Coeliac Blood Test Results Explained

Coeliac blood test results can be confusing, especially if you have symptoms such as bloating, diarrhoea, constipation, tiredness, anaemia, mouth ulcers, weight loss, abdominal pain, brain fog or skin problems. You may see terms such as tTG-IgA, total IgA, EMA, DGP, positive antibodies, weak positive, negative screen or IgA deficiency. You may also wonder whether a normal result rules out coeliac disease, or whether you can trust the test if you have already reduced gluten.

The most important thing to know is this: coeliac blood tests usually need you to be eating gluten before and during testing. If you have already removed gluten from your diet, your antibody levels may fall and the blood test may be falsely negative. This can make diagnosis much harder.

Coeliac disease is not a food allergy and it is not the same as gluten intolerance. It is an autoimmune condition where the immune system reacts to gluten and damages the lining of the small intestine. Blood tests can help identify people who may have coeliac disease, but diagnosis often depends on the full picture, including symptoms, gluten intake, antibody results, total IgA levels and sometimes an endoscopy with biopsy.

This guide explains what coeliac blood tests measure, what positive and negative results may mean, why gluten intake matters, when results can be falsely negative, and what to do after an abnormal or unclear result.

What is coeliac disease?

Coeliac disease is an autoimmune condition caused by a reaction to gluten. Gluten is a protein found in wheat, barley and rye. In people with coeliac disease, eating gluten triggers an immune response that damages the lining of the small intestine.

The small intestine is where many nutrients are absorbed. When the lining is damaged, it can lead to digestive symptoms, nutritional deficiencies, anaemia, fatigue, weight loss, poor growth in children, bone health problems and other complications.

Coeliac disease can affect people of any age. Some people have obvious digestive symptoms. Others mainly have tiredness, low iron, low folate, mouth ulcers, infertility, recurrent miscarriage, osteoporosis, neurological symptoms or abnormal blood tests. Some people have very few symptoms but still have intestinal damage.

Coeliac disease is treated with a strict lifelong gluten-free diet, but it is important to get tested properly before removing gluten. Once gluten is removed, the blood tests and biopsy may become less reliable.

What is a coeliac blood test?

A coeliac blood test looks for antibodies that are commonly present in people with coeliac disease when they are eating gluten. These antibodies are produced as part of the immune reaction triggered by gluten.

The most common blood tests are:

• tTG-IgA — tissue transglutaminase IgA antibody
• Total IgA — checks whether you make enough IgA antibodies for the tTG-IgA result to be reliable
• EMA-IgA — endomysial IgA antibody, often used as a confirmatory test
• DGP-IgG or DGP-IgA — deamidated gliadin peptide antibodies, sometimes used in children, IgA deficiency or selected cases
• HLA-DQ2 and HLA-DQ8 genetic testing — not a routine diagnosis test, but sometimes used to help rule out coeliac disease in complex cases

In UK practice, the usual first-line coeliac screen is commonly total IgA plus IgA tTG. NICE guidance says laboratories should test for total IgA and IgA tTG as the first choice, and consider IgG EMA, IgG DGP or IgG tTG if IgA is deficient.

What does tTG-IgA mean?

tTG-IgA stands for tissue transglutaminase IgA antibody. This is usually the main blood test used to screen for coeliac disease.

Tissue transglutaminase is an enzyme found in the body. In coeliac disease, the immune system produces antibodies against tissue transglutaminase when gluten triggers the autoimmune response. A raised tTG-IgA result can suggest coeliac disease, especially if you are eating gluten and have symptoms or risk factors.

tTG-IgA is useful because it is widely available and generally performs well as a screening test. However, it is not perfect. It can be falsely negative if you are not eating gluten, if you have IgA deficiency, if the disease is mild or patchy, or sometimes for reasons that are not obvious. It can also occasionally be falsely positive in other conditions, although a strongly positive result is more suggestive.

What does total IgA mean?

Total IgA measures the overall amount of IgA antibody in your blood. It is not a coeliac antibody by itself. It is checked because the main coeliac screening test, tTG-IgA, depends on your body being able to make IgA.

Some people have IgA deficiency. If you are IgA deficient, your tTG-IgA result may be falsely low or negative even if you have coeliac disease. In that situation, IgG-based tests such as IgG DGP, IgG EMA or IgG tTG may be used instead.

This is why a proper coeliac screen should usually include total IgA. A negative tTG-IgA result is less reassuring if total IgA is low.

What does EMA mean?

EMA stands for endomysial antibody. EMA-IgA is another antibody test used in coeliac disease. It is often highly specific, meaning a positive result is strongly suggestive when the clinical picture fits.

EMA is often used as a confirmatory test after a positive or borderline tTG-IgA result. Some laboratories automatically add EMA testing when tTG is positive or weakly positive. Others may only do it when requested or as part of specialist assessment.

A positive EMA result can make coeliac disease more likely. However, like other coeliac antibody tests, it usually depends on you eating gluten at the time of testing.

What does DGP mean?

DGP stands for deamidated gliadin peptide. DGP antibody tests may be IgA or IgG-based. They are not always used as the first test in adults, but they can be useful in selected situations.

DGP-IgG may be considered if someone has IgA deficiency. DGP tests may also be used in some children or when clinical suspicion remains despite other results.

If your report includes DGP, it should be interpreted with tTG, EMA, total IgA, symptoms, age and gluten intake. A DGP result by itself is not the whole answer.

What does a positive coeliac blood test mean?

A positive coeliac blood test means antibodies associated with coeliac disease were found. This makes coeliac disease more likely, especially if you were eating gluten at the time of testing.

A positive result does not always mean the diagnosis is complete. In adults, a GP will usually refer you to a gastroenterologist. The specialist may arrange further blood tests and often an endoscopy with small bowel biopsy to confirm the diagnosis.

Possible meanings of a positive coeliac blood test include:

• coeliac disease is likely and needs further assessment
• you may need referral to gastroenterology
• you should usually continue eating gluten until testing is complete, unless told otherwise
• your family members may need advice about testing if diagnosis is confirmed
• you may need checks for anaemia, vitamin deficiencies and bone health

Do not start a gluten-free diet immediately after a positive blood test unless your clinician tells you to. If you stop gluten before biopsy or specialist review, it may make confirmation harder.

What does a weak positive or borderline coeliac result mean?

A weak positive or borderline result means antibodies were detected, but not strongly. This can be difficult to interpret.

A borderline tTG-IgA may happen in early or mild coeliac disease, but it may also be a non-specific finding. Your clinician may consider:

• whether you were eating enough gluten before the test
• whether total IgA is normal
• whether EMA is positive or negative
• whether symptoms strongly suggest coeliac disease
• whether you have risk factors such as type 1 diabetes or autoimmune thyroid disease
• whether the test should be repeated
• whether referral to gastroenterology is needed

A borderline result should not be ignored if symptoms continue. It should also not automatically lead to a lifelong gluten-free diet without proper diagnosis.

What does a negative coeliac blood test mean?

A negative coeliac blood test means coeliac antibodies were not detected, or were below the laboratory’s reporting threshold. If you were eating gluten regularly, total IgA was normal, and symptoms are not strongly suggestive, this makes coeliac disease less likely.

However, a negative result does not always rule it out. False negatives can happen.

A coeliac blood test may be negative if:

• you were not eating gluten before or during testing
• you had already reduced gluten significantly
• you have IgA deficiency and only IgA-based tests were used
• the disease is early, mild or patchy
• you are a young child where different testing strategies may be needed
• there was a lab or sampling issue
• another condition is causing similar symptoms

If your result is negative but symptoms continue, speak to a GP. Do not assume everything is fine if you still have persistent diarrhoea, weight loss, iron deficiency anaemia, unexplained fatigue, bloating, mouth ulcers or other ongoing symptoms.

Why gluten intake matters before coeliac testing

Coeliac blood tests work by detecting the immune response to gluten. If you stop eating gluten, the immune response may reduce. Antibody levels can fall, and the intestinal lining may begin to heal. This can lead to a false-negative blood test or biopsy.

The NHS advises that gluten should be included in your diet when the blood test is done because avoiding it could lead to an inaccurate result.

This is one of the most common problems in coeliac diagnosis. Many people feel better when they reduce gluten, so they stop eating it before testing. Then their blood tests come back negative, but it is unclear whether that means they do not have coeliac disease or whether they were not eating enough gluten for the test to work.

How much gluten do you need to eat before a coeliac blood test?

Advice can vary, so you should follow your GP or gastroenterologist’s instructions. In general, clinicians usually want you to be eating gluten regularly before coeliac testing. Coeliac UK says you need to be eating gluten before testing and recommends including gluten in more than one meal every day for at least six weeks before testing.

Examples of gluten-containing foods include bread, pasta, breakfast cereal, biscuits, crackers, cakes and foods made with wheat, barley or rye.

If eating gluten causes severe symptoms, do not attempt a gluten challenge without medical advice. Speak to your GP or specialist. There may be alternative steps, such as genetic testing to help assess whether coeliac disease is possible, but genetic testing cannot confirm the diagnosis by itself.

What if you already stopped eating gluten?

If you have already stopped eating gluten, tell your GP before having coeliac blood tests. Do not pretend you are eating gluten when you are not, because it can lead to a misleading result.

Your GP or specialist may discuss a gluten challenge. This means reintroducing gluten for a period before repeat blood tests or biopsy. This can be difficult if symptoms return, so it should be planned carefully.

Sometimes HLA genetic testing may be used in people already on a gluten-free diet. If you do not carry HLA-DQ2 or HLA-DQ8, coeliac disease is very unlikely. But if you do carry them, it does not prove coeliac disease, because many people carry these genes and never develop the condition.

What is HLA-DQ2 and HLA-DQ8 genetic testing?

HLA-DQ2 and HLA-DQ8 are genetic markers linked with coeliac disease. Most people with coeliac disease have one or both of these markers.

Genetic testing is not usually the first test for coeliac disease because it cannot diagnose the condition. Many people have HLA-DQ2 or HLA-DQ8 but never develop coeliac disease.

Its main use is to help rule out coeliac disease in difficult cases. If both markers are absent, coeliac disease is very unlikely. If one is present, coeliac disease remains possible but not confirmed.

Coeliac blood test results and endoscopy

In many adults, a positive coeliac blood test is followed by referral to a gastroenterologist for confirmation. This may involve an endoscopy with biopsy of the small intestine.

During an endoscopy, a thin flexible camera is passed through the mouth into the upper digestive system. Small samples are taken from the lining of the small intestine. These samples are checked for changes such as villous atrophy, which means flattening of the tiny finger-like projections that help absorb nutrients.

Some children with very high antibody levels may be diagnosed without biopsy under specialist paediatric criteria, but this is not something to decide yourself. Adults usually still need specialist confirmation according to local pathways and clinical judgement.

If you are waiting for endoscopy, ask whether you should continue eating gluten. In most cases, you should not stop gluten until the diagnostic process is complete unless your specialist advises otherwise.

Can coeliac disease be diagnosed without a biopsy?

Sometimes, but it depends on age, antibody levels, symptoms, local practice and specialist guidance.

Children may sometimes be diagnosed without biopsy if antibody levels are very high and other criteria are met. Adults are more commonly diagnosed using blood tests plus biopsy, although pathways can vary in special circumstances.

If your blood test is strongly positive, do not assume you can skip the rest of the process. Ask your GP or gastroenterologist what confirmation is needed before starting a lifelong gluten-free diet.

Coeliac blood tests vs wheat allergy tests

Coeliac disease is not the same as wheat allergy.

Coeliac disease is an autoimmune condition triggered by gluten. It is investigated with coeliac antibody tests such as tTG-IgA, EMA and DGP.

Wheat allergy is usually an IgE-mediated allergy to wheat proteins. It may cause rapid symptoms such as hives, swelling, wheezing, vomiting or anaphylaxis after wheat exposure. It is investigated with allergy history, wheat-specific IgE blood tests, skin prick tests and specialist assessment where needed.

Non-coeliac gluten sensitivity is different again. It describes symptoms triggered by gluten-containing foods when coeliac disease and wheat allergy have been excluded. There is no simple blood test that confirms it.

If you are unsure whether your symptoms are allergy-related, see Allergy Blood Test Results Explained.

Coeliac disease vs gluten intolerance

Gluten intolerance is a broad phrase people often use when they feel better avoiding gluten but do not have a confirmed diagnosis of coeliac disease or wheat allergy.

The difficulty is that gluten-containing foods often contain other components that can cause symptoms, especially fermentable carbohydrates known as FODMAPs. For example, wheat-based bread or pasta may trigger bloating in some people with IBS, even if gluten itself is not the true cause.

This is why proper testing matters. If you remove gluten before coeliac testing, you may never know whether you have coeliac disease. And if you avoid wheat without dietetic guidance, you may restrict your diet unnecessarily.

If bloating, diarrhoea or abdominal pain are the main symptoms, these related guides may help: Bloating: Common Causes, Relief and When to Worry, IBS: Symptoms, Diagnosis and Treatment and Digestive Health: Symptoms and Common Conditions.

Who should be tested for coeliac disease?

Coeliac testing may be considered if you have symptoms, unexplained deficiencies or risk factors. It is not only for people with diarrhoea.

Testing may be appropriate if you have:

• persistent diarrhoea
• ongoing bloating or abdominal pain
• unexplained weight loss
• unexplained iron deficiency anaemia
• low folate or B12 in some contexts
• mouth ulcers
• fatigue that is persistent and unexplained
• osteoporosis or low bone density at a younger age
• delayed puberty or poor growth in children
• recurrent miscarriage or unexplained infertility in selected cases
• raised liver enzymes without clear cause
• dermatitis herpetiformis, an itchy blistering rash linked with coeliac disease
• type 1 diabetes
• autoimmune thyroid disease
• a first-degree relative with coeliac disease

If tiredness, anaemia or vitamin deficiencies are part of the picture, you may find these guides useful: Full Blood Count Results Explained, Iron, Ferritin and Anaemia Blood Test Results Explained, B12 and Folate Blood Test Results Explained and Fatigue: Why Am I Always Tired?.

Symptoms that may be linked with coeliac disease

Coeliac disease can cause digestive and non-digestive symptoms. Some people have many symptoms. Others have none or only subtle signs.

Digestive symptoms

• diarrhoea
• constipation
• bloating
• excess wind
• abdominal pain or cramps
• nausea
• unexplained weight loss
• pale, bulky or foul-smelling stools

Non-digestive symptoms

• tiredness or weakness
• iron deficiency anaemia
• mouth ulcers
• headaches or brain fog
• bone or joint pain
• low vitamin or mineral levels
• fertility problems in some people
• recurrent miscarriage in some people
• low mood or irritability
• an itchy blistering rash called dermatitis herpetiformis

Because symptoms can overlap with IBS, inflammatory bowel disease, thyroid disease, anaemia, food intolerance and stress-related gut symptoms, testing is important before assuming the cause.

What other blood tests may be checked?

If coeliac disease is suspected or confirmed, other blood tests may be used to assess deficiencies, inflammation, liver function and general health.

These may include:

• Full blood count — to check for anaemia or other blood changes
• Ferritin and iron studies — to check iron stores
• Folate and vitamin B12 — to check for deficiencies
• Vitamin D, calcium and phosphate — relevant to bone health
• Liver function tests — sometimes abnormal in untreated coeliac disease
• Thyroid function tests — because autoimmune thyroid disease is more common in people with coeliac disease
• HbA1c or diabetes-related tests — especially if type 1 diabetes is present or suspected

Related result guides include Liver Function Test Results Explained, Thyroid Blood Test Results Explained, Vitamin D Blood Test Results Explained and HbA1c and Blood Sugar Results Explained.

Coeliac blood tests in children

Children can have coeliac disease, and symptoms may be different from adults. Possible signs include diarrhoea, constipation, bloating, abdominal pain, poor growth, delayed puberty, tiredness, irritability, anaemia or dental enamel problems.

Coeliac testing in children should be arranged and interpreted by a GP or paediatric specialist. Total IgA and tTG-IgA are commonly used, with IgG-based tests considered if IgA is deficient. In some children, very high antibody levels may allow diagnosis without biopsy under specialist criteria, but this should be managed by clinicians.

Do not start a gluten-free diet in a child before testing unless a clinician advises it. Removing gluten can make diagnosis harder and may cause unnecessary dietary restriction if the diagnosis is wrong.

Coeliac blood tests in people with type 1 diabetes or thyroid disease

Coeliac disease is more common in people with some other autoimmune conditions, especially type 1 diabetes and autoimmune thyroid disease.

If you have type 1 diabetes, thyroid disease, or a close family member with coeliac disease, your threshold for testing may be lower, especially if you have symptoms, anaemia, unexplained low nutrients or changes in blood sugar control.

Because symptoms can be subtle, some people in higher-risk groups are tested even without classic digestive symptoms.

Can coeliac blood tests monitor a gluten-free diet?

Yes, coeliac antibody tests may be used after diagnosis to help monitor response to a gluten-free diet. Antibody levels often fall after gluten is removed, although the speed varies.

If antibodies remain high after diagnosis, it may suggest ongoing gluten exposure, accidental contamination, incomplete dietary change, or occasionally another issue that needs review. A specialist dietitian can help identify hidden gluten sources.

However, normal antibody levels do not always prove the intestine has fully healed, and symptoms can persist for other reasons. Follow-up should be personalised.

What if symptoms continue after going gluten-free?

If you have confirmed coeliac disease and symptoms continue after starting a gluten-free diet, speak to your GP, dietitian or gastroenterologist.

Possible reasons include:

• accidental gluten exposure
• hidden gluten in foods or medicines
• lactose intolerance after intestinal damage
• IBS
• small intestinal bacterial overgrowth
• microscopic colitis
• inflammatory bowel disease
• pancreatic problems
• another diagnosis causing symptoms
• rarely, refractory coeliac disease

Do not assume persistent symptoms mean the gluten-free diet has failed. It may need review and further investigation.

Can private coeliac blood tests be trusted?

Private coeliac blood tests can be useful if they measure the correct antibodies, include total IgA, are processed by a reliable laboratory, and are interpreted with symptoms and gluten intake.

However, private results can be misleading if:

• you were already gluten-free or low-gluten
• total IgA was not checked
• only a partial panel was done
• the result is borderline and no follow-up is offered
• the report tells you to go gluten-free without medical confirmation
• the test is confused with food allergy or intolerance testing

If you receive an abnormal private result, share the full report with your GP. Include whether you were eating gluten, how much, and for how long before testing.

For general advice about private blood tests, see What to Do After Abnormal Private Blood Test Results.

What should you do after a positive coeliac blood test?

If your coeliac blood test is positive, the next step is usually to speak to your GP and arrange referral or follow-up according to local pathways.

In general:

1. Do not stop gluten immediately unless your clinician tells you to.
2. Ask whether referral to gastroenterology is needed.
3. Check whether the result included total IgA.
4. Ask whether EMA or other confirmatory testing is needed.
5. Ask whether you need endoscopy and biopsy.
6. Ask whether other blood tests are needed for anaemia, iron, folate, B12, vitamin D, liver and thyroid function.
7. Ask for dietitian referral after diagnosis before making major dietary changes.

A strict gluten-free diet is lifelong treatment for confirmed coeliac disease, so diagnosis should be as clear as possible before committing to it.

What should you do after a negative coeliac blood test?

If your blood test is negative and you were eating gluten regularly, coeliac disease is less likely. But if symptoms continue, you may still need follow-up.

Ask your GP:

• Was I eating enough gluten before the test?
• Was total IgA checked?
• Could I be IgA deficient?
• Do my symptoms still suggest coeliac disease?
• Should any IgG-based tests be considered?
• Could IBS, IBD, lactose intolerance, thyroid disease, anaemia or another condition explain symptoms?
• Do I need referral despite a negative test?

If you were not eating gluten before the test, the result may not be reliable. Do not use it as proof that coeliac disease has been ruled out.

Questions to ask your GP about coeliac blood test results

If you are unsure what your result means, these questions can help:

• Which coeliac antibodies were tested?
• Was total IgA checked?
• Was my tTG-IgA positive, negative or borderline?
• Do I need EMA or DGP testing?
• Was I eating enough gluten for the result to be reliable?
• Do I need referral to gastroenterology?
• Do I need an endoscopy or biopsy?
• Should I continue eating gluten until diagnosis is complete?
• Do I need blood tests for anaemia or vitamin deficiencies?
• Should my family members be tested if I am diagnosed?

When should you seek medical advice urgently?

Coeliac disease itself is usually not an emergency, but some symptoms need urgent assessment.

Seek urgent medical advice if you have:

• severe abdominal pain
• blood in your stool or black stools
• persistent vomiting
• signs of dehydration
• unexplained rapid weight loss
• fainting, chest pain or severe breathlessness
• severe weakness with suspected anaemia
• new jaundice, where the skin or eyes look yellow
• symptoms in a child with poor growth or significant weight loss

For related symptom guides, see Blood in Stool, Abdominal Pain: Common Causes by Location and Diarrhoea and Vomiting in Adults.

How to read coeliac blood test results step by step

If you have your report in front of you, read it in this order:

1. Check whether you were eating gluten. If not, the result may be unreliable.
2. Look for tTG-IgA. This is usually the main screening antibody.
3. Check total IgA. Low IgA can make IgA-based results falsely negative.
4. Look for EMA or DGP. These may be used for confirmation or special situations.
5. Check whether the result is negative, borderline or positive.
6. Compare with symptoms and risk factors. Anaemia, weight loss, diarrhoea and family history matter.
7. Do not start gluten-free until advised. Testing may not be complete.
8. Ask what happens next. You may need repeat testing, referral, endoscopy or other blood tests.

For wider help with blood reports, see How to Understand Blood Test Results and How to Understand Medical Test Results.

The bottom line

Coeliac blood tests are useful, but only when they are done and interpreted correctly. The main screening test is usually tTG-IgA, supported by total IgA. EMA and DGP tests may be used in selected situations, especially when results are borderline, confirmation is needed, or IgA deficiency is present.

The biggest mistake is stopping gluten before testing. If you are not eating gluten, coeliac antibodies may fall and the result may be falsely negative. This can make diagnosis much harder.

A positive result usually needs GP follow-up and often gastroenterology referral. A negative result is reassuring only if you were eating enough gluten and the right tests were done. If symptoms continue, ask what else could be causing them.

Coeliac disease is treatable, but diagnosis matters. A strict gluten-free diet should usually follow proper testing, not replace it.

Frequently asked questions

What is the main blood test for coeliac disease?

The main blood test is usually tTG-IgA, also called tissue transglutaminase IgA antibody. It is often checked together with total IgA.

What does tTG-IgA mean?

tTG-IgA is an antibody commonly found in people with coeliac disease when they are eating gluten. A raised result can suggest coeliac disease and usually needs follow-up.

What does total IgA mean?

Total IgA checks whether you make enough IgA antibodies. If total IgA is low, tTG-IgA may be falsely negative and IgG-based tests may be needed.

What does EMA mean in coeliac testing?

EMA stands for endomysial antibody. It is often used as a confirmatory antibody test when coeliac disease is suspected.

What does DGP mean?

DGP stands for deamidated gliadin peptide. DGP antibody tests may be used in selected cases, such as IgA deficiency, children or unclear results.

Does a positive coeliac blood test mean I definitely have coeliac disease?

It makes coeliac disease more likely, especially if you were eating gluten. However, adults often need specialist assessment and sometimes endoscopy with biopsy to confirm the diagnosis.

Does a negative coeliac blood test rule out coeliac disease?

Not always. It is more reassuring if you were eating gluten regularly and total IgA was normal. It may be falsely negative if you had reduced gluten or have IgA deficiency.

Can I have coeliac disease with normal blood tests?

Yes, although it is less common. This can happen if you are not eating gluten, have IgA deficiency, have early or patchy disease, or if the clinical suspicion remains high despite negative tests.

Do I need to eat gluten before a coeliac blood test?

Yes, in most cases. Coeliac blood tests usually require gluten in the diet to be reliable. If you have already stopped gluten, speak to your GP before testing.

How long do I need to eat gluten before testing?

Advice can vary. Coeliac UK commonly advises eating gluten in more than one meal every day for at least six weeks before testing. Follow your GP or specialist’s advice.

Should I stop gluten after a positive blood test?

Not until your clinician tells you to. You may need further testing or biopsy, and stopping gluten too soon can make confirmation harder.

Can coeliac blood tests diagnose gluten intolerance?

No. Coeliac blood tests look for coeliac disease antibodies. They do not diagnose non-coeliac gluten sensitivity or most food intolerances.

Is coeliac disease the same as wheat allergy?

No. Coeliac disease is autoimmune and triggered by gluten. Wheat allergy is usually an IgE-mediated allergy to wheat proteins and is investigated differently.

Can a private coeliac test be accurate?

It can be accurate if the right tests are done, total IgA is included, the laboratory is reliable, and you were eating gluten. If you were gluten-free, the result may be misleading.

Can children have coeliac blood tests?

Yes. Children can be tested for coeliac disease, but results should be interpreted by a GP or paediatric specialist. Do not remove gluten before testing unless advised.

What happens after a positive coeliac blood test?

Your GP may refer you to a gastroenterologist. Further blood tests and/or endoscopy with small bowel biopsy may be arranged depending on age, result level and local pathway.

Can coeliac disease cause anaemia?

Yes. Coeliac disease can reduce nutrient absorption and may cause iron deficiency anaemia, low folate or other deficiencies.

Can coeliac disease cause tiredness?

Yes. Tiredness can be caused by anaemia, nutrient deficiencies, inflammation, poor absorption or the general effect of untreated coeliac disease.

Can coeliac disease cause bloating?

Yes. Bloating is a common symptom, but it can also be caused by IBS, constipation, food intolerance and other digestive conditions.

What should I do if I feel better gluten-free but tested negative?

Check whether you were eating enough gluten before testing and whether total IgA was checked. Speak to your GP before assuming coeliac disease has been ruled out.