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Celiac Serology after Gluten Challenge

GfreeOH
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Go to solution Solved by Scott Adams,

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GfreeOH Explorer
GfreeOH
Posted

Hello,

I have a one-off question regarding Celiac Serology. I had an EGD on Monday of Last week after a 7/8 week gluten challenge. I had been gluten free for 6 months prior to the gluten challenge. The EGD found Villous flattening and suspected Celiac. I have the Celiac HLADQ Genes confirmed by Mayo clinic already.

My question is:

The Gastro's office called me this AM to let me know that they would still like my to have Celiac Serology drawn and I need to be eating gluten while having them drawn. I explained to them I had gone gluten free again over the weekend (since Thursday evening) to get out of the abdominal pain I was having and asked when I should have the bloodwork drawn. The nurse stated to have them done in a day or two. Would me not eating Gluten Thursday-today skew the ttg-iga/Igg results if I have the labwork drawn in a day or two ? I want to have accurate bloodwork this time and do not mind waiting a week or two to have the lab drawn if I need to eat gluten for a longer period of time for accuracy. I was gluten free for at least 6 months prior to the 7/8 week gluten challenge.  

Thanks in advance for any input:)

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  • Solution
Scott Adams Grand Master
Scott Adams
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Posted

Having stopped for a couple of days may not affect the result greatly, but the recommendation is that you should be eating gluten daily for 6-8 weeks before a blood test. I think if you just started eating it again for the few days before the test it should still be accurate. This article has more info:

 

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GfreeOH Explorer
GfreeOH
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Posted

Thanks Scott. I had that idea as well, so, I went back on a gluten-diet Monday after just a brief few days of being gluten free. I can’t imagine it would skew the blood serology much. I had the bloodwork drawn today - so we shall see what it says. I was instructed to go gluten free post serology testing since I have already had the positive EGD and gene testing, so I will know in a few days if the diagnosis will be confirmed.

I appreciate the feedback.

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Scott Adams Grand Master
Scott Adams
Posted

Let us know how it turns out, and the biopsy results alone mean that a gluten-free diet is very likely in your future.

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GfreeOH Explorer
GfreeOH
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Posted
15 minutes ago, Scott Adams said:

Let us know how it turns out, and the biopsy results alone mean that a gluten-free diet is very likely in your future.

Absolutely will do! 😊

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GfreeOH Explorer
GfreeOH
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On 1/26/2023 at 8:21 PM, Scott Adams said:

Let us know how it turns out, and the biopsy results alone mean that a gluten-free diet is very likely in your future.

So…my TTG-IGA and IGG results just posted to the portal. Both were <1.2 - so they are NEGATIVE. My total IGA is over 200 so I am not deficient in IGA. I asked multiple times if they were doing the full panel and he said yes. I even called the Gastro office before heading to the lab to ensure it was a full Celiac lab panel, and the nurse guaranteed it was.

Now, I sit with a POSTITVE EGD, POSITIVE Gene pairs, and NEGATIVE TTG-IGA & TTG-IGG (not a full panel of serology).

It’s so very frustrating not knowing what’s causing your abdominal pain/symptomology. I’m worried I will get a call Monday once he reads my TTG-IGA is negative only to tell me I am NCGS. How can one be NCGS and still have damage to the Vili/intestinal damage? Everything I read says NCGS has no intestinal damage - so how can that be my answer? 

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Scott Adams Grand Master
Scott Adams
Posted

We've seen your scenario before, and traditionally the biopsy results have always been the gold standard. After all tests are done perhaps you should just try a gluten-free diet for a few months to see if your symptoms disappear? 

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