Myths vs facts: tTG IgA and Müdigkeit

The question of myths vs facts regarding tTG IgA and fatigue centers on celiac disease diagnosis. tTG IgA (tissue transglutaminase antibodies) is a well-established serological marker for celiac disease, an autoimmune enteropathy triggered by gluten. Fatigue is a common but non-specific symptom of celiac disease, often linked to iron-deficiency anemia, malabsorption, or chronic inflammation. Fact: A positive tTG IgA test (especially with concurrent IgA deficiency ruled out) has high sensitivity and specificity for celiac disease. Myth: A positive test alone does not prove that fatigue is caused by celiac disease – other causes are possible. Also, fatigue in celiac disease can occur without elevated tTG IgA (seronegative celiac disease). Evidence is human-strong (guidelines, meta-analyses). Caveat: The test is intended for screening, not for general fatigue workup without appropriate symptoms or risk factors. If celiac disease is suspected, duodenal biopsy is needed for confirmation. A gluten-free diet may improve fatigue in confirmed celiac disease, but not for every case of fatigue.