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Everything You Need to Know About Tissue Transglutaminase (tTG)

The information provided herein does not constitute an expert or medical advice, nor intended to replace such advice.

Health and Wellness

There are many different types of lab tests that can be used to detect a wide range of diseases and syndromes. Many tests aren’t part of the routine lab test panels which are commonly used to assess your overall health status during medical checkups. However, your healthcare provider can order additional testing to diagnose or monitor certain conditions.

A tissue transglutaminase IgA test or tTg-IgA test is one of these special tests, and it’s primarily used to diagnose celiac disease. Find out more about tissue transglutaminase IgA by reading the rest of this article.

What is tissue transglutaminase (tTG)?

In order to understand what this test is used for, first we need to understand the meaning of tTg. 

According to the University of Rochester Medical Center, tissue transglutaminase is a type of enzyme that the human body uses to repair damage in different tissues and organs. People with celiac disease and certain other conditions produce antibodies that attack this enzyme and prevent it from working properly. These antibodies are called anti-tissue transglutaminase antibodies (tTGA), IgA anti-tissue transglutaminase, or IgA Anti-tTG. 

As a result of this process, these patients have elevated tTGA levels, which has been proven to be a reliable indicator for this disease — this has been confirmed by a study published in the World Journal of Gastroenterology

Celiac disease, which is also known as gluten-sensitive enteropathy or celiac sprue, is an autoimmune disease. This disease causes your body to attack itself after you eat gluten, which is a protein found in wheat. According to the Celiac Disease Foundation, celiac disease is associated with a genetic predisposition and it has been estimated to affect approximately 1 out of every 100 people around the world.

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However, only around 30% of all the people who have celiac disease receive the correct diagnosis. That’s why tools such as IgA tTG antibodies for celiac disease are so important, since they can help more people get diagnosed without having to undergo invasive testing, such as intestinal biopsies.

Tissue transglutaminase mechanism

As we mentioned above, people with an abnormal immune response to gluten will produce anti-tissue transglutaminase antibodies that will attack tTG, which doesn’t allow the enzyme to do its job and repair tissue damage. Finding these antibodies in your tissues is a very strong indicator of celiac disease, especially if you also have symptoms of the disease. 

According to the Cleveland Clinic, symptom of celiac disease can include:

  • Abdominal bloating
  • Abdominal pain
  • Gas
  • Diarrhea
  • Constipation
  • Weight loss
  • Pale stools
  • Anemia
  • Hepatitis
  • Muscle cramps
  • Muscle and joint pain
  • Failure to thrive in children
  • A skin rash called dermatitis herpetiforme
  • Mouth sores
  • Abnormal tingling sensations in your limbs
  • Depression

Tissue transglutaminase regulation

tTG IgA levels in celiac patients tend to be higher than normal. tTG tests are often performed in combination with another test called anti-endomysium antibodies (EMA). Your doctor could also order additional tests to monitor the severity of your celiac disease. Celiac disease can prevent you from absorbing nutrients correctly, which can affect other areas of your health.

Updated guidelines published by the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), patients with suspected celiac disease can be diagnosed if they have a tTG antibodies (tTGA) that are at least 10 times the upper normal limit, a positive EMA test, and whose symptoms respond well to a gluten-free diet

What is the normal anti tissue transglutaminase level?

Blood test tTG results can vary depending on a range of factors, such as your age, gender, and medical history.

A tTG test is performed by taking a simple blood sample and analyzing it in a lab. You will need to make sure that you’re consuming gluten in your diet until the test is done. This is because a gluten-free diet will stop your body from producing anti-tissue transglutaminase antibodies if you have celiac disease, since your immune system won’t have to react to the presence of gluten.

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Different labs may also use different reference values. If your healthcare provider has ordered this test for you, it’s very important to discuss your test results with them. Your physician will be the best person to inform you of tTG IgA celiac ranges, so that you’ll know whether your test results are normal or not.

The tTG IgA normal range is between 0 and 5 U/mL. These IgA levels are much higher in celiac patients. According to the Mayo Clinic, this test can also be used to diagnose another condition called dermatitis herpetiformis.

A tTG test is also helpful to monitor how celiac patients respond to a gluten-free diet. The only treatment for celiac disease is to follow a gluten-free diet. Most people experience significant symptom relief after they start this diet, and this should be accompanied by lower tTG IgA test results.

You can visit STDWatch.com now to learn more about many other health topics, including sexual and reproductive health topics and at-home STD testing. 


Anti-Tissue Transglutaminase Antibody - urmc.rochester.edu

Tissue transglutaminase levels above 100 U/mL and celiac disease: A prospective study - ncbi.nlm.nih.gov

What is Celiac Disease? - celiac.org

Celiac Disease - my.clevelandclinic.org

Are ESPGHAN “Biopsy-Sparing” Guidelines for Celiac Disease also Suitable for Asymptomatic Patients? - researchgate.net

TEST ID : TTGG - mayocliniclabs.com

Dr. Andrea Pinto Lopez

Dr. Andrea Pinto Lopez

Sep 19, 2022

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