Introduction Celiac disease is an autoimmune disorder affecting the small intestine, triggered by gluten sensitivity. Its symptoms are highly variable and often overlap with other conditions, making early diagnosis a significant clinical challenge. Early detection is crucial to improve patients’ quality of life and prevent long-term complications. Recommended Screening Methods Screening for celiac disease is primarily performed using the serum tissue transglutaminase IgA (tTG-IgA) antibody test. Referral to a gastroenterology specialist is recommended in cases requiring comprehensive clinical evaluation. Clinical Indications for Testing Celiac disease testing should be considered in patients presenting with unexplained symptoms or signs, including: 1. Gastrointestinal disorders: • Chronic diarrhea or constipation • Reflux or dyspepsia • Irritable bowel syndrome symptoms 2. Reproductive and fatigue-related issues: • Infertility • Chronic fatigue 3. Neurological manifestations: • Neuropathy • Ataxia 4. Growth and developmental concerns in children: • Short stature • Growth failure • Delayed puberty 5. Bone and skin problems: • Osteoporosis or osteomalacia • Dermatitis herpetiformis 6. Hematologic abnormalities: • Anemia due to iron, vitamin B12, or folate deficiency 7. Liver and oral manifestations: • Elevated liver enzymes • Severe and persistent oral ulcers 8. Unexplained weight loss 9. Autoimmune history or family risk factors: • Patients with a history of autoimmune diseases such as type 1 diabetes, thyroid disorders, systemic lupus erythematosus, or autoimmune hepatitis • First-degree relatives of patients diagnosed with celiac disease Conclusion Early diagnosis of celiac disease relies on a combination of laboratory testing and thorough clinical evaluation, particularly in patients with multiple unexplained symptoms. Performing the tTG-IgA antibody test and consulting a gastroenterology specialist are essential steps to ensure early detection and reduce the risk of complications. Dr Miaad Adnan Al-Mustaqbal University The First University in Iraq