Is Zöliakie Test useful for Stress?

A celiac test (e.g., tTG-IgA, endomysial antibodies, HLA-DQ2/DQ8) is primarily designed to diagnose celiac disease – an autoimmune enteropathy triggered by gluten. Stress alone is not an indication for this test. However, chronic stress can exacerbate symptoms in existing celiac disease or complicate diagnosis. Conversely, undiagnosed celiac-related complaints (fatigue, irritability, brain fog) may be misinterpreted as stress. The evidence for using a celiac test in the context of stress is therefore indirect: in patients with unexplained gastrointestinal or psychological symptoms, screening may be reasonable, but no randomized trials support general testing for stress. Test accuracy is high (tTG-IgA: sensitivity ~93%, specificity ~96%), yet the prevalence of celiac disease in the general population is low (~1%), leading to potential false positives. A positive result should always be confirmed by duodenal biopsy. Bottom line: the test is useful when celiac disease is suspected – not as a general 'stress test'. Without relevant symptoms or risk factors, its utility is limited.