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Celiac Monitoring: What’s Next?

The ins and outs of our celiac monitoring test.

Mairi Sutherland

Medically reviewed by


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  • Untreated celiac disease can cause serious damage to your health
  • Understanding how your body is responding to a gluten-free diet is crucial for preventing further harm
  • High antibodies can be a sign you are accidentally ingesting gluten or something else

If you've been diagnosed with celiac disease, you likely already know it is an autoimmune condition where ingesting gluten causes your body to attack itself. The advised treatment plan for this condition is a strict gluten-free diet. Untreated celiac disease can result in severe long-term health effects such as reproductive problems, chronic fatigue, joint and bone pain, neurological issues and digestive distress.1

But when it comes to the short term, it can be hard to tell what's happening inside your body, even if you are experiencing certain outward symptoms. Unfortunately, this also means it can be hard to know if a gluten-free diet is helping your body heal or if the damage continues. 

imaware's celiac disease monitoring test is designed to provide crucial insights into your body's reaction to a gluten-free diet.

Understanding the test

While imaware's celiac disease screening test evaluates your body's reaction to the presence of gluten, the monitoring test checks your reaction to the absence of gluten.

Both celiac disease tests (screening and monitoring) assess the same four key celiac-associated biomarkers: the tissue transglutaminase antibodies (tTG IgA and tTG IgG) and the deamidated gliadin peptide antibodies (DGP IgA and DGP IgG).

In general, antibodies are proteins your immune system produces in response to threats entering your body.2 Common threats include different viruses and other foreign substances, but for those with celiac disease, it also includes gluten. This is why higher than normal levels of these four specific antibodies indicate your body is having an immune response to gluten.

Since you should not be ingesting any gluten on a gluten-free diet, these antibody levels should decrease until they are within a normal range. 

Why bother? The benefits of monitoring

The monitoring test assesses whether going gluten-free is working for you (i.e. antibody levels are in decline) or if something is going wrong along the way. Some individuals with celiac disease may not experience immediate or apparent signs of damage to their health when consuming gluten,3 which is why testing antibody levels is a useful part of celiac disease management.

If your biomarker levels are not decreasing, it could be a sign of a few different things:

  • It's too soon after going gluten-free. Once you start a gluten-free diet, your biomarker levels will not instantly decrease to a normal range — instead, expect a more gradual decline.
  • Gluten is still getting into your system. Going gluten-free can be tricky; even if you don't mean to, high antibody levels can indicate that you are still ingesting gluten. You may need to analyze everything you have recently consumed — check for certified gluten-free labels, thoroughly read ingredients labels and stick to specific gluten-free recipes. For more information about going gluten-free, check out Beyond Celiac.   
  • Talk to your doctor. High antibody levels could mean something else is going on. Consider speaking with your healthcare provider as further testing or treatment may be required.    

If you have celiac disease, starting a gluten-free diet and ensuring it works are essential steps toward protecting your health!


Testing antibody levels is an effective way of assessing your body's reaction to a gluten-free diet. Since ingesting gluten can present little to no outward symptoms, this monitoring test can tell you if something is wrong with your treatment plan.

If you continue to present high levels after consuming a strict gluten-free diet, you should consult your healthcare provider.

Updated on
August 4, 2022
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  1. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Celiac Disease. Accessed July 12, 2022.
  2. Cleveland Clinic. Antibodies. Accessed July 12, 2022. 
  3. Cleveland Clinic. Celiac Disease. Accessed July 14, 2022.

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