You can get tested for celiac disease at your primary care doctor’s office, which is the easiest starting point. A standard blood draw is the first step, and nearly any doctor, urgent care clinic, or direct-to-consumer lab can order or perform it. If blood results suggest celiac disease, you’ll typically be referred to a gastroenterologist for a confirmatory biopsy. Here’s how each part of the process works and what your options look like.
Start With Your Primary Care Doctor
Your regular doctor can order the initial blood test for celiac disease. This is the most straightforward path because the visit is usually covered by insurance, and your doctor already knows your medical history. Simply ask for celiac screening, especially if you’re dealing with chronic digestive issues, unexplained anemia, or a family history of the condition.
If your doctor isn’t familiar with celiac testing or is reluctant to order it, a gastroenterologist can order the same blood work and handle the full diagnostic process from start to finish. You may need a referral from your primary care doctor depending on your insurance plan.
The Blood Test That Screens for Celiac
The main screening tool is a blood test that measures antibodies your immune system produces in response to gluten. The most widely used version, called the tTG-IgA test, has a sensitivity of about 94% and a specificity of 87%, meaning it catches the vast majority of true cases while occasionally flagging people who don’t have the disease. It’s a simple blood draw from your arm, processed at a standard lab.
One critical detail: you need to be eating gluten regularly before the test. If you’ve already cut gluten from your diet, your antibody levels may have dropped, producing a false negative. If you’ve been gluten-free for a while and still want accurate results, you’ll need to do what’s called a gluten challenge: eating 3 to 6 grams of gluten per day (roughly one to two slices of wheat bread) for at least 12 weeks before testing. If that amount of gluten causes severe symptoms, a shortened challenge of 6 to 12 weeks is considered acceptable, though it slightly reduces accuracy.
Direct-to-Consumer Labs and At-Home Kits
If you don’t have a doctor or want to skip the office visit, you can order celiac blood work directly. Labcorp offers a celiac disease antibody panel for $119 without insurance through its online ordering service. You place the order online, visit a local Labcorp draw site, and get results sent to you. Quest Diagnostics offers a similar service.
Point-of-care tests that use a finger prick are also available and increasingly accurate. One well-studied rapid test that checks for the same tTG-IgA antibody showed 98.3% sensitivity and 98% specificity, with perfect agreement between finger-prick blood and standard lab serum samples. These can be useful as an initial screen, but a positive result still needs to be followed up with a gastroenterologist. A negative result on a less sensitive marker (called anti-DGP IgG, used for people with IgA deficiency) had lower accuracy at about 87%, so the type of antibody being measured matters.
Confirming the Diagnosis With a Biopsy
A positive blood test alone doesn’t confirm celiac disease in most adults. The next step is an upper endoscopy with biopsies of the small intestine, performed by a gastroenterologist. During the procedure, a thin flexible tube is passed through your mouth to your small intestine while you’re sedated. The doctor takes small tissue samples to check for the characteristic damage celiac disease causes to the intestinal lining.
Guidelines recommend collecting 4 to 6 tissue samples from one part of the small intestine and 2 more from a second area. In practice, many endoscopists take only 2 samples total, which can miss patchy damage and lead to a false negative. If you’re scheduling this procedure, it’s worth confirming that your doctor follows the guideline of taking at least 6 biopsies. The whole procedure typically takes 15 to 20 minutes, and you’ll go home the same day once the sedation wears off.
When Children Can Skip the Biopsy
The diagnostic path looks different for kids. The 2023 American College of Gastroenterology guidelines recommend a biopsy-free approach for children when blood antibody levels are very high, specifically more than 10 times the upper limit of normal. At that level, the blood test alone has a 99% positive predictive value for celiac disease. When a second confirmatory antibody test (called endomysial antibody) also comes back positive, predictive value reaches 100%. This spares many children from sedation and an invasive procedure.
For adults, biopsy remains the standard in most clinical settings, though some gastroenterologists are beginning to discuss whether the same no-biopsy criteria could apply when antibody levels are extremely high.
Genetic Testing and Its Limits
Genetic testing checks whether you carry specific gene variants (HLA-DQ2 or HLA-DQ8) that are present in nearly all people with celiac disease. This test can be done through a blood draw or a cheek swab, and it’s available through your doctor or consumer genetics services.
The key thing to know: a positive genetic test doesn’t mean you have celiac disease. About 30 to 40% of the general population carries these genes, and most never develop the condition. What makes the test genuinely useful is its negative predictive value, which approaches 100%. If you don’t carry the genes, you almost certainly don’t have celiac disease and can generally rule it out without further testing. This makes genetic testing especially helpful when initial blood work or biopsy results are inconclusive, or when someone has already gone gluten-free and doesn’t want to do a lengthy gluten challenge. In rare cases, people with only a partial genetic match have still developed celiac disease, but this is uncommon.
Specialty Celiac Centers
If your case is complicated, such as inconclusive blood work, biopsy results that don’t clearly fit, or persistent symptoms despite a gluten-free diet, dedicated celiac disease centers can help. Major academic medical centers like the University of Washington’s Celiac Disease Center bring together gastroenterologists, dietitians, and specialists in related conditions like thyroid disease, skin disorders, and neurological complications. These centers are especially useful for patients who’ve been going back and forth between doctors without a clear answer. You can usually find one by searching for “celiac disease center” along with your nearest major city or university hospital system.