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Anti-TTG (Tissue Transglutaminase)

Anti-tTG IgA: Normal Values and What a Raised Result Means

Anti-TTG is a key screening marker for coeliac disease, which affects women more frequently than men. Coeliac disease can contribute to iron-deficiency anaemia, fertility issues, and osteoporosis — making early detection particularly important for women's health.

Doctor's Assessment Included

Anti-TTG (Tissue Transglutaminase): what this test measures

This test measures the level of IgA antibodies directed against tissue transglutaminase in your blood. It is the most sensitive and specific single blood test for coeliac disease screening. For accurate results, you must be consuming gluten regularly at the time of testing.

Anti-TTG (Tissue Transglutaminase): why this value matters

Undiagnosed coeliac disease can lead to nutrient malabsorption, iron deficiency, osteoporosis, and other complications. Early detection through anti-TTG screening enables timely dietary management. A negative result in someone already following a gluten-free diet may be falsely reassuring.

Anti-TTG (Tissue Transglutaminase): how to prepare

Keep eating gluten
Required

Eat gluten every day, in more than one meal, for at least 6 weeks before the draw. If you already eat gluten-free, the test can come back falsely negative.

Water is always fine. Drink as usual beforehand, it makes the draw easier.
Take your usual medication, unless your own doctor told you otherwise.

Anti-TTG (Tissue Transglutaminase): when is testing worthwhile?

Consider testing if you experience persistent digestive symptoms such as bloating, diarrhoea, or abdominal pain after eating gluten-containing foods. Testing is also recommended if you have a family history of coeliac disease, iron-deficiency anaemia of unknown cause, or associated autoimmune conditions. You must be eating gluten for at least 6 weeks before testing.

Anti-TTG (Tissue Transglutaminase): symptoms of a high or low value

Low Levels

Low or undetectable anti-TTG levels are within the normal range and suggest that coeliac disease is unlikely, provided you were consuming gluten at the time of testing and do not have IgA deficiency.

High Levels

Elevated anti-TTG levels may be associated with coeliac disease. Symptoms that often prompt testing include chronic bloating, diarrhoea, fatigue, weight loss, and iron-deficiency anaemia. However, elevated levels can occasionally occur in other conditions. Your healthcare provider will determine whether further investigation such as a duodenal biopsy is needed.

Anti-TTG (Tissue Transglutaminase): lifestyle and this value

If coeliac disease is confirmed, a strict lifelong gluten-free diet is the primary treatment. Even small amounts of gluten can trigger immune activity. Work with a dietitian to ensure nutritional adequacy. Do not start a gluten-free diet before testing is complete, as this can produce falsely negative results.

Anti-TTG (Tissue Transglutaminase): frequently asked questions

Can I test for coeliac disease if I am already gluten-free?

Anti-TTG levels may be falsely normal if you have been avoiding gluten. A gluten challenge of at least 6 weeks is typically required before testing for reliable results.

Is a positive anti-TTG result enough to diagnose coeliac disease?

In adults, a positive anti-TTG usually needs to be confirmed with a duodenal biopsy. In some cases with very high titres and positive endomysium antibodies, a no-biopsy diagnosis may be considered.

What if I have IgA deficiency?

IgA deficiency can cause a false-negative anti-TTG result. If IgA deficiency is known or suspected, an IgG-based coeliac test should be used instead.

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