Cross your fingers.

Often, the doctor will recommend a GI specialist because they do feel uncomfortable ordering tests outside of their speciality when they aren't familiar with medical condition they are testing for, and they aren't familiar with the appropriate tests. That, and I think there is some sort of professional courtesy involved with referring to an appopriate specialist. This is where you sometimes need to be ready to ask really nicely (beg), and explain the "rush" on the situation for accurate results if she's already stopped eating gluten, etc.

I know that I asked our pediatrician to run the entire panel, as you stated it above. He ended up checking with the local children's hospital in the closes big city, and they told him the only tests required were the anti-tTG and total IgA. He called me personally to say the tests were all normal. It wasn't until six months later when I requested copies of all of her past labwork that I learned only two of the tests had been run. I had to go back and ask for the antigliadin antibodies (she was still eating gluten because all the tests were 'normal'). They tried to say the important tests had been run, and I had to convince them why the antigliadin antibody tests were important to me. (It was the only clue we had for my youngest child, and she had already responded remarkably to a gluten free diet).

The doctor may very well not know what she is talking about because not all doctors are familiar with celiac disease. It has really only been increasing in recognition for about 5 years, and many of the antibody tests are less than ten years old.

If the doctor wants to test using only the anti-tTG and Total IgA (based on newer recommendations) your daughter may have to be prepared to explain she would also like the test for antigliadin antibodies because she is interested in any degree of gluten sensitivity.

She could take along a copy of this article, as it has a flowchart that includes the antigliadin antibodies, at least:
Gluten-Sensitive Enteropathy (Celiac Disease): More Common Than You Think by David A. Nelson, JR, MD, MS (AAFP)


Have her ask for the celiac panel through Prometheus Labs, listed in my post below!

I know this is probably totally confusing... sorry about that.

Cara