Family, Internal Medicine, General Medical Questions/Question about celiac disease


This may be a long question, please forgive me but I do not know where to go.  I am a female 34.  I'm overweight BMI 28.4 and am losing the baby weight from my 19 month old.

About 2 months ago I developed pain in my feet and muscle pain in my legs.  I had intermittent joint pain in my hands we well.  My family doctor ran some tests and my ANA came back elevated 1:320.  He told me that he would confer with the local Rheumy and he told me that my feet were not consistent with an AI and that my joint pain wasn't an AI yet and that I could recheck in a few months.  He said that they diagnose based on symptoms not unspecific blood work.

Since then I injured my hand on Valentine's day and it is still stiff, I think I tore a tendon or something in my palm.  On 3/5 I drove to Boston and went to a functional medical doctor there and told him my story.  I showed him all my blood work from a month before and he decided to do more.  While I was at his office I noticed how stiff my leg muscles (calves, ankles)were and that day he told me to go off of the anti-inflammatory drugs I was taking.  Two days later my knees hurt to go up and down stairs.  They grind.  I took my blood work that day.

I am now taking ibuprofen again and sometimes I still get break through pain with my knees.  They hurt all day/night long, as does my feet.  My left hand seems to be the only hand with stiff joints that get better quickly in the morning.  My other hand is hurt and definitely is less stiff on medicine but I need to see a hand surgeon for this according to the nurse at my original doctor.

Okay here is my question:  I do not get to see my Functional Medicine doctor for 6 weeks but was sent my results for my labs and told to not eat gluten.

Can you help me interpret them because I am really confused.  Here is what came back abnormal and I'm showing you my ESR score because with mine done 2 months ago I was normal on both 2/5.  But the ranges were different?

ESR 27 with a high max of 30
CRP 9.5 with a high max of 10  ? but now it's out of 4.9?

Vitamin D 25-hydroxy - 28.3 Low  Reference range 30-100
Sedimentation Rate - Westergren 16 Reference range 0-32
C-reactive protein, Quant 14.5 High Reference range 0-4.9
Iron, Serum - 31 low reference range 35-155
Iron, Saturation - 10 low 15-55

All my other anemia panel was normal.  Then he ran a celiac disease panel.

Immunoglobulin A Qn, Serum  432 high 91-414
Deamidated Gliadin Abs, IgG 24 high >20

So in his notes he states that I could possibly be celiac or gluten intolerant and that may be causing all my problems.  I have hypothyroid disease and psoriasis.  So should I believe all my symptoms are from this?

Could I be celiac or is this more suggestive of gluten insensitivity.  I am so confused and if he wasn't going to explain these abnormal results he should have sent them?

different labs use different scales of what is normal due to different methods of testing.

Your sed is normal in both tests (ESR, Sedimentation rate) so it is unlikely that this is a big autoimmune disease like lupus, etc.  Also the CRP is also normal ( I guess ) 9.5 out of 10.

Vitamin D is ALWAYS low.... non issue

the celiac panel.... you are a little high... it is tough interpreting those tests as they are only markers, but a gluten free diet is worth a try.  

First though, I would make sure your thyroid tests were normal on your thyroid replacement..... . that means your TSH is between 0.5 and 1.5      

I agree these tests are non-specific.... but the diet is worthwhile in the interim.

I hope this helps

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Robert Borucki


I am an expert in Family Medicine and Emergency Medicine.


I am trained and boarded in Family Medicine and have also worked extensively in emergency medicine for over 10 years.

BA in Natural Sciences; MD in 1986\borucki

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