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Greetings All,

This is my first post to this list.  I've been a member for just a few weeks and have enjoyed reading the knowledgeable and helpful posts y'all make.  Now I need to ask your assistance.  I apologize if this gets long...

First, some history...  I was never medically diagnosed with CD, due to the useless physicians I was seeing when I first developed symptoms (One said to me, "If you're so concerned about it, just stop eating wheat."  Helpful, huh?).  It was through my own food testing that I discovered that my beloved wheat breads, pastas, and crackers were causing my digestive problems.  The only test my physician would do for me was the 24-hr fecal fat test for fat absorption (normal is < 7 g, my result was 30 g).  After some research about malabsorption, I placed myself on a good multi-vitamin (should have been taking one anyway, right?!) and on a relatively gf diet for about two years; "relatively", because I was still not knowledgeable enough about CD to realize that I needed to be more vigilant regarding hidden gluten and I still was not aware of the real damage that was being done by ingesting gluten.  About six months ago I found a new doctor, one who is a bit more proactive about her patients' health and who actually listens to me, although she's still not as familiar with CD as I'd like her to be.  But I'm with an HMO and can't afford a separate specialist, so what am I going to do?  Anyway, based on my malabsorption, my recent new problems with my blood drop not sinking during blood donation iron testing, and two poor-results from heel bone density tests performed at employee health fairs, my new doctor agreed to order a DEXA scan for me (despite my age being only 36 at the time) and complete iron testing.  My hip result was -1.9, my spine result was -2.3, and although I'm not anemic (presumably because I take extra iron), I am ferritin deficient, with a value of 3 ng/ml (normal for a female, as you might know, is 12 - 150 ng/ml).  So, now I'm being careful to ingest at least 100% of the rda for iron, in the hopes that I continue to absorb enough to keep me from becoming anemic and having to take a separate supplement, and I also take three 500 mg Viactiv calcium chews daily.  Although I was certainly not a sloth before, I've also increased my weight-bearing exercise, going so far as to register for a marathon in October, for which I'm now in my 11th week of training (to walk it, because I have joint problems that prevent me from running).  My doctor will order a follow-up DEXA scan next March, one year after the first scan, to see if any of this is helping or if she needs to refer me to the endocrinologist to discuss whether or not to place me on Fosamax (I don't want to take it, for one thing, and she's not thrilled with the idea of placing me on it at such a young age because they don't know whether such long-term use will cause me other health problems down the road).

A few weeks ago I requested that my doctor order the CD blood tests, just to see where my numbers are, since I'd discovered that I was still ingesting gluten in some forms.  She ordered the tTG-IgA, AGA-IgG, AGA-IgA, Total IGA, and EMA-IgA.  However, the only results I received are IgA 263 mg/dL ("normal" 40-375); tTG Ab IgG <3 U/mL (negative <7); and tTG Ab IgA <3 U/mL (negative <5).

So here are my questions:

1.  What does the "Ab" after the tTG stand for?  It's not supposed to be a blood type is it?  Because according to Blood Source, to which I donate blood every two months, my blood type is O+.

2.  Is the EMA-IgA buried in one of the three results I received or should I have received a separate result?  I was going to pester my doctor, but thought I'd check with y'all first.

3.  What do you think this all means????  Should I pester my doctor for the EMA-IgA test?  Might I not have CD?  I never had the so-called "classic" symptom of diarrhia, leaning more toward the less "classic" but equally joyless symptom of constipation, and the ever-present gas problem along with other symptoms (sorry to be so graphic, but I know you're all familiar with it!).  I'm certainly not going back to eating gluten, regardless of the test results, because every time I've tried to enjoy just a bite of something I've suffered for days afterward.  What should I do now?  Do I press my doctor for a referral to GI and then try to press them for a biopsy (remember, I'm dealing with an HMO, probably the largest in Nor Cal)?  Will a biopsy show anything at this point, when I've been eating so little gluten for a few years now?  Something is causing my malabsorption, right?  Is this just all in my head at this point????!!

I appreciate any informed comments and advice you can provide.

Thank you,
~Tamara

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