Sunday, December 5, 2010

Gluten blood tests - IgG-gliadin

Today's blog is a bit long but is worth the time!

Gluten intolerance/ sensitivity is very common - it affects more than one in ten people. A simple blood test can identify this problem.

Please do not go gluten-free without first getting your blood tests. There is no room to discuss all of the fine details here. Dr Ford has written extensively about these tests in his book: "The Gluten Syndrome"

What does the IgG-gliadin test measure?

The IgG-gliadin test measures your immune response to gliadin. Gliadin is part of the gluten molecule.
The IgG-gliadin test measures the levels of ANTIBODY to gluten (also called: IgG-anti gliadin antibody). This test doe not actually measure gluten. It measures your body’s REACTION against gluten.

Why does your body make this gliadin antibody?

Gliadin is a short protein that your body finds hard to breakdown in your gut. It is part of the gluten molecule. Because gliadin stays fairly much intact in the bowel, it is easy for it to get through the bowel mucosa in one piece and start to stimulate the cells of the immune system. These irritated immune cells start to make antibody molecules against gluten.

Once your immune system starts making this gliadin antibody, your body can continue to produce it for many years, without you ever eating gluten again. However, after a year or two the antibody levels eventually go right down.

Why do IgG-gliadin the test?

The IgG-gliadin test is useful to detect those people who are reacting to gluten. It turns out that one in ten people have a high gliadin antibody level. Most of these people are experiencing symptoms for gluten.
Gluten causes a whole host of illnesses, these symptoms are grouped together as The Gluten Syndrome (see “The Gluten Syndrome” explanation in detail). Gluten reactions are the basis of about a third of all chronic ill health. Gluten especially causes gut, skin and nerve/brain disturbances.

Do you have to be eating gluten at the time of the blood test?

No. The IgG-gliadin antibody test does not detect gluten. It is not a gluten test, rather it is a gluten reactivity test. Therefore, you do not have to eating gluten at the time of the blood tests. But the longer that you are on a gluten-free diet, the less accurate the IgG-gliadin tests will be.

I recommend having all of your blood tests before you go gluten free.
It takes between 6-18 months for your IgG-gliadin antibody levels to go down. So, as long as you have not been off gluten for more than 6 months, you can just go ahead and have the blood test.
If you have been off gluten for several years, it may take 2-4 months of eating gluten again before your gluten antibodies go high again.

Where can I get the IgG-gliadin tests?

Medlab South in Christchurch , NZ, does the tests for my patients. But unfortunately, many laboratories have abandoned the gliadin antibody test. They say it is “old fashioned” (See the “Dinosaur” article on the doctor gluten website). They prefer to do the tTG test – I think that abandoning the IgG-gliadin test is illogical.

To get your blood tests, I recommend that you “download” our Blood Tests forms and letter and take it to your GP and the Lab. This explains the situation.
It is important to ask your laboratory BEFORE you get bled, as to whether they can, and will, do the IgG-gliadin antibody test for you. This may incur an additional cost.

What if I have a high gliadin tests but have no symptoms?

About 10% of the population have high gliadin antibody levels. Most of these people have some symptoms that are attributable to gluten. However, some have no symptoms. If there is no evidence of gut damage (that is, if you do not have celiac disease), then you can continue to eat gluten (although there is no guarantee that gluten is not causing subtle harm).

Has the tTG tests taken over?

The tTG tests stands for tissue transglutaminase. It is an antibody test. The tTG is NOT a gluten test.
No, the tTG test does not replace the gliadin antibody test. The tTG is ONLY an indicator of tissue damage (in the gut). However, a high tTG level infers gluten damage to the gut – but it is not so accurate.
The tTG, it is not a perfect test, especially in children. I repeat, the tTG tests does not tell you anything about gluten reactivity. However, the tTG test is useful in detecting people who have coeliac disease and they of course get better when gluten is removed from their diet.

The newest test is the Deamidated Gliadin Peptide (DGP)

How much does the IgG-gliadin test cost?

Ask you lab about the costs of the gliadin test - every lab is different and some refuse to do the test. MedLab South in Christchurch New Zealand does the test.

Does my doctor know how to interpret the results?

Probably, your doctor is not familiar with the interpretation of the IgG-gliadin tests. In my experience, most doctors have been taught to ignore this gliadin test. Most doctors at this stage still do not recognise that gluten can cause a lot more disease than just coeliac disease.

The medical focus has been on the tTG test (for tissue damage). The majority of my patients who have had the IgG-gliadin tests by their GPs have been told that their tests were “normal” or “nothing to worry about” or “or just a touch of reaction” or “not coeliac, so nothing to do about it” …

I suggest that you actually look at the tests results yourself. The eClinic can help you interpret them as well.

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  1. Thank you for this article. I was talking to my GP about testing, and left without answers. This will help with my follow-up phone call. Again, thank you!

  2. My daughter has just been tested with an IgG reading of 307 (other tests negative from the gluten perspective so she is not coeliac). She has epilepsy and given that some research shows that high IgG can have neurological consequences, we are holding out hope that a gluten free diet might improve the incidence of these. Thanks for this summary, it has been very helpful in giving an overview of the tests and what they mean :-)

  3. Most tests provide you only with a broad idea of what you are allergic too and are not able to advise you on safe alternatives. Igg Test

  4. My daughter has biopsy-confirmed CD. Her initial blood test results were as follows: deamidated gliadin IgG 60 EIA U/ml and t-transglutaminase IgA > 128 EIA U/ml. Her follow up blood test after going three months gluten free is somewhat surprising, as the IgA went down to 81 but the IgG went up to > 250! What does this mean? Does it mean she has refractory disease (the GI consultant did say she had very severe disease, which is why he wanted us back at 3 months). Could some othe autoimmune thing be going on? We have a very strong family history of type 1 diabetes. I would really appreciate your thoughts on this. I've googled and googled some more but can't get an answer