potatoes (hash browns) that I tried a few months ago with some eggs shot it up over 400. not even a control test with table sugar managed that.
    • Have you tried eliminating high glycemic foods? Fruits, added sugars, starchy grains, potatoes. etc? Also adding in slow digesting fibers and fats can prevent insulin spikes, MCT oil is also known to help and protein. Many find consuming nuts and seeds higher in fiber early on in the meal or before a meal can slow down insulin responses and prevent spikes. I always tend to eat a hand full of whole shell pumpkin seeds, hemp seeds, cocoa nibs, etc. while fixing my food, this gets me starting to feel fuller sooner, and seems to help in over all down the road. I know I had some references somewhere to these. I know I read somewhere about the antioxidants in in whole shell seeds like pumpkin and hemp also helped the body regulate insulin levels.
    • Dear AWOL Cast Iron Stomach, Your husband is right bread is bad for you. Of course it's more than bread and gluten, until now it was amateur hour trying to self diagnose and tame this "lion". However they let you down. You slipped through the cracks over and over again it is not your fault your not the Dr. You made mistakes and errors acting like a celiac , not knowing for sure you were, and not feeling like you could fully claim to be or reach out for support . Now you know your husband was closer than any Dr. up until now to determine your illness. Now something is in your record, now hopefully you will be dismissed less,respected more, maybe they will realize its an actual condition going on- not all in your head. Will they? Who knows! Do you care? This is now official, now explained, you not only have to give up gluten, but milk, and corn. In fact give up 98% of processed anything. The cluster of lifetime symptoms were not  "just you", "in your head", "you are not a difficult patient", "when the Dr or nurse looks at you like a nut job you don't have to feel the dismissiveness and condescension. It's an illness and nothing to be shameful of  what is shameful is they and their colleagues missed you failed you. In fact being missed for 4 decades is unjust to you. You were missed time and time again from age 5 to 43, decade after decade after decade, symptom after symptom. It's not that you didn't try from the 5 year old begging to go to the Dr, to the 20 going to the hospital again for another bout of gastroenteritis hoping to get an IV, to the thirty year old saying something is wrong why is this happening, to the forty something a restaurant fed me gluten when I asked for gluten-free, I have been gluten free for 3 1/2 years ,  I have more symptoms and pain than before . I felt so good for those gluten-free years- please help me-make it stop. So many things explained it makes you experience a range of emotions. Grateful: Relief and gratefulness someone finally agreed to send you to someone to test you. She saw past the other diagnosis' and the albatross IBS diagnosis. All the ages and stages of symptoms are explained they all fit. Everyone of them! Someone else also has had them. You are not alone. Read the forum-you fit like a glove. Anger: Anger for the way you have been treated by the medical community, family, some ex boyfriends, friends and coworkers. Anger for the length of time you endured this. Hurt: Hurt for the times people said unkind things to you when you were symptomatic or flaring . you are experiencing symptoms that change your body people are rude to congratulate you on a "pregnancy" you didn't announce or ask why you are not slim when you hardly eat. you are not over emotional -  you are suffering from neuro symptoms, you are not making this up for attention Sad & Guilty: Can I work again? Do I want to work again? What kind of work can I do now? Can I find a job and work PT from home? You didn't envision this your husband having to be sole bread winner now what? I am overwhelmed thinking about this-stop? You now have closure and know how and why you lost your first pregnancy. You now know why you were high risk, complications,  with your children in Pregnancy & Delivery that they couldn't be explained back then It explains why in pregnancy you lost weight and why your morning sickness was extreme and seemed to last longer than anyone you knew,  that your Puppp rash was likely misdiagnosed DH It is not your fault none of it. Please forgive yourself for what you did not know. Your children forgive you. Believe them when they say its not your fault. You can cry, but you can no longer blame yourself. You are a good mother just one with an illness your children will learn to accept. Withdrawn: Why are you withdrawing from your husband? Should you ask him if he wants a divorce? Should you push him away? You didn't know before marriage what was happening you knew something autoimmune was brewing shortly after, but nothing showed on tests. Was this unfair to do to him? Doesn't he deserve someone better? Someone well? Now you can't retire and travel the world as society retirement cliché dictates. Can you afford this illness ? How will this financially impact your spouse, your family?. Why did you do this to this poor man? You are so selfish, you wanted marriage and kids, but was this fair to them? Don't your kids deserve a healthier mom? How will this impact them? Oh my gosh are they going to get this too? Will they grow to resent you? Your illness and diet has taken over their lives! Oh gosh no one say hi to me-please. I hate people and I am too sick to pretend and be fake friendly today. I don't want to tell you I am ill. I don't want to talk about this. I have to absorb this. I hate you people for being healthy. Don't tell me I don't look well. I will snap, I don't want to snap, I am irritable ,and don't feel well. Just keep giving off the unapproachable vibe keep them away.  Am I strong enough to do this? Acceptance: Calm down the inflammation, lack of nutrients, and GI damage is messing with your head. Your husband said for better for worse. Your kids have no choice you are their mother and you are a good mom -you have always been, always will be even on your worst day. If they get this they will be ok. You are strong enough to do this you are just ill and most importantly you must remain here in case they get this so you can guide them and be there for them. Got it? Go on the forum you are not alone it will be ok. You will get this lion back in the cage and manage it. It will be ok. If you can't travel in retirement one day you will find other hobbies or things to occupy your time. He's not going to leave you over this. If he does it will be ok. You'll manage-you always do. You have an answer, you knew it was coming, keep reading, learning, seeking support, and one day it will all work out. You will process all this and will be at peace-until then keep going and above all AVOID GLUTEN!    
    • I know for certain gastritis  is one of the main reasons I had the scope. That and my EOE symptoms . If it wasn’t for those I would have never been diagnosed 
    • Sometimes when those chilly winds begin to blow, and the temperatures fall, the days get visibly shorter, what we need and what we want is comfort food. Well, look no further than this simple, easy twist on scalloped potatoes. A little ham and a bit of cheese work wonders to turn that old favorite into a meal all its own. View the full article
  • Upcoming Events