You can get tested for celiac disease starting at your primary care doctor’s office, where a simple blood draw is the first step. Most family physicians and internists can order the initial screening panel, and you don’t need a specialist referral to begin. If your blood work comes back positive, you’ll typically be referred to a gastroenterologist for a confirmatory procedure.
Start With Your Primary Care Doctor
The most straightforward path is asking your regular doctor to order a celiac antibody panel. This is a standard blood draw sent to a lab, and nearly any physician can order it. The key test looks for antibodies called tissue transglutaminase IgA (tTG-IgA), which is highly sensitive and specific for celiac disease. Most labs also check your total IgA level at the same time, because roughly 2 to 3 percent of people with celiac disease have an IgA deficiency that can make the primary test falsely negative. If you fall into that group, your doctor will rely on IgG-based tests instead.
A complete celiac panel may also include endomysial antibodies (EMA-IgA) and deamidated gliadin peptide (DGP) antibodies. Not every lab runs all of these, but tTG-IgA plus a total IgA level is the standard minimum. You can have this drawn at your doctor’s office or at any outpatient lab your insurance covers.
Ordering Tests Without a Doctor Visit
If you don’t have a primary care doctor or want faster access, commercial labs like Labcorp and Quest Diagnostics offer celiac antibody panels that you can order directly. Labcorp OnDemand, for instance, lists a celiac disease antibody test at $119 out of pocket. You purchase the test online, visit a nearby draw site, and receive results electronically. These use the same lab-grade blood analysis your doctor would order.
At-home finger-prick celiac kits also exist, but their reliability varies. The FDA notes that direct-to-consumer tests have “varying levels of evidence” supporting their claims, and a finger-prick sample is inherently less controlled than a venous blood draw. A positive at-home result still needs confirmation through standard lab work, so these kits may add a step rather than save one. If cost is the main barrier, a direct-order lab test is a more reliable middle ground.
What Happens After a Positive Blood Test
For adults, a positive antibody result almost always leads to an upper endoscopy with biopsies of the small intestine. This is the gold standard for confirming celiac disease. A gastroenterologist performs the procedure, which involves passing a thin, flexible scope through your mouth to your small intestine while you’re sedated. It typically takes 15 to 20 minutes.
During the endoscopy, the doctor collects small tissue samples from the lining of your small intestine. Guidelines recommend taking 4 to 6 samples from the lower part of the duodenum and 2 more from the duodenal bulb, for a total of 6 to 8 pieces. In practice, many endoscopists take only 2, which can miss patchy damage. If you’re scheduling this procedure, it’s reasonable to confirm that your doctor plans to follow the current biopsy guidelines. The American College of Gastroenterology states that intestinal biopsy is required in most adult patients to confirm the diagnosis.
Testing in Children Is Sometimes Simpler
For children, a biopsy isn’t always necessary. European guidelines from ESPGHAN, which many pediatric gastroenterologists follow, allow a no-biopsy diagnosis when a child’s tTG-IgA level is at least 10 times the upper limit of normal and a second blood sample confirms positive endomysial antibodies. This approach has been validated as safe in both symptomatic and asymptomatic children. The child doesn’t need to carry specific genetic markers or have symptoms for this pathway to apply.
Children who are IgA deficient and test positive on an IgG-based test still need a biopsy for confirmation. Your pediatrician or pediatric gastroenterologist will determine which path fits based on the antibody levels.
You Must Be Eating Gluten for Tests to Work
This is the single most important preparation detail. Both the blood test and the biopsy detect your immune system’s reaction to gluten. If you’ve already cut gluten from your diet, your antibody levels can drop to normal and your intestinal lining can begin healing, producing a false negative on either test.
If you’ve been gluten-free and need accurate results, you’ll need to do a gluten challenge: eating gluten daily for a set period before testing. Current evidence suggests consuming 3 to 6 grams of gluten per day (roughly 1 to 2 slices of wheat bread) for at least 12 weeks before testing to optimize accuracy. If that amount causes severe symptoms, an abbreviated challenge of 6 to 12 weeks is considered acceptable, though it slightly increases the chance of inconclusive results. Historically, the recommendation was 10 grams per day for 6 to 8 weeks, but more recent research shows the lower amount over a longer period works well.
If you haven’t started a gluten-free diet yet, get tested first. It’s much easier to complete testing while you’re still eating normally than to reintroduce gluten later.
Genetic Testing: Useful for Ruling It Out
Genetic testing for celiac disease looks at two gene variants called HLA-DQ2 and HLA-DQ8. About 30 to 40 percent of the general population carries one of these genes, so having them doesn’t mean you have celiac disease. But if you test negative for both, celiac disease is essentially ruled out. This makes genetic testing most useful when results are unclear, such as when someone has been gluten-free too long for antibody tests to be reliable, or when family members want to know their risk. A primary care doctor can order HLA typing, or you can request it through a commercial lab.
Where to Find a Gastroenterologist
If your blood work is positive and you need an endoscopy, your primary care doctor will typically refer you to a gastroenterologist. If you want to seek one out directly, celiac disease foundations maintain directories of physicians experienced with the condition. University-affiliated medical centers and large health systems often have dedicated celiac disease programs with gastroenterologists who see high volumes of cases, which matters because experience affects biopsy quality.
Wait times for a gastroenterology appointment vary widely by region, from a few weeks to several months. While you wait, keep eating gluten. Stopping before your endoscopy can compromise the biopsy results, leaving you without a definitive answer after an invasive procedure.