Evidence check: Zöliakie Test in the context of fatigue

A celiac disease test (e.g., tTG-IgA or HLA-DQ2/DQ8) can be relevant in fatigue, as undiagnosed celiac is a known cause of chronic tiredness. However, a positive genetic test (HLA) indicates only predisposition, not active disease. Serology (tTG-IgA) is the clinical standard, but false negatives occur, e.g., in IgA deficiency. Without classic symptoms (diarrhea, weight loss), the predictive value of a genetic test for fatigue is low. Evidence for routine celiac screening in isolated fatigue is moderate – guidelines recommend it only in risk groups or with additional symptoms. Consumer DNA tests for celiac are not diagnostic and may cause unnecessary worry or false reassurance. If fatigue persists, consult a physician for proper workup including serology and, if positive, duodenal biopsy.