Every year on the third Sunday in May, the Association of European Coeliac Association Societies celebrates Celiac Disease Awareness Day.
The aim of the event is to raise awareness of gluten sensitivity and to inform people affected by the disease about the dangers and dietary ways to control it.
What is celiac disease?
Celiac disease is a systemic autoimmune disease caused by the gluten proteins in the dietary intake of cereal grains. Based on our current knowledge, celiac disease can occur at any age. Nowadays, adult onset is more common than in childhood.
Environmental, genetic and immunological factors play a role in the development of celiac disease. In genetically predisposed individuals, autoimmune processes can be activated by increased gluten content of the diet or by exposure to viral infection, stress or trauma.
It is estimated that one per cent of the European and Hungarian population is affected by the disease. There is no cure for the disease, the only therapy is a gluten-free diet, which should be followed throughout life.
What are the symptoms of celiac disease and when should you get tested?
The most typical symptoms of celiac disease are fatty stool, bloated, thin abdomen (tubby), loss of appetite, low weight with weight loss or normal eating, migraines, irritability, loss of height and weight in children, abdominal pain, deficiencies (protein, trace elements, vitamins), severe anemia, and constipation in adults.
However, the disease may not present with the usual symptoms but in a less typical way. These include stunted growth, iron deficiency anemia, malformations of tooth enamel, hair loss, frequent miscarriages, skin symptoms, depression, osteoporosis, delayed puberty, late first menstruation, absence or non-patterning of menstruation.
Failure to conceive or spontaneous and recurrent miscarriages, low birth weight and premature birth may also be caused by celiac disease. In addition, if menopausal symptoms appear between the ages of 35 and 40 (early menopause), it is also worth having a screening test for celiac disease. Liver enzyme elevation of unknown origin may also be due to celiac disease.
How can celiac disease be diagnosed?
Celiac disease can now be detected by blood tests even in asymptomatic states. If someone suffer from celiac disease, their body produces antibodies against gluten and the so-called endomysium (connective tissue) and tissue transglutaminase (an enzyme produced in the gut), which can be detected by blood tests.
The first recommended test for suspected celiac disease is the anti-tissue transglutaminase test (anti-tTTG), which has a high sensitivity and specificity in untreated patients. The laboratory test requires no preparation and it is not necessary to arrive on an empty stomach.
Tissue transglutaminase antibody (atTG), IgA is the primary test used to screen for celiac disease. Although these tests are called “tissue”, they are measured from blood. It is the most sensitive and specific blood test for celiac disease.
This test was recommended in 2013 by the American College of Gastroenterology and the American Gastroenterological Association for suspected cases of celiac disease, particularly in people over 2 years of age. The test can also be used to follow-up celiac disease and to evaluate the effectiveness of treatment, as a gluten-free diet should reduce blood antibody levels.
Our laboratory package includes the measurement of antibodies against tissue transglutaminase and 24 additional parameters (inflammatory factor, blood count and erythrocyte sedimentation). You should not follow a gluten-free diet before the test as this will cause a false negative result.
What should I do if I was on a diet before the test?
If a person has not consumed gluten for a long time, antibodies cannot be detected in their blood and they may get a false negative result. In this case, you will need to return to a gluten-containing diet before starting the tests. This means you will need to eat gluten again for 6-8 weeks.
Celiac disease may have non-specific general laboratory signs, which refer to malabsorption; thus, routine laboratory tests may show reduced levels of hemoglobin, iron, total protein, albumin, cholesterol or blood glucose.
Liver function can also be impaired by untreated celiac disease, so liver function tests are recommended for newly diagnosed gluten intolerant people. The laboratory package includes tests for all these parameters.
Around 10 percent of people with celiac disease have autoimmune thyroid disease. Compared to the general population, they are 4.4 times more likely to develop Hashimoto’s thyroiditis and 2.9 times more likely to develop Graves’ disease.
If thyroid problems and coeliac disease co-exist, the specialist prescribes medication, which, together with a gluten-free diet, can relieve the patient of the discomfort and symptoms.
The package includes tests for thyroid hormones and autoantibodies, in addition to the tests included in the Laboratory testing for diagnosed Celiac disease package.