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Allergy & Intolerance

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

Anti-TTG (Anti-Tissue Transglutaminase) is an IgA antibody test used as a first-line screening tool for coeliac disease. Tissue transglutaminase is an enzyme involved in tissue repair, and the immune system of individuals with coeliac disease may produce antibodies against it when exposed to gluten. An elevated result may suggest coeliac disease but does not confirm it on its own — further evaluation by a healthcare provider is always required.

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 the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
on its own €111,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Anti-TTG (Tissue Transglutaminase): how to prepare

  1. 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.

Tests with related values

These panels measure values from the same category as this marker.

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Complete Blood Count (CBC) ALP (Alkaline Phosphatase) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) Albumin Total Protein Bilirubin (Total) ApoB (Apolipoprotein B) Total Cholesterol LDL Cholesterol HDL Cholesterol Triglycerides Lipoprotein(a) Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Calcium Bicarbonate Chloride Sodium Potassium Magnesium Cortisol DHEA-S Estradiol (E2) FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) SHBG (Sex Hormone Binding Globulin) Total Testosterone Free Testosterone TSH (Thyroid Stimulating Hormone) Glucose (Fasting) HbA1c (Glycated Hemoglobin) Insulin (Fasting) HOMA-IR CRP (C-Reactive Protein) Homocysteine Ferritin Iron (Serum) Transferrin Transferrin Saturation Vitamin D (25-OH) Leptin Zinc Selenium Iodine Copper Free T3 (Triiodothyronine) Free T4 (Thyroxine) GGT (Gamma-Glutamyl Transferase) Bilirubin (Direct) Bilirubin (Indirect) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
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A 54-biomarker women's health panel inspired by the WHOOP Women's Health Panel — fertility, cycle and thyroid hormones plus a complete metabolic and nutrient base.

Complete Blood Count (CBC) ALP (Alkaline Phosphatase) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) Albumin Total Protein Bilirubin (Total) ApoB (Apolipoprotein B) Total Cholesterol LDL Cholesterol HDL Cholesterol Triglycerides Lipoprotein(a) Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Calcium Bicarbonate Chloride Sodium Potassium Magnesium Cortisol DHEA-S Estradiol (E2) FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) SHBG (Sex Hormone Binding Globulin) Total Testosterone Free Testosterone TSH (Thyroid Stimulating Hormone) Glucose (Fasting) HbA1c (Glycated Hemoglobin) Insulin (Fasting) HOMA-IR CRP (C-Reactive Protein) Homocysteine Ferritin Iron (Serum) Transferrin Transferrin Saturation Vitamin D (25-OH) AMH (Anti-Müllerian Hormone) Progesterone Prolactin TPO Antibodies Free T3 (Triiodothyronine) Free T4 (Thyroxine) Leptin Vitamin B12 Folate (Folic Acid) Phosphorus Bilirubin (Direct) Bilirubin (Indirect) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
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Whoop Men's Health

A 49-biomarker men's health panel inspired by the WHOOP Men's Health Panel — testosterone, PSA and prostate health plus a complete metabolic and hormone base.

Complete Blood Count (CBC) ALP (Alkaline Phosphatase) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) Albumin Total Protein Bilirubin (Total) ApoB (Apolipoprotein B) Total Cholesterol LDL Cholesterol HDL Cholesterol Triglycerides Lipoprotein(a) Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Calcium Bicarbonate Chloride Sodium Potassium Magnesium Cortisol DHEA-S Estradiol (E2) FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) SHBG (Sex Hormone Binding Globulin) Total Testosterone Free Testosterone TSH (Thyroid Stimulating Hormone) Glucose (Fasting) HbA1c (Glycated Hemoglobin) Insulin (Fasting) HOMA-IR CRP (C-Reactive Protein) Homocysteine Ferritin Iron (Serum) Transferrin Transferrin Saturation Vitamin D (25-OH) PSA (Prostate-Specific Antigen) Prolactin Leptin Uric Acid Zinc Bilirubin (Direct) Bilirubin (Indirect) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€659,-

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Anti-TTG (Tissue Transglutaminase)

€111,-