Low IgA, dr won’t test IgG

[Runningyogi]

Just wondering how common this is. I had tTg-IgA and gliandin IgA tested and they both came back at 2, which is without a doubt a “negative result.” However my IgA was 48, the lab cited 79-335 as “normal” and flagged me as low. My PCP said the test shows no celiac, I had already googled and discovered the low IgA situation so I asked her about testing IgG and she said it wasn’t necessary. 

 

Is my IgA just not low enough? I obviously make the antibody just not at a normal level. 

Has anyone else been told this, if so did you push for further testing or get a second opinion? I’m mostly trying to just rule some things out, my son has EoE so it’s not totally unlikely im suffering from something more than IBS. Thanks!

[kareng]

5 minutes ago, Runningyogi said:

Just wondering how common this is. I had tTg-IgA and gliandin IgA tested and they both came back at 2, which is without a doubt a “negative result.” However my IgA was 48, the lab cited 79-335 as “normal” and flagged me as low. My PCP said the test shows no celiac, I had already googled and discovered the low IgA situation so I asked her about testing IgG and she said it wasn’t necessary. 

 

Is my IgA just not low enough? I obviously make the antibody just not at a normal level. 

Has anyone else been told this, if so did you push for further testing or get a second opinion? I’m mostly trying to just rule some things out, my son has EoE so it’s not totally unlikely im suffering from something more than IBS. Thanks!

Your total IGA is not too low for Celiac testing.  The test range isn't specific to Celiac.

"Any level of IgA above 20 mg/dl should make the tTG-IgA test valid, regardless of age."

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[cyclinglady]

Your Immunoglobulin A (IgA) is low or below range, but it is enough to determine if the celiac tests work.  It would have to be close to zero.    So, two negatives is probably correct.  However, some celiacs are seronegative.  Some, like me, do not test positive to all the celiac tests (DGP, TTG and EMA).  (I test positive to only the DGP).  Some people at the time of testing might gluten free or gluten light.  In those cases, an endoscopy may be ordered.  

Do you have any deficiencies like low iron or B-12?  That can also help determine a celiac diagnosis.  Or do you already have another autoimmune disorder, like Hashimoto’s Thyroiditis or autoimmune diabetes?  

I am sorry to hear about your son suffering;g from EOE.  

[Runningyogi]

41 minutes ago, cyclinglady said:

Your Immunoglobulin A (IgA) is low or below range, but it is enough to determine if the celiac tests work.  It would have to be close to zero.    So, two negatives is probably correct.  However, some celiacs are seronegative.  Some, like me, do not test positive to all the celiac tests (DGP, TTG and EMA).  (I test positive to only the DGP).  Some people at the time of testing might gluten free or gluten light.  In those cases, an endoscopy may be ordered.  

Do you have any deficiencies like low iron or B-12?  That can also help determine a celiac diagnosis.  Or do you already have another autoimmune disorder, like Hashimoto’s Thyroiditis or autoimmune diabetes?  

I am sorry to hear about your son suffering;g from EOE.  

I suffered from low iron for a few years but then had an IUD placed and my iron levels have been normal since.  No other autoimmune that I know of. Just a long history of IBS. 

Thanks for your help! 

[GFinDC]

I think they say that around 5% of people with celiac disease also have low IgA production.  I'd try another doctor for the complete celiac panel.  There are other antibodies they can test and you might show up positive on one of them.  Maybe search for local celiac support group and ask them for a doctor recommendation.

[Runningyogi]

12 hours ago, GFinDC said:

I think they say that around 5% of people with celiac disease also have low IgA production.  I'd try another doctor for the complete celiac panel.  There are other antibodies they can test and you might show up positive on one of them.  Maybe search for local celiac support group and ask them for a doctor recommendation.

 

Thank you! I am seeing lots of conflicting info on low IgA and how it affects the testing. It’s also difficult because when I search most results are for IgA deficiency and not low IgA (deficiency is the close to zero result from what I understand)

i did find a couple of sites that mentioned low IgA specifically and did say to check the IgG, but at this point I feel like a hypochondriac chasing a diagnosis. 

Anyway, thanks for your help everyone. I have a GI appointment next month so I just need to decide if I should trial myself off gluten before hand or wait on the off chance he wants to run another test. I’m just kind of sick of being sick and I’ve felt better off gluten in the past. (I was off gluten due to nursing my wheat, barley and rye allergic son for almost two years)

[ravenwoodglass]

1 hour ago, Runningyogi said:

 

Anyway, thanks for your help everyone. I have a GI appointment next month so I just need to decide if I should trial myself off gluten before hand or wait on the off chance he wants to run another test. I’m just kind of sick of being sick and I’ve felt better off gluten in the past. (I was off gluten due to nursing my wheat, barley and rye allergic son for almost two years)

Please wait to go gluten free as if you go gluten free now the doctor won't be able to test you for celiac.  If your son is 'allergic' to wheat, rye and barley it sounds like he may be celiac. Your being diagnosed could help him as well as yourself.

[Runningyogi]

55 minutes ago, ravenwoodglass said:

Please wait to go gluten free as if you go gluten free now the doctor won't be able to test you for celiac.  If your son is 'allergic' to wheat, rye and barley it sounds like he may be celiac. Your being diagnosed could help him as well as yourself.

He actually outgrew the wheat allergy! Hooray!  He has traditional, IgE mediated, food allergies. He's still allergic to barley and rye.

I think it's probably best to leave the gluten in just in case, even though it really looks like celiac is not what I have. 

[erika1petrus]

Hello ? I have low IgA. My doctor said that IgA is the immune protein that keeps one from getting sinus infections & breaks down gluten & dairy in the gut. With low IgA, a celiac test will come back with a “false positive”. I was told to treat myself as if I have celiac disease & that the consequences of eating gluten are the same. I am never supposed to eat gluten or dairy. Hope this helps!

[tessa25]

21 minutes ago, erika1petrus said:

With low IgA, a celiac test will come back with a “false positive”

Low IGA can cause TTG IGA and DGP IGA celiac tests to show a false negative.

Welcome to the forum!

[Runningyogi]

4 hours ago, tessa25 said:

Low IGA can cause TTG IGA and DGP IGA celiac tests to show a false negative.

Welcome to the forum!

Thanks! It’s interesting because the link someone shared above says as long as the IgA is over 20 the test is accurate but I’ve read annecdotal stuff suggesting otherwise. 

[cyclinglady]

39 minutes ago, Runningyogi said:

Thanks! It’s interesting because the link someone shared above says as long as the IgA is over 20 the test is accurate but I’ve read annecdotal stuff suggesting otherwise. 

That link is pretty spot on.  The University of Chicago is a leading celiac research center.  We are discussing testing for celiac disease (used as a control test) and not issues with a low Immunoglobulin A and the health issues that arise from that. 

Some celiacs are seronegative period (rare).   If you think your IgA results are incorrect, then ask for the IgG test versions.   If you  and your GI strongly suspect celiac disease, your GI should order an endoscopy.  

You should remain on gluten until all testing for celiac disease is complete.  Since your GI appointment is just a month away, I would advise sticking to a full gluten diet.  Some research centers advise 2 to 4 weeks prior to an endoscopy.  We have seen too many members who just did 2 weeks and then received a negative biopsy result.  Was it because their bodies were slow to generate antibodies and two weeks was just not long enough?  Who knows?  Now they are in diagnostic limboland.  Use the more conservative number, would be my non-medical advice.  

Keep in mind, that sometimes we jump to conclusions with out all the facts.  I could have sworn my niece had celiac disease.  Turns out it was Crohn’s.  I could have sworn I had active celiac disease with my symptoms and an elevated celiac antibodies.  My recent repeat endoscopy revealed healthy villi.    My  current issues were with a new diagnosis — Chronic Autoimmune Gastritis. 

[Runningyogi]

Yeah sorry wasn’t trying to insinuate that the link was wrong. Also, i don’t have any strong feelings that I have celiac. I don’t know WHAT I have unfortunately! I was just trying to rule it out and then I had the low IgA which led to me to researching that and I was curious if that was indicative of something yadda yadda...I fell down an Internet rabbit hole. Lol

[pupppy]

You have iga deficiency... it's called partial iga deficiency. Anything under the range is iga deficient and can invalidate the iga test. According to mayoclinic's algorithm they are supposed to run the igg tests so you are right. I don't know what that other link is saying, but I think you are right

Open Original Shared Link

Open Original Shared Link

[pupppy]

 

On 4/12/2018 at 3:45 PM, cyclinglady said:

Your Immunoglobulin A (IgA) is low or below range, but it is enough to determine if the celiac tests work.  It would have to be close to zero.    So, two negatives is probably correct.  However, some celiacs are seronegative.  Some, like me, do not test positive to all the celiac tests (DGP, TTG and EMA).  (I test positive to only the DGP).  Some people at the time of testing might gluten free or gluten light.  In those cases, an endoscopy may be ordered.  

Do you have any deficiencies like low iron or B-12?  That can also help determine a celiac diagnosis.  Or do you already have another autoimmune disorder, like Hashimoto’s Thyroiditis or autoimmune diabetes?  

I am sorry to hear about your son suffering;g from EOE.  

You're wrong. Partial iga deficiency is still iga deficiency and the doctor is supposed to run igg tests. 

[pupppy]

On 4/12/2018 at 3:42 PM, kareng said:

Your total IGA is not too low for Celiac testing.  The test range isn't specific to Celiac.

"Any level of IgA above 20 mg/dl should make the tTG-IgA test valid, regardless of age."

Open Original Shared Link

 

You and your link are wrong. Algorithms for testing state that if iga is out of range they should test for igg.