Who to test

The National Institute for Health and Care Excellence (NICE) guideline states that serological testing should be offered to children and adults with any of the following signs and symptoms:
  • persistent unexplained abdominal or gastrointestinal symptoms
  • faltering growth
  • prolonged fatigue
  • unexpected weight loss
  • severe or persistent mouth ulcers
  • unexplained iron, vitamin B12 or folate deficiency
  • type 1 diabetes, at diagnosis
  • autoimmune thyroid disease, at diagnosis
  • irritable bowel syndrome (in adults)
  • first degree relatives of people with coeliac disease.
The NICE guideline also recommends to consider serological testing for coeliac disease in people with any of the following:
  • metabolic bone disorder (reduced bone mineral density or osteomalacia)
  • unexplained neurological symptoms (particularly peripheral neuropathy or ataxia)
  • unexplained subfertility or recurrent miscarriage
  • persistently raised liver enzymes with unknown cause
  • dental enamel defects
  • Down's syndrome
  • Turner syndrome.

NICE recommends having a low threshold for retesting people with symptoms or risk factors for coeliac disease who have previously been found to be serologically negative. 

NICE also recommend referral of people with negative serological test results to a gastroenterologist specialist for further assessment if coeliac disease is still suspected.

Read more about how to test for coeliac disease and important advice for patients prior to testing.

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