Evidence check: Zöliakie Test in the context of menopause

The question of celiac testing in the context of menopause is clinically relevant because symptoms like fatigue, joint pain, and bone loss can overlap between menopause and undiagnosed celiac disease. Standard diagnostic tests (tTG-IgA, EMA, DGP) are well-validated for celiac disease, but no specific studies have examined their accuracy during menopause. Hormonal changes could theoretically affect serology, but evidence for this is weak. Genetic testing for HLA-DQ2/DQ8 can rule out celiac disease but cannot confirm it. The evidence for the test itself is human-strong (celiac diagnosis), but in the specific menopause context it is human-moderate due to lack of direct data. Be cautious of direct-to-consumer tests that often market markers like 'gluten sensitivity' without clinical validation. If celiac is suspected, a physician should initiate the diagnostic pathway, including duodenal biopsy if serology is positive.