9 Symptoms of Celiac Disease You Should Know

Celiac disease is a chronic autoimmune disorder, occuring when your immune system attacks your body. With celiac disease, the trigger for the immune system to attack is gluten. Gluten is a protein found in wheat, barley, and rye ingredients.

When someone with celiac disease consumes gluten, their immune system damages the small intestine. That can lead to various health problems, and the inflammation brought on by this immune response can contribute to various symptoms.

Those symptoms differ from person to person and can affect every body system. Here are some of the most common symptoms of celiac disease you should know about.

Common Symptoms of Celiac Disease

When you think about celiac disease, you might first think about gastrointestinal (GI) symptoms, or symptoms related to the digestive tract. 

"For a large portion of people—40% to 60%—their main manifestation of the disease is gastrointestinal," said Salvatore Alesci, MD, PhD, chief scientist and strategy officer at the patient advocacy and research organization Beyond Celiac. 

Those symptoms can include:

• Constipation
• Diarrhea
• Cramps
• Bloating
• Gas
• Abdominal pain
• Stools that float or have a foul smell

It can be difficult to differentiate these symptoms from other common GI disorders, like irritable bowel syndrome (IBS). 

"Before I diagnose someone with IBS, I rule out celiac," said Amy Burkhart, MD, RDN, an integrative medicine physician and registered dietitian specializing in gut health.

While GI symptoms might be one of the most common symptoms of celiac disease, 40% to 60% of people with the condition don't have any GI symptoms, according to Dr. Alesci. And an absence of the telltale GI symptoms is the number one reason why patients are misdiagnosed or stay undiagnosed.

Brain Fog

"Most people don't think about celiac disease as a disease of the brain, but there is a group of researchers at the University of Sheffield in the [United Kingdom] that has shown that people with celiac have damage to their brains," noted Dr. Alesci.

One of the things that the study found was that those with celiac disease had slower reaction times. Dr. Alesci added that short-term memory loss, inability to concentrate or find the right word, and attention difficulties are other neurological signs of celiac disease.

Anxiety and Depression

Dr. Alesci explained that your body is constantly threatened by chronic inflammation and may also experience anxiety. Malabsorption of nutrients from celiac disease may also impact brain function, predisposing you to depression. Symptoms of anxiety could also come from being diagnosed with a chronic condition.

The University of Sheffield study also found that participants had symptoms of anxiety, thoughts of self-harm, depression, and health-related unhappiness.

Coordination and Balance Problems

The same antibodies that attack your small intestine can also be found in a brain region called the cerebellum, which controls coordination and movement, explained Dr. Alesci. 

"Patients may have poor coordination in their balance, gait, and eye movements," noted Dr. Alesci. Numbness, tingling, and weakness (neuropathy) are also symptoms of celiac disease.

Bone Density Loss

Osteoporosis, a disease where bones become weak and brittle, is a risk when you have celiac disease. Because the body can't absorb nutrients, the bones become weaker.

According to Dr. Alesci, that results from the malabsorption of calcium and vitamin D3. A gluten-free diet will help absorb those nutrients from your diet, but you'll also likely have to take supplements.

Thyroid Disorder

Another downstream effect of not absorbing nutrients: Thyroid dysfunction. 

Celiac disease can cause autoimmune thyroid diseases such as Hashimoto's thyroiditis and Graves' disease. It is thought that because the body isn't absorbing iron and vitamin D, that could cause thyroid disease.

Dental Problems

According to Dr. Burkhart, enamel defects, like spots on teeth, and recurrent canker sores are possible signs of celiac disease. 

"If you're getting mouth sores on a regular basis or experiencing other dental issues like fractures and tooth decay, that should trigger a celiac screening," mentioned Dr. Burkhart.

Chronic stress or inflammation may play a role in the development of mouth sores. In addition, your tongue may burn and feel dry, which has to do with malabsorption of vitamin B12, folate, and iron. 

Over time, those symptoms may increase the odds of oral and esophageal cancers if you're not on a gluten-free diet.

Anemia

Anemia can result from not consuming or absorbing enough iron. This nutrient helps your body make hemoglobin, a protein in the blood that ferries oxygen around your body and is necessary for energy. And because celiac disease makes it difficult for the body to absorb nutrients, that can result in an iron deficiency.

The go-to treatment is iron supplements. Dr. Burkhart explained that anemia does not get better after supplementation is a potential sign of celiac disease.

Infertility

Celiac disease can make it hard to become and stay pregnant. That's because the antibodies produced from eating gluten may attack the placenta, explained Dr. Alesci. 

Research has suggested that between 1% to 3% percent of women with unexplained infertility had undiagnosed celiac disease. Other studies show that undiagnosed celiac disease also causes lower fertility rates among men.

One study found that the risk of miscarriage and stillbirth was much higher in people who had celiac disease but were not yet diagnosed. After diagnosis, the risk of reproductive issues was similar to those who don't have celiac disease.

Fatigue and Weight Loss

With all the stress and demands of daily life, it's not unusual to feel tired or realize you've lost weight. While those are both extremely common, they can point to various diseases, including autoimmune disorders. 

So, if you're feeling extra tired or are losing weight even though you are not trying to (which can happen if you're not absorbing nutrients properly), talk to your healthcare provider about the potential explanation being celiac disease.

How Do You Know if Your Symptoms Are Being Caused by Celiac Disease?

One of the tough things about diagnosing celiac disease is that so many symptoms show up all over the body. There are more than 250 known symptoms of celiac disease.

And yet, "Celiac is the most underdiagnosed or misdiagnosed disease among all of the chronic autoimmune disorders," said Dr. Alesci.

Diagnosis often requires connecting the dots between seemingly unrelated symptoms—and you might see different specialists for each problem. While one in 133 Americans have celiac disease, just 17% are aware of it.

"Celiac has a reputation as a rare disease, but I do not consider one in 100 rare," explained Dr. Burkhart.

While people who develop celiac disease have a genetic predisposition to the disease, there also needs to be an environmental trigger that sets the disease process in motion. According to Dr. Burkhart, triggers can include viral illnesses, pregnancy, menopause, or dietary factors.

And since celiac disease can run in families, it's important to tell your healthcare provider if a first- or a second-degree family member has the condition, which can help you get tested sooner.

The first step to diagnosing celiac disease is a simple antibody blood test. Then, a biopsy of the small intestine can confirm the diagnosis. One thing to remember is that if you are getting a blood test for celiac disease, you need to continue to consume gluten before the test so that you get an accurate result.

How Can You Manage Symptoms of Celiac Disease?

Once diagnosed, "the only treatment is a lifelong strict, gluten-free diet," said Dr. Burkhart. Because of that, some patients don't want to know if they have celiac. Still, it is critical to know.

Having celiac disease and not following a gluten-free diet increases your risk of cancer of the small intestine and esophagus. It can also lead to a narrowing of the small intestine due to inflammation. Additionally, your risks of developing osteoporosis, infertility, neuropathy, and several vitamin deficiencies increase if you don't manage your celiac disease.

A Quick Review

Celiac disease is an autoimmune disorder that causes a wide array of symptoms. From GI symptoms (like bloating, diarrhea, and abdominal pain) to neurological symptoms (like brain fog and depression), the disease can affect every system in the human body.

If you are having any symptoms of celiac disease, it is important to get diagnosed to prevent the risk of further health complications. Talk to your healthcare provider if you are experiencing celiac disease symptoms or have a relative with celiac disease.