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That means many people are walking around for years with early, detectable signs while being told their labs are fine. What You Should Do With This Information (Practical Steps) If you or someone you love has any combination of the following: hemoglobin drifting down (especially iron-deficiency pattern / low MCV) persistently slightly high ALT or AST unexplained lean body weight or difficulty maintaining weight (malnutrition from malabsorption) recurring GI symptoms (even if labeled IBS) infertility concerns alongside odd labs or a known higher-risk genetic background Ask your doctor about celiac screening

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