I just came across this article that seems to recommend less screening for celiac.
npr.org/sections/health-sho...
The thing is, I wouldn't have been screened at all if I didn't have a B12 deficiency and, even after I was screened and it came back inconclusive (high gliadin IgA but negative TTG), I still had no reason to mentally connect the dots between gluten and dizzy spells. It wasn't until I tried going off of gluten and then adding it back in several months later that it became apparent that I have gluten ataxia. Until that point, I didn't realize I had any symptoms that could be related to gluten at all. (I actually never heard of gluten ataxia until I started looking into how gluten and dizzy spells could possibly be related.)
Screening only people who have symptoms would mean that I'd still be having dizzy spells. I would still have no idea what caused them. And I wouldn't know that I was potentially causing my brain irreversible harm every time I ate a sandwich.
From one standpoint, the symptoms of celiac are so widespread that the screening net would basically be everyone. From another standpoint only a very narrow group of people who meet all the textbook criteria when they walk into a doctor's office need to be screened. Isn't there a happy middle somewhere?