Learning to Live With Celiac Disease
You may not know you have it, but celiac disease can rob the body of nutrients it needs to thrive.
Dangers of Misdiagnosis continued...
People with undiagnosed celiac disease tend to have fewer university degrees
and fewer managerial jobs, which may possibly be related to childhood
behavioral problems, according to a Finnish study.
This may be related to the increased prevalence of depressive and disruptive
behavioral disorders described in teenagers with untreated celiac disease,
"In adults and kids iron deficiency -- even without anemia -- is a risk
factor for poor performance on standardized math tests, so anemia can play a
role as well," LaPook adds.
Diagnosing celiac disease may be part of the problem.
"It can be very tricky," LaPook says. The first step is typically blood
tests looking for the presence and levels of certain antibodies. These tests
may include anti-gliadin, anti-endomysial, anti-tissue transglutaminase
antibodies, and total immunoglobulin A. If blood test results are positive, a
person will then go for a biopsy of the small intestine to confirm the
diagnosis and assess the degree of damage.
Sometimes blood tests are inconclusive, LaPook explains, and that's when we
test for specific HLA (human leukocyte antigen) genes associated with celiac
disease. If these genes are not present, it is unlikely that a person will
develop celiac disease. A positive HLA test, however, does not mean that the
individual has the condition, as these genes are common in the general
"About 30% of the general population has the genetic propensity for celiac
disease and yet only about 1% get it, so most people with the genetic
propensity don't have celiac disease, and the thinking is that there may be
something that unmasks it, like a virus or other factors that we don't
understand yet," LaPook says.
A diagnostic clue, however, is the presence of a skin problem called
dermatitis herpetiformis, which is marked by itching and blisters. This
typically goes hand-in-hand with celiac disease.
Should You Get Tested?
As far as who should get tested, anyone with symptoms should talk to their
doctor about getting a blood test -- and perhaps anyone with any of the
secondary conditions such as the brittle bone disease osteoporosis or
infertility, experts tell WebMD.