Friday, January 9, 2009

My Celiac Blood Panel Results

According to the classical definition of Celiac disease my bloodwork falls somewhere in limbo. Recent thinking on the subject more strongly suggests that I'm positive, but as I understand it there's still a good amount of debate.  What isn't up for debate is that in the six months since I started a gluten-free diet I've seen both subjective and objective improvements in pretty much all aspects of my health.

So without further ado, here are the numbers:

Gliadin IgA 0.9; where <5 is negative
Gliadin IgG 12.9; where <10 is negative
TTG IgA 0.6; <4 is negative, 4-10 is weak positive; >10 is positive
TTG IgG 21.4; >9 positive.  Whoah!
Total IgA:  253; where 69-382 is the normal range

A lot of doctors would consider this a negative test.  IgA is considered the primary indicator of Celiac disease in blood tests, and while both IgA tests came out negative, my overall level of IgA was normal, ruling out the selective deficiency that some Celiacs suffer from.  Typically the IgG tests are only used in those cases.  

But clearly something is going on with those IgG antibodies.  TTG IgG shows up in a number of other conditions,  but none of those match my symptoms very well.  Furthermore, the use of IgA antibodies as a primary indicator is predicated on the idea that Celiac is only confirmed by a positive intestinal biopsy, not "this person's symptoms improve on a gluten-free diet."  Call it Celiac or call it non-Celiac gluten-sensitivity; it's got the same symptoms and the same treatment if not the same pathology. But from what I've seen lately, many people, my doctor included, are considering it to be slightly different manifestations of the same disease.  Not every symptom shows up in every person.  

A biopsy in my case would have been interesting, but even if it was negative it seemed a gluten-free diet was my next step, so I didn't push for it, opting instead to see how the diet treated me.  Since I've responded so well, I feel like I have my answer.


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