How to test for celiac disease

Medically reviewed on August 1, 2022 by Amy Harris, RN. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What is celiac disease?
• What are the most common symptoms of celiac disease?
• How do you test for celiac disease?
• What are the long-term health risks of celiac disease?
• Everlywell: Your source for accurate celiac testing

Eating a wide variety of foods can be a rich and delicious way to enjoy life. But if the foods you eat have you feeling bloated, nauseous, or dealing with gastrointestinal discomfort, you’re likely questioning what’s going on with your digestive system.

If you have long suspected celiac disease, it could be time to consider celiac disease testing.

This prevalent autoimmune disease is underdiagnosed but is estimated to affect nearly 1 in every 100 people worldwide. [1] If you’re wondering how to test for celiac disease, this article will guide you.

We’ll explore the chronic symptoms, telltale signs, and common testing procedures for celiac disease. In addition, we’ll go in-depth into the related long-term health conditions and the next steps after receiving a celiac diagnosis.

What is celiac disease?

Before you can delve into testing, it’s worth learning a little bit about what this disease is, is celiac disease genetic, and how it functions. Becoming familiar with celiac disease can help you to trace symptoms and provide a fuller report to your healthcare provider if needed.

Autoimmune disease

Firstly, you want to understand that celiac disease, or coeliac disease, is a type of autoimmune disease. [1] According to the Celiac Disease Foundation, celiac affects 1 in 100 people worldwide.

Autoimmune diseases are distinctly different from other common illnesses for the following reasons: [2]

• They cause your immune system to attack your body – When functioning normally, your immune system is your main defense against viruses and bacteria that can invade your system and cause illness. An autoimmune disease causes your immune system to mistake healthy cells and tissue for harmful germs.
• They are not contagious – You don’t have to worry about catching your friend’s autoimmune disease. These diseases aren’t caused by any known viruses or bacteria and are non-contagious.
• They are chronic – Most autoimmune diseases—including celiac disease—are considered treatable but not necessarily curable. While you may find relief from your symptoms, recurrences of autoimmune diseases are common. Even those who don’t experience any symptoms for an extended period may still be susceptible to unexpected flare-ups.

As with most autoimmune diseases, the causes of celiac are relatively unknown. Your genetics and living environment could play a role in the development of this disease. It’s impossible to predict who might develop celiac disease, and it’s believed that only 30% of those with celiac disease are accurately diagnosed. Therefore, a genetic test may be recommended by your healthcare provider to determine if you carry the genes responsible for the development of the disease.

Gluten intolerance

One of the main characteristics of celiac disease is the inability to consume gluten without experiencing side effects. [1] Those with celiac disease must be wary of bread, pasta, cereal, and beer, and read ingredients lists carefully.

Gluten is a binding protein known for holding foods together and helping foods retain their shape. Gluten is commonly found in:

• Wheat
• Oats
• Rye
• Barely

Because these grains are found in so many foods, those with celiac disease must pay close attention to their dietary restrictions.

If you do happen to eat gluten as a person with celiac disease, your body may respond by: [1]

• Producing an immune response – Because your body recognizes gluten as a harmful substance, your immune system will respond by attacking your small intestine.
• Damaging cells and tissue – The immune attack can cause temporary or permanent damage to your small intestine, potentially interfering with your ability to absorb nutrients from food.

What are the most common symptoms of celiac disease?

If you’re concerned that you may have celiac disease, you’ll want to identify your symptoms and whether they align with this condition.

Pay close attention to your body and keep track of any of the following symptoms: [1]

• Diarrhea, gas, and constipation – Because celiac disease results in total gluten intolerance, consuming any amount of gluten can result in major digestive problems. These side effects could easily be confused with mild food poisoning or an unagreeable meal. However, if they recur regularly, you may want to consider the potential of an underlying health condition.
• Fatigue and weight loss – If untreated, the digestive problems associated with a celiac flare-up can lead to weight loss and accompanying fatigue. Not only is your digestion interrupted, but this condition may also hinder your small intestine's ability to absorb essential nutrients.
• Anxiety, depression, and cognitive issues – Your gut health can substantially impact your mental health. The exhaustion and malabsorption associated with celiac disease may result in a diminished mood and struggles with critical thinking or memory.
• Headaches – Another common factor for those not receiving adequate nutrition, moderate to severe headaches can be a regular occurrence for those with untreated celiac disease.
• Joint pain and anemia – When left undiagnosed, a prolonged flare-up of celiac disease could lead to an iron deficiency. With a malfunctioning small intestine, it may become nearly impossible to absorb all the iron body requires to perform several essential functions. As a result, you could experience other health issues like anemia and pain in your joints.

The effects of this condition are varied, and if you have celiac disease, you may experience multiple symptoms simultaneously. While most celiac disease symptoms are related to various stomach issues, you’ll also want to note the less obvious signs. They could provide an essential clue to your celiac disease diagnosis.

How do you test for celiac disease?

After you’ve traced and tracked your symptoms, the next step is to take a celiac disease test. A simple blood test is typically the best way to begin your celiac screening journey. [3] The standard celiac disease screen will examine your blood for the specific antibodies found in high concentrations in celiac patients.

Before preparing for a celiac blood test, it’s important to understand your options. The two most applicable antibody tests include:

• Tissue Transglutaminase IgA (tTG-lgA) – TTG-lgA is one of the main antibodies released by celiac patients after consuming gluten.
• Total IgA – These antibodies help protect your body from various illnesses and are found in your blood, lungs, and stomach. When testing for celiac disease, it is necessary to test for your total lgA antibody levels to ensure that other antibody tests are accurate. If you have below normal lgA levels, your tTG-lgA test may not be accurate or usable. An IgA deficiency is 10 to 15 times more common in people with celiac disease than in those who do not. [4] For people with IgA deficiency, IgG antibodies testing may be helpful. [5]
• DGP-IgG – This is another celiac-related antibody that is typically tested if previous tests cannot provide an accurate result. In the event of a lgA deficiency, a DGP-lgG test may be able to provide you with more information regarding your condition.

While these tests are commonly performed at a healthcare facility, you can also find accessible options for taking an initial celiac disease screening test at home.

It’s important to note that celiac testing may not report accurate results if you have been on a gluten free diet and haven’t consumed gluten for several months. If this is the case, your healthcare provider may recommend a “gluten challenge” prior to testing. Your healthcare provider may also recommend further genetic testing for celiac disease.

Food allergies and food sensitivities

There is often some confusion around the differences between food allergies, food sensitivities, and celiac disease. During the testing process, it may become necessary to take several tests to eliminate the possibility of a misdiagnosis.

Consider the differences between celiac testing and these other types of tests: [6]

• Food allergies – Food allergies can range from mild to severe and result from your immune system reacting to a foreign substance. A gluten allergy can be similar to celiac disease, though notably less severe. Instead of long-term tissue damage, a gluten allergy reaction may result in temporary bloating and discomfort. However, in more severe cases, allergies can pose a deadly threat. Food allergies can be detected with the help of an at-home food allergy test.
• Food sensitivities – Though less serious than allergies, food sensitivities can still cause minor reactions and discomfort. Those with gluten sensitivity might notice some digestive issues or mild headaches after consuming gluten. Luckily, sensitivities can be found by taking an at-home food sensitivity test. Those with sensitivities may choose to avoid some foods altogether or simply limit their intake.

It's crucial to distinguish between celiac disease and non celiac gluten sensitivity. People with non celiac gluten sensitivity do not experience the same effects on their overall health as those with celiac disease. [7]

Consulting with your healthcare provider Receiving positive results on your celiac screening isn’t the end of this process. It’s important to consult with your healthcare provider immediately after receiving your results to confirm an accurate diagnosis.

After your initial screening, your healthcare provider may request: [3]

• Additional antibody testing – Your provider may request additional health screenings to test for other antibodies, including IgA Endomysial antibody (EMA) and Deamidated gliadin peptide (DGP IgA and IgG). These tests are highly specialized and often expensive, but they may offer a useful alternative for hard-to-diagnose patients.
• Video capsule endoscopy – Also known as VCE, this medical procedure may be used to diagnose celiac disease. A medical technician will use a small, ingestible camera to examine your digestive tract, taking pictures and relaying video back to a terminal for further study. However, your healthcare provider may request a standard upper gastrointestinal endoscopy to take a tissue sample for biopsy.
• Radiology – Medical imaging and X-rays can provide clear images of your digestive tract, allowing a potential celiac diagnosis. This process is rarely implemented, but it is an option for those looking for further information about their health.

What are the long-term health risks of celiac disease?

Ultimately, it’s crucial to seek out testing and treatment as soon as you begin noticing the various symptoms of celiac disease. Being proactive can help you avoid longer-term problems and find relief from your symptoms sooner.

The longer celiac disease goes untreated, the higher potential you have for developing additional related health problems, such as: [1]

• Long-term malnutrition – Untreated celiac disease can lead to a variety of malnutrition-related side effects. This can result in brittle, weakened bones in adults and stunted growth in children.
• Cancer – Current trends suggest that untreated celiac disease can lead to higher rates of some types of cancer, including small bowel cancer.
• Reproductive issues – Malnutrition caused by celiac disease may result in reproductive issues for both men and women. These conditions typically stem from a lack of vitamins and nutrients.
• Coronary artery disease – Celiac disease may also increase your risk for heart-related illnesses, including the prevalent and potentially deadly coronary artery disease.

Everlywell: Your source for accurate celiac disease screening

Facing celiac disease head-on doesn’t have to be difficult. You can avoid long-term health complications and relieve short-term discomfort by testing for this condition early and following up with your healthcare provider to build a treatment plan.

If you’re ready for a high-quality home celiac test for screening, we’ve got you covered. Not only can you receive your results quickly and privately through your mobile device, but you can also explore our Food Allergy Test and Food Sensitivity Test to ensure a more complete picture of your health.

Related content

How to prepare for celiac blood test

How is celiac disease diagnosed?

Gluten intolerance vs. celiac disease: understanding the difference

References

1. What is Celiac Disease? Celiac Disease Foundation. URL. Accessed August 1, 2022.
2. Autoimmune Diseases. MedlinePlus. URL. Accessed August 1, 2022.
3. Testing. Celiac Disease Foundation. URL. Accessed August 1, 2022.
4. Celiac Disease and Immunoglobulin A Deficiency: How Effective Are the Serological Methods of Diagnosis? National Library of Medicine. URL. Accessed August 1, 2022.
5. Celiac Disease Tests. National Institute of Diabetes and Digestive and Kidney Diseases. URL. Accessed August 1, 2022.
6. Food Allergy Testing. MedlinePlus. URL. Accessed August 1, 2022.
7. Celiac Disease vs. Gluten Intolerance (Infographic). Northwestern Medicine. URL. Accessed August 1, 2022.
8. Celiac disease. MedlinePlus. URL. Accessed August 1, 2022.
9. Celiac disease. Mayo Clinic. URL. Accessed August 1, 2022.