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I have latent celiac disease. What does that mean? Do I need to eat gluten-free?

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Updated January 19, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: I have latent celiac disease. What does that mean? Do I need to eat gluten-free?
Answer:

If your doctor has told you that you have latent celiac disease, it means that your celiac disease blood tests came back positive, but your duodenum doesn't show damage typical of celiac disease.

The diagnosis of celiac disease usually involves a series of celiac disease blood tests looking for specific antibodies, followed by an endoscopy looking for damage to your intestinal villi.

In latent or "silent" celiac disease, your blood tests indicate celiac disease-related antibodies, but your intestines appear normal. However, one medical study shows that people with latent celiac disease have a very slightly increased risk of death when compared with people who don't have the condition.

People with true latent celiac disease show no typical or atypical celiac disease symptoms, a long list that can include diarrhea, constipation and other gastrointestinal ailments, depression, infertility and unexplained anemia.

If you don't have any celiac disease symptoms and your doctor says that your intestinal biopsy was normal, then most physicians won't advise you to follow the gluten-free diet. You should follow up regularly with your doctor, however, because many people with positive blood tests develop full-blown celiac disease eventually.

If, however, you have celiac disease symptoms that correlate with your positive blood tests, you might want to discuss with your doctor the possibility of genetic testing.

Some people also decide to go gluten-free on the basis of positive blood tests alone, even if they haven't been officially diagnosed with celiac disease. But if you choose this option, you need to make sure you've finished all medical testing for celiac disease first. Once you're gluten-free, you'll most likely test negative for celiac disease even if you have the condition, because the standard celiac disease tests look for damage you get when you're eating gluten.

Sources:

The National Institutes of Health Development Conference on Celiac Disease, June 2004.

Positive serologic tests in the presence of a normal biopsy. Columbia University Medical Center. Accessed September 20, 2010. http://www.celiacdiseasecenter.columbia.edu/C_Doctors/C05-Testing.htm.

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