How to ask GP for coeliac testing

[MrsResponder]

I am constantly tired and feeling burnt out. This has been the case since I went through puberty, when a suite of symptoms that I've always thought were connected appeared. Mentioning this I was rudely told to go away by GPs as a child/young adult in the 80s &90s. Gave up for a long time.

I was diagnosed with asthma at 12, PCOS at 21, ADHD at 36 and hypothyroidism at 45. With the last I thought I'd cracked the tiredness, but have had various burnouts since. The last I ended up in hospital with sespis which wasn't diagnosed (or treated) for over a week. Eventually eggerthella lenta was found in my blood sample. No one explained how or why. The googling I've done over it since has been worrying as it suggests that there is usually an underlying cause.

I had a test for coeliac about 15 years ago. A really rude doctor had a go at me when I went in having had a burnout, yet again, causing me to fail a uni course. She said she'd test for coeliac but that it wouldn't be that. I got a sheepish phone call off her saying it wasn't coeliac but did have low IgA. No explanation of what that was. Recently I saw that if you have low IgA a different test is needed to the standard coeliac test and a biopsy would be required for confirmation of diagnosis, which I didn't have back then. I've also seen that coeliac can cause increased levels of Eggerthella lenta in the gut, which made me wonder if that had anything to do with the burnout and sepsis that hospitalised me 18 months ago.

We've recently moved and have a new GP who I've not yet visited. I've no idea if they're sympathetic or the kind of GP I've had in the past so I'm nervous about asking for the test. Do I have a right to one? There are lots of long term symptoms and I believe the other conditions I have frequently overlap making it a possibility I'd at least like to rule out. How do I go about asking and getting a test? My previous experiences have left me terrified of doctors and poor at advocating for myself, I feel like a rabbit in headlights if they are short with me. I also know some get peeved at the use of 'Dr Google', and as explaining how and why I've got to the point of wanting the test involves quoting Google research, I'm not sure how that will go down. Any advice welcome.

This is what I've got for the whole Iron profile:

Serum ferritin 47 ug/L (reference range 30 -150)
Tell patient test normal

Iron studies
Serum iron level 13 umol/L (reference range 5.8 - 34.5)
Serum transferrin 2.17 g/L (reference range 2.00 -3.60
Se unsat iron binding capacity 54 umol/L ( reference range 50-90)
% TRANSF. SATURATION 24% (reference range 16-40)
Tell patient test normal

It's very common to have low iron particularly ferritin, with undiagnosed coeliac disease so even with negative antibody tests it can still be possible. Because your iron is good it shows you're absorbing your nutrients so damaged villi in your duodenum is unlikely.

You can however have non coeliac gluten sensitivity which might be the case so if you're not going to be out forward for more coeliac testing it might be worth cutting it out to see if that helps with your fatigue.

Thanks, I might give that a go. I'm just desperately trying to find a reason why I feel so rubbish, no real idea what is but I find going with exhaustion as the main symptom doesn't seem to yield any answers.