What This Test Measures
This profile looks at the most clinically established celiac antibodies, plus total IgA to rule out an IgA deficiency that can mask results.
- Anti–tissue transglutaminase (tTG) IgA
- Anti–tissue transglutaminase (tTG) IgG
- Anti–deamidated gliadin peptide (DGP) IgA
- Anti–deamidated gliadin peptide (DGP) IgG
- Total IgA
- Reflex Anti–endomysial antibody (EMA IgA) when indicated by positive tTG IgA or DGP IgA These markers are the core immunologic signals used worldwide to evaluate for celiac disease. EMA is run as a confirmatory reflex for added specificity.
Methodology. Genova uses FEIA for tTG and DGP, immunoturbidimetric analysis for total IgA, and IFA when reflex EMA is performed.
Who Should Consider It
- Ongoing bloating, gas, diarrhea, constipation, or abdominal pain
- Unexplained iron deficiency, folate deficiency, weight loss, or fatigue
- Dermatitis herpetiformis, neuropathy, infertility, or osteopenia with unclear cause
- First-degree relative with celiac disease
Autoimmune thyroid disease or type 1 diabetes with gastrointestinal or nutrient issues. Current guidelines recommend tTG IgA with total IgA as the front-line serology in most patients, which this panel includes in a single draw.
How To Prepare
- Keep gluten in your diet before testing. Serology is most accurate when you are eating gluten. If you have already removed gluten, a medically supervised gluten challenge may be needed for accurate diagnosis.
- Medications can affect antibody levels. Immunosuppressants, chemotherapy, and certain other drugs may blunt serologic responses; timing may need discussion before you draw.
What Your Results Mean
- Strongly positive tTG and DGP, especially with reflex-positive EMA, indicate a high likelihood of celiac disease and typically prompt a gastroenterology referral for confirmation and management. Studies summarized by Genova note that combining tTG with DGP yields very high diagnostic performance. Final diagnosis may still require an endoscopic biopsy in adults per guidelines.
- Negative serology does not fully exclude celiac in certain cases, including IgA deficiency, minimal gluten exposure, or early disease. Additional steps can include HLA-DQ2/DQ8 genotyping, repeat serology while on gluten, and endoscopic evaluation when suspicion remains high.
Sample, Logistics, And Timing
- Sample type: Serum.
- Collection: In-office venipuncture by a phlebotomist.
- Typical turnaround: results are released to your clinician in roughly 7 to 21 business days after the lab receives your specimen.
How Peak by MD Integrates Your Results
We do not stop at a lab flag. Your antibody pattern is integrated with your history, symptoms, nutrition status, micronutrient labs, stool testing when appropriate, and body composition data. If celiac disease is likely, we coordinate GI referral for confirmation, begin evidence-based nutrition guidance, address deficiencies, and map out gut healing and long-term follow up to protect bone, cardiovascular, neurologic, and hormonal health. Guideline-concordant care remains our standard.
Frequently Asked Questions
No fasting is required. Staying on a gluten-containing diet is the key preparation step for valid serology.
In adults, a biopsy is often recommended to confirm the diagnosis, especially if results are discordant or risk is high. Selected pediatric cases may qualify for non-biopsy pathways under strict criteria. We follow current ACG guidance.
The panel measures total IgA and includes IgG-based markers, which helps preserve accuracy in IgA deficiency. Further steps can be tailored if suspicion remains.
