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What’s Sometimes Missing with Celiac Testing & What to Ask For

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Often, Celiac can be missed even when tested for. Here is why… and what you can ask for!

Here are the Top Reasons Celiac is Missed with your Provider:

  • Not having adequate gluten prior to testing. Sometimes providers don’t ask if someone is gluten free already prior to testing – this combined with the fact that 1 in 5 IBD patients will try a gluten free diet at some point increases the odds that celiac could be missed.
  • Only testing for 1 antibody – Although current research suggests we should test for 6 antibodies, sometimes providers only test for 1 which we know from a recent study can lead to 10% of celiac cases being missed.

Top Ways the Internet Makes Things Confusing with Testing:

  • Unreliable test markers – Testing for genetic markers, anti-gliadin and zonulin are not validated markers to check for celiac. However, some mistakenly confuse the two.
  • Confusing an allergy with celiac- Wheat allergies are not the same as Celiac. Celiac is different- it is an autoimmune process where gluten damages the gut.

How to Properly Test for Celiac:

  • Have gluten for 6 weeks prior to the test (at least 1 slice of whole wheat bread for 6 weeks)
  • Test for all 6 Antibodies in labwork:
    • total IgA
    • tissue transglutaminase (tTG-IgA)
    • immunoglobulin A (IgA)
    • tTG immunoglobulin G (IgG) tests
    • endomysial antibody (EMA) – IgA test
    • deamidated gliadin peptide (DGP) -IgA DGP-IgG tests
  • Biopsy with endoscopy or capsule to look for damage to villi under the microscope