We at Root Cause Medical Clinic San Jose know that, as if it wasn’t hard enough to convince some doctors to do a celiac disease test—let alone one for gluten sensitivity—once you finally DO get tested, the interpretation of the results can be faulty.
While you shouldn’t have to question your doctor, unfortunately when it comes to the interpretation of lab tests relating to celiac disease or gluten sensitivity, you may have to learn some test interpretation lingo in order to save your own health.
Don’t worry about it being difficult to learn this data. I’ll make it easy to understand. The important thing to know is that if you don’t feel well, there is a reason. It may be a problem with gluten, it may be something else, but it IS something. Don’t give up. If you need my help, I’m here for you!
Before jumping into the lab test, I wanted to clear up a couple of words you commonly hear regarding tests—and that is their sensitivity and specificity. The definitions of these words are as follows:
Sensitivity simply means the true positive rate or the proportion of positive results are correctly identified. If 90% of celiacs were correctly identified by a certain test, it would be said to have a high sensitivity.
Specificity is the opposite and is often called the true negative rate. It is the proportion of negative results that are correctly identified. If a test identified correctly 90% or more of healthy people as having a negative result, that test would be considered to be highly specific.
A perfect test (it doesn’t yet exist) would be one that was 100% sensitive and 100% specific.
The tests we are about to discuss detect autoantibodies which are substances the body auto-creates as part of an immune response to dietary proteins it considers are toxic (antibodies)—such as gluten and gliadin. These autoantibodies can cause intestinal inflammation and damage in the lining of the intestinal wall as well as other parts of the body, resulting in autoimmune disease.
Below are some commonly used lab tests for celiac disease and gluten sensitivity. Feel free to use this section as a reference for the later section which discusses real-life examples that people have shared after receiving a celiac disease test:
Anti-tissue Transglutaminase Antibodies, IgA – abbreviated tTG-IgA.[Note: these are substances produced by your immune system that is directed or targeted against “self” tissue – meaning parts of your own body. After gliadin (the destructive part of the gluten protein) crosses the intestinal lining, a special enzyme called tissue transglutaminase binds to gliadin and takes off a portion of the protein. This portion is called glutamine. tTG antibodies are antibodies that are directed against the complex made up of gliadin attached to the tissue transglutaminase enzyme.
When positive this test is considered 90 percent sensitive at accurately diagnosing celiac disease because the presence of these antibodies correlates highly with the immune system attacking and destroying the intestinal lining, known as villous atrophy.
The test is not only sensitive (90%) but highly specific (98%), the latter meaning that it won’t tell you that you have celiac disease if you don’t. There is a “loophole” to the sensitivity feature, however. Much damage needs to occur to the lining of the small intestine before this celiac disease test shows positive, making it a poor early marker for celiac disease. One doesn’t want to have to wait until they are at an advanced state of intestinal destruction. This test won’t show positive until the damage is severe. Additionally, not all celiac sufferers demonstrate villous atrophy and therefore this wouldn’t be the best celiac disease test for them. TTG- IgA is also not a test for gluten sensitivity.
Another liability to this most common celiac disease test is that typically only immunoglobulin A (IgA) is evaluated. IgA, a part of the immune system primarily found in mucous membranes, such as the small intestine, is the most sensitive for antibody testing, but only when a patient has normal functioning.
Total Immunoglobulin A, abbreviated total IgA, is an adjunctive test that should be done to prevent false-negative test interpretation. IgA deficiency is 10 to 15 times more common among patients with celiac disease than in the general population. Thus, total IgA levels should be quantified in a separate “total IgA” test to ensure that the IgA function is normal. If a deficiency is present, all tests utilizing IgA could be falsely negative, causing one to miss the presence of celiac disease or gluten sensitivity. Low IgA level s suggest inflammation of the intestinal lining and greater chronicity of the disease. A low IgA level may provide some insight into the duration of disease.
If IgA sensitivity is suspected or confirmed, measuring IgG in the form of a DGP test is the best alternative, or Cyrex Labs, mentioned below also offer great alternatives. Knowing this data is critical to ensure that you are not told that a test is negative when it’s a false negative.
Deamidated gliadin peptide, IgA and IgG, abbreviated DGP – IgA/ IgG has a high specificity and is considered a useful test among patients who have selective Immunoglobulin A (IgA) deficiency.
Endomysial antibody, IgA, abbreviated EMA-IgA. [Note: endomysium is a thin connective tissue layer that covers muscle fibers. These antibodies develop in reaction to damage to the intestinal lining. When the immune system attacks gliadin, it is not attacking “self” tissues but instead a foreign food protein. In contrast, as gliadin is absorbed through the intestinal lining, it attaches to the smooth muscle cells of the intestinal wall. EM antibodies are directed against proteins of these smooth muscle cells, and therefore EM antibodies are directed against “self” tissue. This defines them as auto-antibodies. Due to their attack on the smooth muscle of the small intestine, EM antibodies correlate better with damage to the intestine wall.]
Studies have supported an accuracy rate of approximately 90 percent for celiac disease. Actually, in one study, EM antibodies were present in 100 percent of individuals when total villous atrophy was present, and therefore like the tTG test, it suffers from a lack of accuracy when only mild damage has occurred to the intestinal lining.
This is a highly specific celiac disease test but it has variable sensitivity of 70 to 100 percent, due to the technical difficulty associated with performing the test. This liability associated with a higher expense makes it more of an adjunctive or follow-up test rather than a first-line screening tool.
Anti-Gliadin Antibodies, IgG and IgA, abbreviated AGA –IgA/IgG. [Note: Gliadin, the most abundant protein in wheat, is part of the gluten protein (similar proteins are found in rye, barley). Gliadin is broken down in the intestine to segments of protein (polypeptides) called exorphins. These exorphins can be responsible for many of the “extra-intestinal” symptoms associated with gluten sensitivity as they can cross into the brain creating behavioral changes, outbursts, inattention, mania, and other symptoms associates with schizophrenia, bipolar, ADHD, and autism. According to Dr. Davis, ingesting gliadin increases one’s caloric consumption by 400 calories per day!]
Antibodies to gliadin can bind to nervous system tissue and contribute to many of the neurological symptoms associated with gluten sensitivity such as ataxia, migraine, mood swings, and more.
There is no official test that has been approved for testing gluten sensitivity, but many feel that AGA is one of the best we have and both IgA and IgG are tested. AGA isn’t typically used to diagnose celiac disease but it is recommended as a follow-up test to help ensure the celiac patients are following their gluten-free diet. A positive AGA test on a celiac patient can indicate poor adherence to the diet.
Genetic testing – a simple swab of the cheek can tell you if you carry the genes for celiac disease (HLA-DQ2 or HLA-DQ8). If you do not carry the genes it is impossible for you to ever develop the disease. Upon that point, everyone is in agreement. However, beyond that, there are some varying opinions. Many doctors point out that if you aren’t showing signs of the disease there’s no reason to implement a gluten-free diet. Personally I think having one gene, let alone two is more than enough reason to embark on a gluten-free diet if you are experiencing any health issues. Of course, following up on a positive genetic test (there are some genes that are thought to predispose one to gluten sensitivity vs celiac disease and we often see patients who are clearly sensitive to gluten possessing one of each type. More research needs to occur in this area.) with available blood tests for both celiac disease and gluten sensitivity, along with the presence of typical symptoms and the improvement of said symptoms once a gluten-free diet is embarked on, all total to a valid diagnosis, without the need of an intestinal biopsy.
Anti-Reticulin Antibodies, IgA, abbreviated ARA-IgA. This test is not ordered as frequently due to its lack of sensitivity and specificity as compared to other autoantibodies. It is found in about 60% of celiac disease patients and about 25% of patients with dermatitis herpetiformis, the skin condition associated with celiac disease. When used, ARA is ordered along with other celiac disease tests as part of a panel.
Cyrex Labs – 11 Arrays. Saving the best for last, I want to mention Cyrex Labs that are fairly new on the scene as a lab but are, to date, offering some of the best insights to how a body is being affected by gluten, be it a celiac disease or gluten sensitivity. The lab offers many “Arrays” that shed light on not only a reaction to gluten but secondary effects of gluten as well in the form of cross-reactive foods, leaky gut autoimmune tendencies, and many more.
I mention this lab last as it is a specialty lab and therefore not available from most traditional medical doctors and I dare say that most gastroenterologists have likely never heard of them. But they provide excellent tools that are currently unavailable elsewhere.
Below are some real-life examples that have come to my attention via my blog and practice regarding a celiac disease test and what patients have had to endure regarding the faulty interpretation of their tests.
“Was told I’m not celiac….But I feel horrible. Below is my celiac disease test, what do you think?”
First are my old results:
Gliadin Antibody IgG 31 – High Range Normal = <11
Gliadin Antibody IgA 6 – Normal = <6
Tissue Transglutaminase IgA <3 – Normal = <5
Then last year everything was pretty much the same but Gliadin IgG 23.4 High Range , Normal = <10
What does it mean and if I’m not celiac why does gluten seem to make me feel so horrible? Help!
It hurts my heart to see such things. To interpret, this gentleman tested positive for non-celiac gluten sensitivity years ago. His doctor interpreted his celiac disease test as negative for celiac, an evaluation with which I don’t disagree. However, and this is a BIG however, the doctor neglected to mention that his immune system was definitely having a negative reaction to gluten – something we call non-celiac gluten sensitivity (NCGS). Of course, since he didn’t eliminate gluten his test continued to be positive, which we see in the later results.
The poor man feels horrible and it could have been completely prevented by correctly interpreting the celiac disease test correctly the first time.
Moral of the story: get the most comprehensive test you can. If you see anything abnormal, find someone who can correctly interpret the test. Don’t ignore what your body is telling you. If you need my help, I’m here for you.
Here’s another one:
My daughter recently had the following blood work results. These were ordered by her General Doctor as she was experiencing diarrhea. No other major symptoms. The results were/are:
Endomysial Ab IgA – Negative
Tissue Transglutaminase Antibody (tTG) 23 – Normal is 0-20.
She was advised that she is allergic to all glutens. Is that correct?
She has been referred for an endoscopic examination with a specialist.
Let’s look at this one. Realize this is a mom writing about her child so the phrase “allergic to all glutens” isn’t exactly correct, but that’s fine. Where the potential problem lies is in the outcome of the endoscopy test with the specialist. If it’s negative, is the specialist going to tell the mom that there isn’t any damage so therefore she shouldn’t subject her child to the rigors and severity of a gluten-free diet? I’ve seen that happen on many occasions.
The tTG test above is clearly positive and that indicates celiac disease. The child has diarrhea which is a classic symptom of celiac disease. If she removed gluten from her diet and was shown to have the genes for celiac disease, the outcome of the endoscopy would be moot. It would mean that four out of five necessary criteria for a celiac diagnosis would be met without the need for either doing the endoscopy or having a positive result.
Too often doctors are unaware of these criteria, which were published worldwide several years ago, by leading research experts from around the world in the area of celiac disease. About twelve different experts agreed on these criteria while also validating the presence of non-celiac gluten sensitivity as a valid condition.
I truly hope this child is put on a gluten-free diet before more damage can occur to her body.
Moral of this story: Do some research and know what it takes to receive a positive celiac disease test result, as well as a positive NCGS diagnosis. Actually your research is done right here by reading this blog! If you need more help, feel free to contact us through HealthNOW Medical Clinic San Jose.
Patricia V said…
I have been having stomach issues. I went for a blood test and this is the result of the celiac disease test:
Transglutaminase IgG <15
Transglutaminase IgA 27.3
Gliadin IgG: <15
Gliadin IgA <15
My primary Dr. said he thinks I might have Celiac Disease (and so does my mother). He wants me to make an appt with a Gastroenterologist. Just by the numbers (after all my research) it looks like Celiac. Transglutaminase is elevated – isn’t that indicative of Celiac? I am just confused by the “might” comment. Any thoughts?
I include this one as it is a classic example of something we see often. Now, this particular patient is very pro-active. She did her own research and correctly, I might add, diagnosed herself. She’s correct, her test is highly indicative of celiac disease with the transglutaminase value (tTG) being elevated. As I mentioned in the previous example, many doctors don’t know that a biopsy doesn’t have to be positive in the face of adequate criteria that make the diagnosis of celiac disease.
Let’s imagine this patient wasn’t so pro-active. Let’s imagine she didn’t have the wherewithal to go to see a specialist – the gastroenterologist. What if the thought of seeing a specialist, let alone the cost of doing so was overwhelming to her? What if there was a 6 to 9 month (or more) wait to see the specialist? In other words, there could be many reasons a patient who very likely has celiac disease is not going to pursue it further. And because the doctor was keeping it all so vague, an individual could very likely leave with the idea that they “might” have something but since the doctor wasn’t emphatic they can brush it off.
If this sounds unlikely, let me assure you that I have run into this scenario more times than I’d like. The result is a person who becomes more and more ill from a disease that they later find could have been prevented by removing gluten from their diet. If they had only had their lab test interpreted correctly, they could have stopped eating gluten and prevented the development of a disease that is now shortening their life.
Here’s another real-life example:
A woman had been previously diagnosed from her doctor with DH (dermatitis herpetiformis), a very unsightly and uncomfortable skin condition and a form of celiac disease. DH is absolutely known to be caused by gluten, yet this was never told to this patient. Fast forward a few years and this woman has now developed more health problems, specifically multiple sclerosis, an autoimmune disease of the nervous system.
Gluten is known to create autoimmune disease. Further, gluten is known to affect the nervous system more than any other system in the body, including the digestive tract.
Upon seeking help after her M.S. diagnosis, a smart doctor noted that she had DH and recommended a gluten-free diet. She is feeling better gluten-free but she now has M.S., a disease she could have avoided developing.
Can we state categorically that if she had eliminated gluten upon first being diagnosed with DH that she would not have developed M.S.? No, we can’t. But it does cause one to wonder what could have occurred if, once the “skin manifestation of celiac disease” (DH) was first diagnosed, a gluten-free diet was implemented.
The reader also asks if blood tests can be negative with DH. Yes, they can and frequently are. Also, remember that even those diagnosed with celiac disease via biopsy show negative blood results 15% of the time.
That’s why the moral of the story at this time is to evaluate how you feel when you eat 100% gluten-free for a couple of months. Until we have highly sensitive tests we can rely on to accurately diagnose gluten sensitivity, diagnosing will involve “building a case” by pulling together many pieces of information about the patient including symptoms, response to a gluten-free diet, lab tests, genetic history, presence of intestinal infections, etc.
This leads us to explain some things about this particular patient. She has known to have DH which is solely due to gluten, yet it can be present with negative blood tests. Does that make the diagnosis or need for a gluten-free diet in question? Not at all. She has now been diagnosed with MS. We know that second to the digestive tract, the most common system to be affected by gluten is the nervous system, with autoimmune diseases occurring at a very high rate. Does the negative celiac disease test ensure that gluten had nothing to do with the development of MS? No, it doesn’t, since that often happens with DH patients. We’d need to know a lot more about this patient (which by the way is the most difficult part of hearing from readers long distance – I want more data.) but I wouldn’t be surprised to find other factors which point to gluten as the culprit.
Gluten-sensitive patients not only have to do their own research regarding their symptoms but they have to self-diagnose and sometimes are forced to interpret their own lab tests!
What a sad story. I would like to say it’s unique and uncommon but unfortunately, quite the opposite is true. The lack of understanding of the damage gluten can cause is staggering.
The next example is another classic example of where, in my opinion, our medical profession “falls down” when diagnosing celiac disease. The individual below has a positive celiac disease test, yet after 4 months on a gluten-free diet, feels no better. As confused as she is, how long do you think she will continue the diet when she feels no better? Let’s take a look and then I’ll explain what is likely going on.
These are my test results:
Gliadin Ab (IGA) 49 units (<20)—[Is it very high? What would be the highest number?]
Gliadin Ab (IGG) 13 units(<20)
Endomysial Ab : Positive
Those were tests I had for celiac. Doctor told me to go on gluten free diet since tests are positive for celiac disease. But what does it mean that IGG is negative? And IGA 49 confirms celiac?
I didn’t have a biopsy performed. I am 4 months on gluten free diet and I am not feeling better. 🙁
It is a positive endomysial test that has caused her doctor to diagnose celiac disease. The AGA – IgA test is also positive, giving us strong evidence that her body is having a negative reaction to gluten. We, humans, are so funny sometimes. In an effort to justify why we can go against the result of a positive test, we ask “how positive is it’? It’s like getting a positive pregnancy test back and asking “how pregnant am I?” It’s an all or nothing proposition. When a test is positive it’s positive, period.
I further went on to explain to her that a body either has celiac disease or it doesn’t. There’s no such thing as ‘mild celiac’ or ‘a little celiac’.
With that said, I don’t blame her for questioning the diagnosis when she’s not feeling any better following the diet. This individual wrote in from a blog. Since she wasn’t a patient, I had no more data to hand than what was provided. But since the EM test is so highly accurate, it’s unlikely that Ada is not being negatively affected by gluten. The reason she doesn’t feel better likely lies in the area of the secondary effects of gluten that haven’t been addressed that are perpetuating her symptoms. I speak often on this topic, feel free to search the blog for more information.
We mentioned earlier when reviewing celiac disease test options that a low IgA can potentially falsely affect test results. Below is such an example.
My results are:
Transglutaminase Ab (Iga) <3
IgA SERUM 52 low
C-reactive is high
Feel awful, weight gain, have high blood pressure, inflammation and pain.
When the total IgA results are low, any test utilizing that immunoglobin will be false. Therefore we cannot tell whether this person has a positive tTG or not. It’s too bad that the lab did not also measure IgG in the form of other tests. The high C-reactive protein shows inflammation, so it is important to figure out where it coming from.
We definitely cannot state for sure that the individual has celiac disease but we do know that inflammation is present and something is overwhelming his/her IgA, a key constituent of the immune system. And of course, we know that he/she feels terrible.
Having done this job for decades, what I too often witness is a patient such as this one walking away from such a celiac disease test result with the feeling that they: a) looked for a disease, b) it wasn’t found and now, c) they just need to “get used to” feeling terrible. It may sound silly but believe me, it’s a very common occurrence. It makes me want to scream, honestly, but it happens a lot. Helping such people get to the root cause of their problem is what I specialize in.
The stable datum is that if the body is feeling terrible there IS a reason for it. Finding out the root cause of why is not terribly difficult when you know-how.
We have the diagnostic and testing tools, the clinical experience, and a different medical approach to discovering the root cause of why you have the symptoms that are bothering you. As long as you are ready to make some dietary and lifestyle changes, we can help you. We will "hold your hand" through the changes, step by step, to make each step an easy one. We are located in Clearwater, FL, at 1000 S Ft Harrison, at the corner of Ft. Harrison Ave. and Magnolia St. There is plenty of parking space directly accessible from Ft Harrison. If it is not convenient for you to come to Root Cause Medical Clinic, we offer telehealth/telemedicine consultations to residents of certain states. Call us for details.
Contact us for a Consultation – Call 727-335-0400
Dr Vikki Petersen is a public speaker, author of two books, several eBooks and creates cutting edge content for her YouTube community. Dr Vikki is committed to bringing Root Cause Medicine and its unique approach to restoring health naturally to the world.
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Gluten free diet can tak up to 18months to notice affects as receptors in stomach need to repair leaky gut syndrome
Everyone is different Stuart. Also remember that while avoiding gluten is a “must” some people never heal until they address other components causing inflammation.
Diagnosed a coliac as an infant as failing to thrive and followed a very strict gluten free diet regime until teenage years. I had regular hospital testing throughout childhood into my teenage years. At the age of approx 15/16 I was taken off the gluten free regime by hospital and advised to eat normally. Now aged 57 after some years of abdominal discomfort I have had an endoscopy and blood testing and have now been told I should never have been removed from the gluten free diet? I have asked previously a number of years ago if this was an issue but never given advice to restart the gluten free regime. Still early doors but already I see a huge difference after just a few weeks Gluten Free. All advice online says I should never have stopped the Gluten Free regime and looking on here at the potential implications of type 1 diabetes and MS etc is absolutely terrifying. How can this be the case?
So frustrating William and I’m sorry you were given such poor advice.
Moving forward there are several things that can be done to lessen the chances of developing other conditions that you wish to avoid. These are the secondary effects of gluten that conventional doctors do not look at nor have testing to evaluate. It’s all natural as regards treatment, but I would definitely investigate any possible secondary effects if it were me.
Please consider contacting us for a free phone consultation – call 408-733-0400.
I apologize in the delay getting back to you. For some reason your question was overlooked.
I’m so confused because I was told I was borderline Celiac…what does that even mean? Any clarification would be greatly appreciated.
My test results:
Gliadin IgA Ab range is 0.0-14.9 mine was 88.8 H
Tis Transglut Ab IgA range is 0.0-14.9 mine was <0.5 (I)
Is there a way to contact you, an email? I am currently in a situation similar to your posts. Thank you. (Timothy)
My daughter is a type I diabetic these are her results: t-Transglutaminase (tTG) IgA
t-Transglutaminase (tTG) IgA
What does this mean? Thanks
Hey. I’m a girl 17 years old, who very coincidentally got tested for celiac disease 1 year ago since I stopped growing and I had no period. I got biopsy which showed grade 1, I had HLA Dq2 (I don’t know what that is) and Anti tTg IgA 21 U/ml positive but the doc said it was not enough to diagnose yet. Then I tried gluten-free diet for a month and suddenly my Anti tTg IgA got down to 10 U/ml but then I started to eat gluten again, and today my level of IgA has raised to 31 U/ml. What does that mean? I’ve no symptoms. Can high anti tTg IgA be caused by other things?
Sorry for the delay in getting back to you, your question got “lost” amid a great deal of others unfortunately.
Yes, elevated tTG can be caused by other things, but you have the gene that makes it possible for celiac disease, the HLA DQ2 you referred to. Also Ivy, your tTG went down when you stopped gluten and elevated when you resumed.
I would be more than happy to assist you in sorting out your diagnosis. Since you are 17, please ask a parent to give us a call and we can set up a free phone consultation – call 408-733-0400. This is our area of expertise and we would be delighted to help.
My son was diagnosed with celiac disease 3 weeks ago and I just received his blood test results in the mail. I am in no way trying to “deny” the positive results, but after reviewing, I am skeptical. In all honesty, while I do not want him to have a lifelong sentence, I was relieved to have an answer. He has been gluten free since his diagnosis, but I am looking for some clarification on his tests.
IgA TMCL 150 (60-337)
Tiss Transglut ab IgA TMCL <1.2 (<4 Neg)
Tiss Transglut ab IgG TMCL 7.7 (H) (<6.0 Neg)
I assume they reacted because of the elevated IgG, but with the low IgA I'm not 100% convinced.
You’re right Cheila,
The results are potentially not aligned with celiac.
There are more metrics that should be looked at.
If you’d like to receive a free phone consultation we’d be delighted to help. Sorry for the delay in getting back to you; your comment somehow was overlooked by my team.
Please consider contacting us for a free phone consultation – call 408-733-0400.
This is our area of expertise and we’d be delighted to assist you and your son.
Are there conflicting info in this article or did I misread this? Under the 6 stories of celiac cases, the first one mentions the normal range of t-Transglutaminase IgA is <= 5, while the second story says it's <20. Which one is correct?
Different labs are different and when it comes to celiac they are looking for highly elevated levels. But the problem with that is that more slightly elevated levels are negated which many disagree with. Diagnosing celiac disease involve “building a case” and taking many measurements into account.
If you’d like to provide your symptoms and full test results we’d be delighted to help.
We can offer you a free phone consultation to assist you in the best direction to take. Call us at 408-733-0400.
We look forward to hearing from you.
Still confused by my results (Anti ttg iga <1.9, & iga 1.4)
Those tTG results are negative but in order to help you I’d need to know more about your symptoms Paul.
Feel free to contact us via the website: http://www.RootCauseMedicalClinics.com. We can set up a free phone consultation (call 408-733-0400) and decide the best approach for you.
We’d be delighted to help.
My initial testing for Celiac showed my DGP IgA @ 83 units. The DGP IgG was 3 units. The tTg IgA and IgG were both negative. A Gluten Free Diet alleviated my symptoms of chronic diarrhea and my DGP IgA went down. But I was still not convinced that I actually had Celiac’s Disease especially after my egd and colonoscopy also came back negative. I asked for DNA testing for months as I can’t afford a GF diet if it is not necessary. My Dr told me to quit reading the internet. But finally after almost a year my Dr gave in and ordered the test. My DQ2 and DQ8 both came back as negative. I’m thinking I fall in the lines of NCGS. What is your opinion Dr Vikki? If the only test i had in the beginning that showed positive was the DGP IgA, what does that mean? Does it point to NCGS instead? Can I go off of this extremely expensive GF diet and just reduce the amount of gluten I consume? Thank you for your time. Lisa
I agree that you do not fall within the criteria of celiac disease. HOWEVER, and this is important, you do fall within the NCGS criteria and the diet recommendation is still a no-gluten diet.
You do not want to treat NCGS lightly. It has been well researched that gluten creates a great deal of damage for the those with NCGS even though they don’t have celiac.
I’m sorry; I know you’d like to hear that “less gluten” will suffice, but I must tell you that isn’t the case.
Your long term health and longevity will thank you for the effort to avoid all gluten.
Let me know if that makes sense.
I’m happy to help!
There are celiac fully diagnosed patients with positive intestinal vili atrophy that do not carry the genes. This is even stated on the celiac. Org website.
You are correct Ashley, but while showing no villous atrophy is fairly common, not carrying either the DQ2 nor DQ8 gene is rare. And, the diagnosis of what exactly villous atrophy/inflammation IS precisely is also a problem. Thx for the comment.
Hi Dr. Petersen, my labs showed positive ttg iga ab of 19 (>/=4 antibody detected) however the biopsy could not confirm any intestinal damage. I’m worried maybe it was missed since only 2 biopsies were taken. I’ve been gluten free most days of the week since the lab results but haven’t felt any different. I have atypical symptoms. Is the ttg iga ab result high enough to take action? Wondering how to manage this long term.
Hi Thomas, I understand and have a lot of patients that have been going through something similar. I would have to have a consultation to give you more insight though. Unfortunately I’m not allowed to give personalized medical advice online to those that aren’t patients. Give my office a call and we can get you scheduled. 408-733-0400
Can you help interpret these numbers for me? I have been suffering from stabbing and burning pain in my upper stomach off and on for 3 years so my Dr had me do a EDG and Colonoscopy. After she had me give a blood sample for these:
Immunoglobulin A, Qn, Serum 238/mg, Deamidated Gliadin Abs Iga LC 5 units, Deamidated Gliadin Abs, IgG LC 3, units tTg lgG LC 2/ml,
tTG LgA LC <2 She told me to start a gluten free diet and we will retest in 3 months. What do these numbers mean to you?
Hi Corina, I would love to discuss this with you. I can help with the labs, but unfortunately I’m not allowed to give medical advice online to those that aren’t patients. Give my office a call and we can get you scheduled for a consultation: 408-733-0400
I just had a celiac test done with only 2 numbers on it.. They are Transglutaminase IgA <0.5 U/mL <15.0 U/mL,
IgA, Celiac 101 mg/dL 85 – 499 mg/dL. That is all they did, not sure what these mean.
It’s a little confusing.
tTG IgA < 0.5 is definitely negative. You then write <15.0/mL, which I don't understand. Are you giving the range of the tTG IgA? What exactly was your result of your tTG IgA? You then write IgA, Celiac 101 - there is no "test" called celiac 101. It seems that the 2 values measured were all within normal limits but to be sure I would need the following: 1. Each test result listed, the result and the reference range. 2. What prompted you to get the test; in other words what are your symptoms. I'd be happy to help but I need some clarification. Best, Dr Vikki Petersen
Hi! Could you help me with understanding whether or not I have celiac disease. My doc said no. But I have severe nausea everyday, bloating, head and body aches. Extreme distention, fainting, anemia, hair loss and very low ALK on blood tests. My TTG igg and iga was negative. My Dgp IGG was positive. Anything over 10 was positive and I was a 16. Dgp IGA was positive. Anything over 14.7 was positive and I was a 15.3. I also have 2 DQ2 genes for celiac disease with put me in the high risk category. My endoscopy was negative which is why my doc is saying I don’t have it. That and the ttg was negative. What are your thoughts? Thank you so much for any help you can give. I’m desperate for some help.
I’m sorry I just saw this Katie. It’s sad that doctors still don’t know that a positive biopsy is no longer required for a celiac diagnosis.
1. The diagnosis which it seems you have based on the testing. The only additional questions are if you see any improvement with your symptoms when you are 100% off gluten.
2. Even if gluten is removed and you’re feeling better, more is required to fully rebalance your immune system, gut and hormones.
I’d be delighted to help you fully sort this out but I need more data. Consider contacting us for a free phone consultation – call 408-733-0400.
My results came back and the doctor continues to say celiac is likely but nothing definitive. I have been on an elimination diet (started after the first test) without gluten, so at this point, should I follow up with a GI for a biopsy? Or is this conclusive enough? Is there benefit to doing a biopsy to understand the extent of the damage given these results?
2/28/22 (pre-elimination diet):
TTG AB, IG = 27 (range is > or = 15, antibody detected)
IGA = 239 (range is 47-310 mg/dl)
Endomysial Antibody SCR (IGA) w/refl to titer = Negative
CBC all normal except platelets that were slightly elevated
HS CRP was >10 showing high levels of inflammation
Thyroid panel all normal
3/22/22 (one week on elimination diet):
Gliadin deamidated AB IGA = 41.2 (range > or = 15, antibody detected)
Gliadin deamidated AB IGG = 15.7 (range > or = 15, antibody detected)
Endomysial Antibody SCR (IGA) w/refl to titer = Negative
HLA DQ2 = Positive
Since you’ve been off gluten a biopsy doesn’t make sense. Your genetics are positive; you have a positive blood test (tTG), in order to fulfill the 4 out of 5 rule you only need to have symptoms of celiac AND feel better removing gluten from your diet. It’s important to realize such changes are seen over a 6 to 8 week period, not 1 week. I’d be delighted to help you fully sort this out but I need more data. Consider contacting us for a free phone consultation – call 408-733-0400.
I am currently in the process of querying whether an endoscopy/gastroscopy is required for full diagnosis. I would like to hear your thoughts on whether you think this is required and your interpretation of my results.
My results are below:
Endomysial Ab : Positive
Other result was either Gliadin Ab or Tissue Transglutaminase Antibody (tTG) (apologies cannot remember which was done), was told normal range is 0-20 and my results came out as 388. Should I be concerned about such a high number?
Yes, it sounds like you potentially have celiac disease. It’s important to not ignore these results.
If you’d like a consultation, we’d be delighted to assist you: call 727-335-0400.
How do I send my test results
Hello Dawn, Once you schedule a consultation, we can go over your test results. Are you interested in a consultation? 408-733-0400
My DGP Iga was 21 positive but everything else on the panel was negative. I can’t get in to the Dr for another 2 weeks to discuss my results. Can you help me understand?
What does the IGA sufficient at 314 mean? Thank you!
Hi Amy, we would have to set you up for a consultation to learn more about your health and results. Would you like to set that up?
Blood Test results for child age 14- stomach aches very common and trying to find out why…
Wheat IgG Moderate 6.15 mg/L <3.5 mg/L
Gliadin IgG Low 5.89 mg/L <3.5 mg/L
Gluten IgG Low 5.30 mg/L <3.5 mg/L
Says test is negative for Celiac Disease. Could this be correct?
Yes, that could be correct, but the results don’t rule out gluten sensitivity. We’d be happy to explain the next steps if you’re interested. You can call us for a consultation: 727-335-0400.
I haven’t had. Lood work yet but my new gastroenterolist has already done biopsies, it came back saying suggestive of celiac disease, does that mean a positive diagnosis?
It depends! We would have to see your test results and see our doctor. Please give us a call: 727-335-0400
Hello Dr. Trying to understand my test results…. I have symptoms of tons of gas, bloating, burning, abdomen pain, back pain, white tongue, etc… Had a biopsy a couple yrs ago, negative, got bloods done recently.
Ttg iga neg
Ttg igg neg
Diam igg neg
Diam iga 22. 3 positive
I would need some more data, but the deamidated IgA is suspicious. Consider calling us for a consultation so that we can discuss. 727-335-0400.
I had an IgA of 2 and an IgG of 40. My son just tested positive for celiac sprue with and IgG of 40. My endoscopy is negative, his was positive. According to 23&me I do not have variants in HLA-DQA1 or HLA-DQB1. I have had stomach problems all my life. My mom lives gluten free and she didn’t want to reintroduce gluten to test for it, but her life is much better. I think I should go gluten free…anyone agree? disagree? Thanks.
Based on everything you’ve said, I would recommend the lab test Wheat Zoomer by Vibrant America. You deserve to find out if you’re gluten sensitive since you don’t seem to have celiac disease. We can help you with the test if you’re inteterested.
I’ve been in pain for 7 yrs without a diagnoses other than gastritis and ibs. I have abdomen pain, tons of gas, constipation, back pain, large soft sticky stools, white tongue and more. I had a celiac test. ttg iga neg, ttg igg neg, Diam glad iga 22.3 positive, diam glad igg neg , all tests <15 total iga normal, Just had another endoscopy, found inflammation in Antrum, and duodenitis, inflammation of duodenum….waiting on biopsy.
Jeremy, I’m sorry you’ve been going through that. Our clinicians have a lot of experience in this area and we can absolutely help you. The first step is getting a consultation. What’s the best number to reach you at? Our office number is: 727-335-0400
My GLUTEN (F79) IGG test revealed <2.0. What does this mean? I tested negative for celiac disease. Which specific test do I need to take to rule out celiac genetic marker as it was informed one of my parents carry this gene.
Hello Michelle, We would be happy to answer your detailed question, but would need to first do a health consultation. What’s the best number to reach you at? Our office number is 727-335-0400