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Ttg iga accuracy?

Sickofbeingsick2023
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Sickofbeingsick2023 Newbie
Sickofbeingsick2023
Posted

Hello! I’m not really sure if I’m doing this right… I’m kinda confused about why ttg iga is the most common blood test checking for celiac but when I read through everyone’s posts and questions I see that it is often negative. I’m in the middle of a gluten challenge and will go for blood work in a few weeks. My background - father has celiac, I have abnormal thyroid antibodies, non responsive to hep b vaccine, years of belly pain and bowel issues when consuming gluten, itchy blisters on my scalp and neck when consuming gluten, meralgia paresthetica when consuming gluten, low vitamin D. My dr ordered a celiac screen with reflex and I know that is IGA and TTG IGA. Is a 6-8 week gluten challenge (2wks light gluten, 4 weeks heavy gluten) enough to show an actual result?

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trents Grand Master
trents
Posted
(edited)

Welcome to the forum, Sickofbeingsick2023!

The tTG-IGA is the most common celiac antibody test ordered by docs because of three factors:

1. It has very good sensitivity

2. It has very good specificity

3. It is a relatively inexpensive test to run.

Most other celiac antibody tests suffer from either lack of good sensitivity, lack of good specificity or, in the case of the EMA, are expensive to administer. It is good that your doc ordered the total serum IGA as a reflex. In the case where total serum IGA is low, it lowers the value of individual IGA tests and can cause false negatives. It would have been better had he ordered a full celiac panel which would have included a wider range of antibody tests. You might find this informative:

I would think that your stated gluten challenge strategy will be adequate to render valid antibody test results. But I'm not clear on one thing. Were you on a gluten free diet before beginning the gluten challenge? Normally, the gluten challenge is outlined in the context of someone who was never tested for celiac disease but decided to go gluten free because of symptoms. But then later on they decide they want to get tested to establish ether a formal diagnosis of celiac disease or NCGS (Non Celiac Gluten Sensitivity).

Edited by trents
Sickofbeingsick2023 Newbie
Sickofbeingsick2023
Posted
  • Author

Yes I was gluten free (for the most part) since January 1st. I had been struggling to lose weight and discovered that I am insulin resistant. Went low carb and gluten free, lost 20lbs. Then we went on vacation and I started eating gluten here and there… I was reminded how awful it makes me feel. I have done gluten free in the past due to my symptoms and family history. I was tested once before, about 13 years ago and everything was negative.

Wheatwacked Veteran
Wheatwacked
Posted
(edited)

As far as I can see, you already know the answer, just want proof.

Up to ~40% of 1st degree relatives of people with Celiac Disease have undiagnosed Celiac. Father counts as 1st degree.

These will also help:  They are all essential nutrients commonly deficient with Celiac Disease.  These doses are well within safe intake limits.  Each helped me individually but combined has been life changing.

These are minimum nutritional requirements not supplements to fix something.  While getting them from your diet would be best, you have deficiencies that need to be addressed, ASAP.  They will not be apparent from testing (except D and B12).  Deficiencies that will elicit Medical symptons but not caused by disease.  Perhaps one bottle of each will be enough while the benefits of your diet kick in.  It has taken me 8 years to get here. Save yourself time and suffering.

  • 10,000 IU vitamin D to control autoimmune.
  • 500 mg Thiamine - neurologic symptoms
  • 500 mg Nicotinic Acid - increase capillary blood flow
  • 500 mg Pantothenic Acid - creates energy from glucose Krebs Cycle
  • 1000 mcg B12 - creates hemoglobin for oxygen transport
  • 500 mg Taurine - essential amino acid, a powerful antioxident that we make indogenously so it is officially labeled "Conditional Essential" as Choline used to be, but not enough when sickness increases inflammation. reduces Reactivite Oxygen Species (ROS are are free radicals.).
  • 840 mg Phosphatidly Choline - essential for fat digestion.
  • Iodine - muscle tone, testosterone, hyper and hypo thyroid, slow healing.  I eat Nori and Kelp

 

Other symptoms you may have possibly Celiac related:  

 

 

Edited by Wheatwacked
someday I'll stop making typos
Sickofbeingsick2023 Newbie
Sickofbeingsick2023
Posted
  • Author
15 minutes ago, Wheatwacked said:

As far as I can see, you already know the answer, just want proof.

Up to ~40% of 1st degree relatives of people with Celiac Disease have undiagnosed Celiac.

These will also help:  They are all essential nutrients commonly deficient with Celiac Disease.  These doses are well within safe intake limits.  Each helped me individually but combined has been life changing.

These are minimum nutritional requirements not supplements to fix something.  While getting them from your diet would be best, you have deficiencies that need to be addressed, ASAP.  They will not be apparent from testing (except D and B12.  Deficiencies that will elicit Medical symptons but not caused by disease.  Perhaps one bottle of each will be enough, while the benefits of your diet kick in.  It has taken me 8 years to get here. Save yourself time and suffering.

  • 10,000 IU vitamin D to control autoimmune.
  • 500 mg Thiamine - neurologic symptoms
  • 500 mg Nicotinic Acid - increase capillary blood flow
  • 500 mg Pantothenic Acid - creates energy from glucose Krebs Cycle
  • 1000 mcg B12 - creates hemoglobin for oxygen transport
  • 500 mg Taurine - essential amino acid, a powerful antioxident that we make indogenously, but not enough when sickness increases inflammation. reduces Reactivite Oxygen Species (ROS are are free radicals.)
  • 840 mg Phosphatidly Choline - essential for fat digestion.
  • Iodine from food. - muscle tone, testosterone, slow healing.  I eat Nori and Kelp.

 

 

Other symptoms you may have:  

 

 

Honestly, I’m so scared the tests will be negative. I know that sounds twisted but I feel like I need justification at this point. Especially after this gluten challenge, I thought I would try to enjoy eating normal food but it’s just been awful. Thank you for the link, I definitely do have some of those other symptoms, and thank you for the list of supplements too. I do currently take super D but none of the others.

Scott Adams Grand Master
Scott Adams
Posted

As @trents mentioned, approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If you test negative for celiac you can still go gluten-free and if your symptoms go away on a gluten-free diet it would likely signal NCGS.

 

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      Elevated tissue transglutaminase IgA (tTG-IgA) levels are highly specific for celiac disease, and they are a key biomarker used in its diagnosis. However, there are some rare instances where elevated tTG-IgA levels have been reported in conditions other than celiac disease. While these cases are not common, they have been documented in the literature. Below are some examples and references to studies or reviews that discuss these scenarios:  1. Non-Celiac Gluten Sensitivity (NCGS)    - NCGS typically does not cause elevated tTG-IgA levels, as it is not an autoimmune condition. However, some individuals with NCGS may have mild elevations in tTG-IgA due to intestinal inflammation or other factors, though this is not well-documented in large studies.    - Reference: Catassi, C., et al. (2013). *Non-Celiac Gluten Sensitivity: The New Frontier of Gluten-Related Disorders*. Nutrients, 5(10), 3839–3853. [DOI:10.3390/nu5103839](https://doi.org/10.3390/nu5103839)  2. Autoimmune Diseases    - Elevated tTG-IgA levels have been reported in other autoimmune conditions, such as type 1 diabetes, autoimmune hepatitis, and systemic lupus erythematosus (SLE). This is thought to be due to cross-reactivity or polyautoimmunity.    - Reference: Sblattero, D., et al. (2000). *The Role of Anti-Tissue Transglutaminase in the Diagnosis and Management of Celiac Disease*. Autoimmunity Reviews, 1(3), 129–135. [DOI:10.1016/S1568-9972(01)00022-3](https://doi.org/10.1016/S1568-9972(01)00022-3)  3. Chronic Liver Disease    - Conditions like chronic hepatitis or cirrhosis can sometimes lead to elevated tTG-IgA levels, possibly due to increased intestinal permeability or immune dysregulation.    - Reference: Vecchi, M., et al. (2003). *High Prevalence of Celiac Disease in Patients with Chronic Liver Disease: A Role for Gluten-Free Diet?* Gastroenterology, 125(5), 1522–1523. [DOI:10.1016/j.gastro.2003.08.031](https://doi.org/10.1016/j.gastro.2003.08.031)  4. Inflammatory Bowel Disease (IBD)    - Some patients with Crohn’s disease or ulcerative colitis may have elevated tTG-IgA levels due to intestinal inflammation and damage, though this is not common.    - Reference: Walker-Smith, J. A., et al. (1990). *Celiac Disease and Inflammatory Bowel Disease*. Journal of Pediatric Gastroenterology and Nutrition, 10(3), 389–391. [DOI:10.1097/00005176-199004000-00020](https://doi.org/10.1097/00005176-199004000-00020)  5. Infections and Parasites    - While infections (e.g., giardiasis) are more commonly associated with false-positive tTG-IgA results, chronic infections or parasitic infestations can sometimes lead to elevated levels due to mucosal damage.    - Reference: Rostami, K., et al. (1999). *The Role of Infections in Celiac Disease*. European Journal of Gastroenterology & Hepatology, 11(11), 1255–1258. [DOI:10.1097/00042737-199911000-00010](https://doi.org/10.1097/00042737-199911000-00010)  6. Cardiac Conditions    - Rarely, heart failure or severe cardiovascular disease has been associated with elevated tTG-IgA levels, possibly due to gut ischemia and increased intestinal permeability.    - Reference: Ludvigsson, J. F., et al. (2007). *Celiac Disease and Risk of Cardiovascular Disease: A Population-Based Cohort Study*. American Heart Journal, 153(6), 972–976. [DOI:10.1016/j.ahj.2007.03.019](https://doi.org/10.1016/j.ahj.2007.03.019)  Key Points: - Elevated tTG-IgA levels are highly specific for celiac disease, and in most cases, a positive result strongly suggests celiac disease. - Other conditions causing elevated tTG-IgA are rare and often accompanied by additional clinical findings. - If celiac disease is suspected, further testing (e.g., endoscopy with biopsy) is typically required for confirmation. If you’re looking for more specific studies, I recommend searching PubMed or other medical databases using terms like "elevated tTG-IgA non-celiac" or "tTG-IgA in non-celiac conditions." Let me know if you’d like help with that!
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      By trents · Posted

      I agree. Doesn't look like you have celiac disease. Your elevated DGP-IGG must be due to something else. And it was within normal at that after your gluten challenge so it is erratic and doesn't seem to be tied to gluten consumption.
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