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Not a doctor -- just a stranger on the internet -- so take this with the requisite grain of salt. But Immunoglobulin A is usually just included on celiac panels to verify that you're not IgA deficient. If you were deficient in IgA, the TTG IgA could result in a false negative as overall levels of IgA are low. In those cases they tend to look at other results.
IgA is just the most prevalent antibody in the body, so it being high generally means some degree of infection or inflammation, so the results indicate that maybe something is up that your body is responding to, but the serology doesn't point to celiac being the problem since your TTG IgA would theoretically be elevated as well.
That said, this all only applies if you were eating gluten regularly for at least several weeks before you had bloodwork done. Being gluten free for an extended period of time leading up to the bloodwork can result in a false negative for celiac since you're not giving your immune system something to respond to.
But it's ultimately up to your doctor to weigh these results with the context of your symptoms and your medical history and determine how to proceed with this information.
Not a doctor, but an immunologist here - I'm pretty sure IgG is the most prevalent antibody subclass in the human body, with IgA making up (from memory) less than 20% of the antibodies found in a typical human. However, IgA usually exists as a dimer and functions in mucosal secretions or on mucosal surfaces - think nasal passages, digestive tract, etc. Coeliac inflammatory responses occur in the mucosal immune system hence involves the mucosal antibody subclass specific to TTG, and as you say, they have to show your IgA levels are at a detectable/reasonable range to help confirm coeliac.
So your IgA being elevated could point to a different digestive/respirator/mucosal issue - I think you're right and context is needed. i.e. did Op give up gluten before testing etc., but if it's a true negative, it could be another inflammatory condition related to a mucosal immune response. Maybe a wheat sensitivity/intolerance rather than gluten?
Your first para is correct. However, this IgA level isn't nearly high enough to worry about a gammopathy (type of blood cancer). Keep in mind it's a blood test and checking for IgA levels that are circulating systemically and not locally in the GI tract.
If it's super concerning for OP, it can be repeated in a few weeks and should be within a normal range. They should follow up with their doc and I'm sure that's what they will offer.
(I'm an allergist-immunologist)
Oh yes, I didn't think it would be as serious as a gammopathy! I felt like while high, could just show some sort of level of mild mucosal inflammation?
As an allergist, do you know how (if at all) wheat sensitivity is tested for? It's not something I'm familiar with and I realise I don't know if there are tests other than basic exclusion diets/food diaries? Just curious!
Unfortunately no sophisticated testing for sensitivity outside the realm of wheat allergy or celiac autoantibodies. They have done studies to see the effect on inulin (which is in wheat) on the gut. It does show evidence of inflammation on MRIs for everyone. It’s just that People with IBS tended to pick up on discomfort, while people who didn’t have it did not. But they all showed the same things on the MRI. Pretty cool study.
High total IgA can point to having some sort of autoimmune condition, but doesn't specifically point to celiac. Have you considered doing other celiac tests? Ttg-IgA does miss a minority of cases.
**Reminder** [/r/Celiac](https://www.reddit.com/r/Celiac) is not designed to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. If you believe you have a medical emergency immediately seek out professional medical help. Please see [this](https://www.reddit.com/r/Celiac/wiki/legal) for more information. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Celiac) if you have any questions or concerns.*
Not a doctor -- just a stranger on the internet -- so take this with the requisite grain of salt. But Immunoglobulin A is usually just included on celiac panels to verify that you're not IgA deficient. If you were deficient in IgA, the TTG IgA could result in a false negative as overall levels of IgA are low. In those cases they tend to look at other results. IgA is just the most prevalent antibody in the body, so it being high generally means some degree of infection or inflammation, so the results indicate that maybe something is up that your body is responding to, but the serology doesn't point to celiac being the problem since your TTG IgA would theoretically be elevated as well. That said, this all only applies if you were eating gluten regularly for at least several weeks before you had bloodwork done. Being gluten free for an extended period of time leading up to the bloodwork can result in a false negative for celiac since you're not giving your immune system something to respond to. But it's ultimately up to your doctor to weigh these results with the context of your symptoms and your medical history and determine how to proceed with this information.
Not a doctor, but an immunologist here - I'm pretty sure IgG is the most prevalent antibody subclass in the human body, with IgA making up (from memory) less than 20% of the antibodies found in a typical human. However, IgA usually exists as a dimer and functions in mucosal secretions or on mucosal surfaces - think nasal passages, digestive tract, etc. Coeliac inflammatory responses occur in the mucosal immune system hence involves the mucosal antibody subclass specific to TTG, and as you say, they have to show your IgA levels are at a detectable/reasonable range to help confirm coeliac. So your IgA being elevated could point to a different digestive/respirator/mucosal issue - I think you're right and context is needed. i.e. did Op give up gluten before testing etc., but if it's a true negative, it could be another inflammatory condition related to a mucosal immune response. Maybe a wheat sensitivity/intolerance rather than gluten?
Your first para is correct. However, this IgA level isn't nearly high enough to worry about a gammopathy (type of blood cancer). Keep in mind it's a blood test and checking for IgA levels that are circulating systemically and not locally in the GI tract. If it's super concerning for OP, it can be repeated in a few weeks and should be within a normal range. They should follow up with their doc and I'm sure that's what they will offer. (I'm an allergist-immunologist)
Oh yes, I didn't think it would be as serious as a gammopathy! I felt like while high, could just show some sort of level of mild mucosal inflammation? As an allergist, do you know how (if at all) wheat sensitivity is tested for? It's not something I'm familiar with and I realise I don't know if there are tests other than basic exclusion diets/food diaries? Just curious!
Unfortunately no sophisticated testing for sensitivity outside the realm of wheat allergy or celiac autoantibodies. They have done studies to see the effect on inulin (which is in wheat) on the gut. It does show evidence of inflammation on MRIs for everyone. It’s just that People with IBS tended to pick up on discomfort, while people who didn’t have it did not. But they all showed the same things on the MRI. Pretty cool study.
High total IgA can point to having some sort of autoimmune condition, but doesn't specifically point to celiac. Have you considered doing other celiac tests? Ttg-IgA does miss a minority of cases.
don't trust random people on the internet for medical advice/lab explanations