Can a blood test diagnose coeliac disease?
Our coeliac disease guide contains everything you need to know about the condition, including symptoms, diagnosis, and treatment.
One in 100 people in the UK have coeliac disease – a lifelong autoimmune condition [1]. This article explains who is at risk of coeliac disease, how you can test for the condition, and where to get support in your treatment journey.
In this article, we explain:
- What is coeliac disease?
- Coeliac vs. gluten intolerance
- What are the symptoms of coeliac disease?
- Who is at risk of coeliac disease?
- Is there a test for coeliac disease?
- How is coeliac disease treated?
- Support for coeliac disease
What is coeliac disease?
Coeliac disease is a lifelong autoimmune condition that is caused by a reaction to gluten.
Gluten is a naturally occurring protein found in wheat plants and other grains. It’s commonly found in most bread, pasta, and beer, but is also added to many products to enhance their texture, flavour, protein content, and ability to hold a shape (e.g. burgers).
The body can never truly break down gluten, and this means that you are left with undigested gluten [2]. Most people can handle this, but in some people, it causes unwanted symptoms or can trigger, you guessed it, coeliac disease.
When people with coeliac disease eat foods containing gluten, their immune system attacks tissues in the body, damaging the gut lining, which can hinder the absorption of many nutrients, causing deficiencies.
Coeliac disease vs. gluten intolerance
Gluten can affect people to varying degrees but having a gluten intolerance doesn't necessarily mean you will have coeliac disease.
Some people have milder reactions to gluten which, unlike coeliac disease, doesn't damage the gut lining.
These conditions may be termed gluten sensitivity and gluten intolerance, which can cause unwanted symptoms. Neither of these terms is clearly defined by the medical community, but (generally) gluten sensitivity is milder than intolerance.
How do I know if I have coeliac disease?
People with coeliac disease can have a range of symptoms which are not always gut-related.
General symptoms of coeliac disease:
- Fatigue (because of malnutrition)
- Unintentional weight loss
- Itchy rash
- Neurological issues
Gut symptoms associated with coeliac disease:
- Diarrhoea
- Stomach aches
- Bloating
- Indigestion
- Constipation
Who is at risk of coeliac disease?
There are a few conditions linked to coeliac disease, but often there's not enough evidence to know for sure if one causes the other.
Coeliac disease increases your risk of developing [2]:
- Another autoimmune disease such as a thyroid condition
- A gut-related intolerance such as lactose intolerance [3]
- Osteoporosis (weakened bones)
- Lymphoma and small bowel cancer (if coeliac untreated)
- Iron deficiency anaemia
- Vitamin B12 and folate deficiency anaemia
Similarly, people with certain conditions may be more vulnerable to having coeliac disease, or have found a gluten-free diet helpful.
Conditions include [2]:
- Type 1 diabetes
- Thyroid condition
- Down’s and Turner syndrome
- Autism
Is coeliac disease hereditary?
Research shows some people are genetically more susceptible to coeliac disease. If you have a family history of coeliac disease, you’re more at risk of developing it.
It is recommended if you are diagnosed with coeliac disease that all your first degree relatives are screened.
How is coeliac disease diagnosed?
It’s thought that in the UK only around 36% of people with coeliac disease have been diagnosed. This means there’s nearly half a million people in the UK living with untreated coeliac disease [1].
It’s because the range of symptoms is so wide, that they can be confused for other conditions.
Coeliac disease blood test
Coeliac disease is initially screened for via a blood test that looks for specific antibodies, i.e. IgA tissue transglutaminase antibody (tTG).
Some people with coeliac disease have a general IgA deficiency. If this is the case, your tTG IgA result may be falsely negative. For this reason, your healthcare provider will often measure total IgA and tTG IgA together.
You can also check for anti-endomysial antibodies, which are highly specific for coeliac disease. This test is often not provided by your GP, however some specialists can request it.
To be referred for this blood test, you will need to be experiencing at least one of the symptoms listed on the NHS website. You may also be offered a blood test if one of your parents, siblings, or children has coeliac disease.
Before your blood test, you need to have been eating foods containing gluten for a minimum of six weeks. Your blood test results will measure antibodies that are more common in people with coeliac.
If the results are positive, then you may be referred for a biopsy of your intestine. But not always.
It's possible to have a negative blood test result but still have coeliac disease, known as a false negative result. Often this is due to two reasons:
- Reduced gluten intake around the time of your test — this can cause an inaccurate result. If you've removed gluten from your diet before your test, you will need to reintroduce it before being retested.
- You’re recommended to consume gluten for 6 weeks prior to taking the test. If this makes you too unwell, then we recommend speaking to your doctor.
- IgA deficiency — around one in 200 people have an immunoglobulin A (IgA) deficiency which can cause a normal blood test result even in the presence of coeliac disease. You should discuss this possibility with your GP if your results are normal, but you still have symptoms of coeliac disease.
How is coeliac disease treated?
The primary treatment for coeliac disease is a gluten-free diet. You will need to be on a gluten-free diet for the rest of your life to prevent any unwanted complications, such as malnutrition or deficiencies.
Being gluten-free also means you will need to avoid foods that have ‘may contain’ on the label, as the risk of cross-contamination is high for people with coeliac disease.
How to manage a gluten-free diet
It may seem overwhelming at first but once you get into the swing of things, a gluten-free diet is manageable.
1. Plan meals in advance
Planning meals is a biggie.
It can help you feel prepared, and make sure you don’t accidentally eat the wrong thing.
Going out for dinner? Try looking up the menu online in advance, so you don’t feel pressure to choose.
2. Cook from scratch
Cooking from scratch might feel like a lot of work, but it can take the stress out of worrying about whether you can eat a particular ready meal or not.
Many supermarkets now have gluten-free versions of things such as pasta and flour, which can mean you can continue to eat your favourite meals – just with simple substitutes.
If you’re busy, you can also batch-cook meals. Try setting out a block of time to prepare a few meals and freeze them.
3. Create a gluten-free cupboard
Like to grab and go?
Having a cupboard solely dedicated to gluten-free snacks and foods makes gluten-free life easier.
It’s especially useful a “yes place” for kids, and helps you focus on things that you can have, rather than looking in a cupboard and reminding yourself of the things you can’t.
4. Test yourself
Getting regular blood tests can help you to check on your inner health, such as whether you are deficient in any nutrients, or are at risk of any other health conditions.
Blood tests, such as our Advanced Well Woman and Advanced Well Man Blood Tests, can help you do this.
Where can I get support for coeliac disease?
It is important to remember that you are not alone. And though it may seem overwhelming, there are some great online resources and charities there to help.
- Glutafin is a great website that has plenty of information, recipes, and stories of people living with coeliac disease. They also are the manufacturers of the gluten-free brand, Schär, whose products can be found in most supermarkets.
- Coeliac UK is a charity that has over 50 years of experience helping people with coeliac disease and has plenty of information and resources to help you along your coeliac journey.
- If you live in Wales, you can get a subsidy card for gluten-free products, allowing you to purchase gluten free products if you are on a low income. Your GP can also prescribe gluten free products [3].
References
- About coeliac disease. In: Coeliac UK [Internet]. [cited 28 Oct 2025].
- Conditions linked to coeliac disease. In: Coeliac UK [Internet]. [cited 28 Oct 2025].
- Wales rolls out subsidy card for gluten-free food | GOV.WALES. 24 Jul 2025 [cited 19 Nov 2025].