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TTG 25

LP023
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LP023 Contributor
LP023
Posted

I recently had a ttg and the results were 25 and I was told that it was positive by Gastro. I don’t hurt when I eat gluten but I feel awful when I eat vegetables and meat like on a keto diet. Could it be false positive? Is 25 high enough to be a for sure diagnoses? I can go several months with no issues at all and then get sick but eating bread, pasta, pizza and other foods that contain gluten don’t bother me.

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trents Grand Master
trents
Posted

Welcome to the forum, LP023!

Can you also supply the reference range for negative vs. positive? Without that it is not possible to say whether or not your score represents a strong positive as each lab uses a different standard.

Yes, it is possible that this represents a false positive but not likely. The tTG-IGA is considered to a celiac test with good specificity and good sensitivity. The next logical step is for you to schedule an endoscopy with biopsy of the small bowel lining. That is considered to be the gold standard test for celiac disease.

The fact that you do not experience GI distress when you consume gluten products certainly does not rule out celiac disease. A high percentage of those with active celiac disease do not have GI distress, at least not until the damage to the small bowel villi gets to an advanced stage. We call them "silent celiacs". The fact that you have trouble digesting meat and veggies could very well be caused by a damaged gut from celiac disease.

If you intend to go for the endoscopy/biopsy, make sure you do not start a gluten free diet until that is done.

Scott Adams Grand Master
Scott Adams
Posted

Did they also run any other celiac disease tests in your panel, for example DPG?

LP023 Contributor
LP023
Posted
  • Author
15 hours ago, trents said:

Welcome to the forum, LP023!

Can you also supply the reference range for negative vs. positive? Without that it is not possible to say whether or not your score represents a strong positive as each lab uses a different standard.

Yes, it is possible that this represents a false positive but not likely. The tTG-IGA is considered to a celiac test with good specificity and good sensitivity. The next logical step is for you to schedule an endoscopy with biopsy of the small bowel lining. That is considered to be the gold standard test for celiac disease.

The fact that you do not experience GI distress when you consume gluten products certainly does not rule out celiac disease. A high percentage of those with active celiac disease do not have GI distress, at least not until the damage to the small bowel villi gets to an advanced stage. We call them "silent celiacs". The fact that you have trouble digesting meat and veggies could very well be caused by a damaged gut from celiac disease.

If you intend to go for the endoscopy/biopsy, make sure you do not start a gluten free diet until that is done.

I think 0-3 negative

4-10 week positive and anything over 10 positive. 

LP023 Contributor
LP023
Posted
  • Author
2 hours ago, Scott Adams said:

Did they also run any other celiac disease tests in your panel, for example DPG?

Not that I know of. CRP was fine. I guess that’s for inflammation.  Vitamins were fine. Running a colonoscopy, swallow test and upper endo but the wait is long. I haven’t eaten gluten in 4 days. Ate a salad with no dressing and pain started. Mine seems to be vegetables and fruit. Sometimes meat. Makes no sense to me. 

trents Grand Master
trents
Posted

If you eliminate or cut back on gluten before all testing is complete you will undermine the results. Since you say gluten doesn't bother you, you should be able to weather that period without undue suffering. Can you do dairy and eggs without discomfort so as to meet protein needs?

LP023 Contributor
LP023
Posted
  • Author

Eggs is a no. Dairy sometimes. It’s looking like 2 months before the tests will be done. I thought I would try it for awhile to see what happened if I cut out gluten for a week. I’ve read that the blood test was 98% accurate. 25 is 15 over the positive limit but I’ve seen where some people were in the 100s. I had Covid a year ago and since then I’ve felt hungry non stop and stomach noises are constant. Most days I feel good. Just some really bad weeks scattered in. 

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trents Grand Master
trents
Posted

If you eliminate or cut back on gluten before all testing is complete you will undermine the results. Since you say gluten doesn't bother you, you should be able to weather that period without undue suffering. Can you do dairy and eggs without discomfort so as to meet protein needs?

The Mayo Clinic Guidelines for the pretest gluten challenge leading up to the endoscopy/biopsy is the daily consumption of two slices of wheat bread (or the gluten equivalent) for two weeks prior. That should help you in your planning.

  • 2 weeks later...
Raptorsgal Enthusiast
Raptorsgal
Posted

Mine ttg. was 80 a lot higher . I also stop gluten it’s been a few days seem to be helping gluten in everything 

Scott Adams Grand Master
Scott Adams
Posted

As @trents mentioned, be sure not to eliminate gluten until all tests for celiac disease have been completed.

Raptorsgal Enthusiast
Raptorsgal
Posted

The doctor pretty sure I had it there’d been no test scheduled if they are it could be months and months .

oat milk and granola are they l always gluten free so confusing 

trents Grand Master
trents
Posted
2 minutes ago, Raptorsgal said:

oat milk and granola are they l always gluten free so confusing 

Oats and granola are not necessarily gluten free because of the likelihood of cross contamination with wheat in the field, in transport, in storage and in processing. Milk is gluten free.

Raptorsgal Enthusiast
Raptorsgal
Posted

It’s so hard I needed to eat something hopeful things get better waiting for a library book

  • 2 weeks later...
RecoveredCeliac Apprentice
RecoveredCeliac
Posted
On 1/26/2023 at 2:12 PM, LP023 said:

25 is 15 over the positive limit 

doesn't matter if other people were hundreds over normal range

ttg iga?    ttg iga is over 99% accurate for celiac

If you have 15 above normal ttg iga then you are definitely positive

 

LP023 Contributor
LP023
Posted
  • Author
51 minutes ago, RecoveredCeliac said:

doesn't matter if other people were hundreds over normal range

ttg iga?    ttg iga is over 99% accurate for celiac

If you have 15 above normal ttg iga then you are definitely positive

 

Most likely am positive but I know when I worked in the lab several years ago I learned really quick false positives for several things aren’t as uncommon as we think. Other autoimmune diseases can cause false positives. HIV antibody testing is a huge false positive risk and they say it’s 99% accurate. Every time we had a positive it was sent off for confirmation testing to make sure it was really positive. As far as I know there isn’t another blood test to confirm celiacs if one comes back positive but it’s been awhile since I worked in that field. 

trents Grand Master
trents
Posted
3 hours ago, LP023 said:

Most likely am positive but I know when I worked in the lab several years ago I learned really quick false positives for several things aren’t as uncommon as we think. Other autoimmune diseases can cause false positives. HIV antibody testing is a huge false positive risk and they say it’s 99% accurate. Every time we had a positive it was sent off for confirmation testing to make sure it was really positive. As far as I know there isn’t another blood test to confirm celiacs if one comes back positive but it’s been awhile since I worked in that field. 

There are a number of celiac antibody tests that can be ordered. The most popular one with PC physicians is the tTG-IGA, and it may be the best all around test for celiac disease but full panel is always better.

https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/

LP023 Contributor
LP023
Posted
  • Author

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    • Scott Adams
      Test interpretations

      By Scott Adams · Posted

      Based on those results alone, it’s not possible to say you have celiac disease. The test that is usually most specific for celiac, tTG-IgA, is negative in your results, and the endomysial antibody (EMA) is also negative, which generally argues against active celiac disease. However, your deamidated gliadin IgA is elevated, and your total IgA level is also high, which can sometimes affect how the other antibody tests behave. Another important factor is that you were reducing gluten before the test, which can lower antibody levels and make the results less reliable. Because of that, many doctors recommend a gluten challenge (eating gluten regularly for several weeks) before repeating blood tests or considering an endoscopy if symptoms and labs raise concern. It would be best to review these results with a gastroenterologist, who can interpret them in context and decide whether further testing is needed.
    • trents
      Test interpretations

      By trents · Posted

      Since you compromised the validity of the antibody testing by experimenting with gluten withdrawal ahead of the testing, you are faced with two options: 1. Reintroduce significant amounts of gluten into your diet for a period of weeks, i.e., undertake a "gluten challenge". The most recent guidelines are the daily consumption of at least 10g of gluten (about the amount found in 4-6 slices of wheat-based bread) for at least two weeks leading up to the day of testing. Note: I would certainly give it more than two weeks to be sure. 2. Be willing to live with the ambiguity of not knowing whether gluten causes you problems because you have celiac disease or NCGS (Non Celiac Gluten Sensitivity). There is no test for NCGS. Celiac disease must first be ruled out and we have tests for it. Celiac disease has an autoimmune base. NCGS does not. GI symptoms overlap. In the early stages of celiac disease, other body systems may not be showing stress or damage so, symptomatically, it would be difficult to distinguish between celiac disease and NCGS. Both conditions require elimination of gluten from the diet for symptom relief. Some experts feel that NCGS can be a precursor to celiac disease.
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    • MicG
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      I had been eating reduced gluten until about 3 days before the test. I did realize that wasn’t ideal, but it was experimental to see if gluten was actually bothering me. One slip up with soy sauce and it was quite clear to me that it was, lol. 
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      Possibly. Your total IGA (Immunoglobulin A, Qn, Serum) is actually high so you are not IGA deficient. In the absence of IGA deficiency, the most reliable celiac antibody test would be the t-Transglutaminase (tTG) IgA for which your score is within normal range. There are other things besides celiac disease that might cause an elevated DGP-IGA (Deamidated Gliadin Abs, lgA) for which you do have a positive score. It might also be of concern that your total IGA is elevated as that can indicate some other health problems, some of which are serious.  Had you been practicing a gluten free or a reduced gluten free diet prior to the blood draw? Talk to your physician about these things. I would also seek an endoscopy/biopsy of the small bowel to check for damage to the villous lining, which is the gold standard diagnostic test for celiac disease.
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