What is anti-tissue transglutaminase (anti-Ttg)?

Transglutaminase antibodies are found in the blood of people with an autoimmune disease called celiac disease. Celiac disease causes a response to gluten, a protein found in wheat, rye, and barley. Gluten consumption triggers celiac disease in susceptible people.

Anti-tissue transglutaminase activity detects antibodies to tissue transglutaminase, an enzyme that causes the cross-linking of these proteins. It is considered the most sensitive and specific blood test for celiac disease.  This test is measured alongside a test for IGA deficiency, which can affect the results of the test.


Why Test Anti-Ttg (Anti-Tissue Transglutaminase)?

Family history
NICE Guidelines (UK) recommend considering all immediate family members of celiac disease for celiac screening.

Symptoms include abdominal pain, diarrhea, constipation, poor growth, weight loss, fatigue, irritability, and behaviour problems.

Health Condition
NICE recommends screening those with type 1 diabetes, autoimmune thyroid disease, autoimmune liver disease, growth problems, frequent mouth ulcers, prolonged fatigue, persistent abdominal/gastrointestinal symptoms, unexplained iron, B12, and folate deficiencies, unexpected weight loss, irritable bowel syndrome (IBS).

You think that you react to gluten-containing foods and would like to confirm this.

If you have been diagnosed with celiac disease we recommend doing a Cyrex test known as Cyrex Array 3. This can be used to identify cross-reactions.

What do the results mean?

A positive or borderline test result suggests a person may have celiac disease and should visit a doctor to discuss the results. Positive and borderline tests may be followed by an intestinal biopsy in order to make a definitive diagnosis of celiac disease.  

You have no antibodies to the marker tested. A negative test cannot rule out celiac disease or gluten sensitivity. As only one marker can be tested for in Sweden, we may recommend following up with Cyrex testing.

Cyrex labs specialises in tests for autoimmune conditions and other chronic diseases, in particular celiac disease and non-celiac gluten sensitivity (NCGS).  People with celiac disease who eat gluten almost always have these antibodies in their blood. Although Cyrex is not yet clinically validated for use in the healthcare system, we have used it clinically for several years and find it very helpful, especially because many people react to different types of gluten.

More Information
Many people react – or think they react – to gluten-containing foods.  Nordic Wellth’s basic gluten package includes the two recommended tests, namely tissue transglutaminase (tTg) test, and Total IGA.  Based on the results of both tests, our doctor will determine whether further testing is needed.

You must be eating a moderate amount of gluten every day for 2-3 weeks before taking this test in order for it to be accurate. 

As hospital lab tests offer a limited number of gluten markers, we regularly send tests for our clients to Cyrex Labs in the USA, which tests for several different types of transglutaminase and 20 additional NCGS markers including different types of gliadin, glutenin, wheat, wheatgerm, Gluteomorphin, and Prodynorphin.  In our clinical experience, this is an extremely useful test. 

Ensure that you have been consuming gluten every day for around 3 weeks before taking this test.

On the day of the test
Remember to take I.D. with you when going to take a test.

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