I've been gluten intolerant for as long as I can remember. I get terrible cramps and fatigue/ feel like I've got the flu. In the last 3 months I've felt increasingly unwell. I started to get very bad diarrhea after eating gluten, which would take 4-5 days to recover from with a very bland gluten-free diet. It escalated 4 weeks ago after having a small piece of bread. The diarrhea got so bad I went to the doctor thinking I had gastro. It was just before a trip overseas so he put me on antibiotics. The stool test for virus/ infection was negative. While overseas I had a terrible episode. I had some wheat (I know - I was missing western food), and that evening had chills for two hours. I had a bad episode of diarrhea. The next morning was the worst. I was shaking, felt like I was going to be sick, and had the worst diarrhea of my life. It was basically water, and I couldn't leave the bathroom for 2 hours. We had to change our train tickets and get a late checkout. Awful. I'll never eat gluten again. That was 1.5 weeks ago. I've eaten gluten-free since then, and my body is still working through things. Most foods are now causing irritation. I'm on a very bland gluten-free diet which seems to be working. I saw my Dr today. I was hoping she would say its my gallbladder/ pancreas. She said its hallmark celiac disease symptoms. She wants me to have a blood test tomorrow, and if thats negative go to the gastroenterologist. She will also test liver/ kidney etc. I haven't had any gluten for 1 week, with the exception of some soy sauce. My dr said my stomach is so inflamed that even though I haven't had gluten, if its celiac disease it might show up on the blood test. Separately, I had a test for celiac disease 3.5 years ago (colonoscopy/ endoscopy) which came back negative. To be fair, I didn't eat enough gluten beforehand. Please let me know your thoughts about the blood test. I'm wondering if I should gluten up and then do it, or just do it tomorrow since I've had issues with diarrhea all week, and if its negative have more tests/ gluten up.

Based on your test results (IgG ELISA: 106 units, IgA ELISA: 135 units, tTG: 251 units), all of which are well above the >30 units threshold for moderate to strong positive, there is a very high likelihood—as you noted—that you have celiac disease. While a biopsy was traditionally considered the gold standard for confirmation, your exceptionally elevated antibody levels, combined with your long-standing gluten sensitivity and strict adherence to a gluten-free diet, strongly support the diagnosis. Given that you’ve been gluten-free for 20 years, a biopsy now might not be reliable (since it requires gluten exposure to detect damage). Your assessment aligns with current understanding—many experts would consider these results diagnostic in the right clinical context. That said, if you ever needed formal confirmation (e.g., for medical documentation), a discussion with a gastroenterologist about potential gluten challenge testing (though challenging) could be an option. Regardless, your proactive approach to avoiding gluten is absolutely the right course! Thanks for sharing your experience—it’s a great example of how patient awareness and adherence can manage celiac effectively. There are benefits to not having a formal diagnosis, for example people with a formal diagnosis may face higher life insurance costs, as well as higher private health insurance costs.

Hi Scott, I just came across your article regarding blood tests to determine celiac disease and wanted to thank you for writing it so clearly. Today I pulled out my 20 year old test results from Immumo labs and followed along as I reread the article.   I was first tested in April 2005. At the time I was told that I’m highly sensitive to gluten and must avoid but the practitioner would not say I had celiac disease without a biopsy to confirm.   Based on the information in the article, it looks like there’s a 97% chance that I have celiac disease [here are my results: IgG ELISA test :106 units; IgA ELISA: 135 units; tTG: 251units). The range for all the tests is: <20=negative, 20-30=week positive, >30units =moderate to strong positive]. Am I correct in my assessment? Is there any doubt that I have celiac? I’m not looking for medical advice but I’d love your opinion on this. I have eaten strictly gluten free for 20 years now and wouldn’t ever consider otherwise regardless. Thanks in advance, and thanks again for your article. Dana

The description of their patented technology is quite vague, so I would say beware of it until you have more information.

Scott, thank you. This article is very informative and cogent. Thank you for sharing.