Brenda Khan
Celiac disease is a digestive disorder triggered by gluten, a protein found in foods containing wheat, barley, or rye. When people with celiac disease consume gluten, their immune system attacks the small intestine, leading to symptoms like diarrhea, abdominal pain, bloating, and weight loss. The only treatment for celiac disease is a strict gluten-free diet. Not adhering to a gluten-free diet can result in serious health complications, including dermatitis herpetiformis (an itchy skin rash), anemia, osteoporosis, infertility, neurological conditions, heart disease, intestinal cancers, and more. The longer a person with celiac disease consumes gluten, the more challenging it becomes to reverse the damage, with some complications, like infertility and severe bone loss, potentially becoming irreversible.
Characteristics and Values
| Characteristics | Values |
|---|---|
| Skin rashes | dermatitis herpetiformis, acne |
| Digestive issues | diarrhea, abdominal pain, bloating, nausea, vomiting, weight loss |
| Infertility | |
| Bone weakness | softening of the bone, osteoporosis, weak tooth enamel |
| Nerve damage | neurological conditions like epilepsy and migraines |
| Malabsorption | lactose intolerance, vitamin and mineral deficiencies |
| Cancer | lymphoma, intestinal cancer, bowel cancer |
| Other autoimmune diseases | type 1 diabetes, multiple sclerosis, ulcerative colitis |
| Heart issues | coronary artery disease, heart disease |
| Other | delayed puberty, short stature, miscarriage, gallbladder issues, balding, cysts, fatigue, joint pain, headaches, seizures, dementia |
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What You'll Learn
Infertility and bone weakness may not reverse
Celiac disease is a digestive disorder triggered by gluten, a protein found in foods containing wheat, barley, or rye. When people with celiac disease consume gluten, their small intestine is damaged, reducing its ability to absorb nutrients. This damage can lead to a range of problems, including infertility and bone weakness.
Untreated celiac disease can cause severe bone loss, also known as osteopenia or osteoporosis, which may not be reversible. Osteopenia is a condition of lower-than-normal bone density that often precedes osteoporosis. Celiac disease damages the intestinal villi, impairing nutrient absorption and leading to deficiencies in calcium, vitamin D, and magnesium, which are crucial for bone health. This results in weakened bones and an increased risk of fractures, particularly in the spine, hips, and wrists. Even those with mild celiac symptoms may be at risk due to compromised bone integrity.
The exact link between celiac disease and excess bone loss is not fully understood, but the damage to the intestines caused by the disease makes it difficult for the body to absorb nutrients essential for bone density. A strict gluten-free diet is the primary treatment for celiac disease, and it can help halt bone density loss and improve nutrient absorption, supporting the restoration of bone density over time. However, complete healing and bone regrowth may take months or even years, depending on the severity of the damage.
Infertility caused by untreated celiac disease may also be irreversible in some cases. Celiac disease can affect fertility in both men and women. In women, it may be related to altered hormonal levels, a lower body mass index, or nutritional deficiencies. Nutritional deficiencies, particularly in folic acid, iron, zinc, and selenium, can impact fertility in both men and women. Women with untreated celiac disease may have a higher risk of pregnancy complications and adverse birth outcomes. However, a gluten-free diet has been shown to improve fertility and reduce the risk of reproductive problems.
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Risk of autoimmune diseases increases
Celiac disease is an autoimmune disorder affecting around 1% of the general population. It is triggered by gluten, a protein found in wheat, barley, and rye. When people with celiac disease consume gluten, their small intestine is damaged, reducing its ability to absorb nutrients.
The risk of developing one or more additional autoimmune diseases increases if a person with celiac disease continues to consume gluten. The prevalence of other autoimmune conditions in people with celiac disease is estimated to be up to 15%, which is significantly higher than the 5 to 8% prevalence in the general population. The later the age of diagnosis of celiac disease, the greater the chance of developing another autoimmune disorder.
The most common autoimmune disorders associated with celiac disease are type 1 diabetes, autoimmune thyroid disease (including Grave's disease and Hashimoto's thyroiditis), and arthritis. Other autoimmune disorders that are linked to celiac disease include:
- Addison's disease: a disorder of the adrenal glands, causing them to produce insufficient amounts of cortisol and aldosterone.
- Autoimmune hepatitis: the body's immune system attacks the liver, causing damage.
- Primary biliary cirrhosis (PBC): a rare autoimmune disease where the bile ducts are slowly destroyed, leading to liver failure.
- Dermatitis herpetiformis: a skin rash that can occur in people with celiac disease.
- Pernicious anemia: the stomach lining is damaged, resulting in a vitamin B-12 deficiency.
- Myasthenia Gravis: a disease impairing nerve impulses to the muscles, leading to muscle weakness.
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Intestinal damage and inflammation
Celiac disease is an inherited autoimmune disorder that affects the small intestine. When people with celiac disease consume gluten, their body mounts an immune response, sending antibodies to attack the small intestine. This results in inflammation and damage to the mucosa, the membrane lining the small intestine.
The mucosa, or mucous membrane, is lined with villi, small finger-like projections that promote nutrient absorption. When the mucosa is damaged, the villi can become atrophied, impairing the absorption of nutrients from food and causing nutritional deficiencies. This can lead to malnutrition, which can have serious consequences for the body, including the nervous and skeletal systems. Malnutrition can cause rickets in children or osteomalacia in adults, osteopenia and osteoporosis, permanent dental enamel defects, and nervous system issues such as peripheral neuropathy, with symptoms like tingling, numbness, muscle spasms, and balance and coordination problems.
The inflammation caused by celiac disease can also lead to other problems in the intestine. Severe inflammation can cause ulcers in the small intestine, and if left untreated, these ulcers can wear through the intestinal wall, resulting in a medical emergency. Inflammation can also cause scarring, and excessive scar tissue can lead to a narrowing of the intestine, resulting in a bowel obstruction.
Additionally, chronic inflammation increases the risk of cancer in the small intestine. Studies show that around 7% of people with celiac disease develop intestinal lymphomas, and there is also an increased risk of intestinal adenocarcinoma and esophageal cancers.
The only treatment for celiac disease is a strict gluten-free diet, which must be maintained for life to prevent further damage to the small intestine.
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Nutritional deficiencies
Celiac disease is an inherited autoimmune disorder that causes a reaction in the body to gluten, a protein found in grains, especially wheat, barley, and rye. These grains are common in staple foods such as bread, pasta, and baked goods. When a person with celiac disease consumes gluten, their immune system produces antibodies that damage the lining of the small intestine (the mucosa). This impairs the intestine's ability to absorb nutrients from food, leading to nutritional deficiencies.
The symptoms of celiac disease vary widely, and some people may not notice any symptoms at all. However, some people experience gastrointestinal issues and nutritional deficiencies, such as anemia, after consuming gluten. Other symptoms include stomach pain, bloating, constipation, weakness, fatigue, unintended weight loss, muscle wasting, mood changes, and mouth sores.
To manage celiac disease, a strict gluten-free diet is essential. This involves avoiding gluten-containing grains, processed foods, sauces, soups, packaged foods, and condiments. Even a small amount of gluten can trigger a reaction and cause intestinal damage. A gluten-free diet can relieve symptoms, heal intestinal damage, and prevent further issues.
- Iron: Iron deficiency anemia is common in celiac disease, especially in women who are menstruating or pregnant, and in growing children.
- Vitamin B12: As this vitamin is absorbed in the lower part of the small intestine, which can be affected by celiac disease, deficiency is common.
- Vitamin D: Malabsorption of vitamin D is often seen in untreated celiac disease.
- Zinc: Celiac disease can lead to inadequate zinc absorption.
- Magnesium: This mineral is essential for enzymatic reactions and, along with vitamin D, aids in calcium absorption.
- Folate (Vitamin B9): In the past, folic acid deficiency was the second most common cause of anemia in celiac disease.
It is important to consult a doctor or a registered dietitian when starting a gluten-free diet to ensure adequate nutrient intake. A well-balanced gluten-free diet, along with supplements if necessary, can help address these nutritional deficiencies and improve overall health in people with celiac disease.
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Other health issues like diabetes, balding, cystic acne, delayed puberty, etc
Celiac disease is a digestive disorder triggered by gluten, a protein found in foods containing wheat, barley, or rye. When people with celiac disease consume gluten, their small intestine reacts, leading to symptoms like diarrhoea, abdominal pain, bloating, and weight loss. Early diagnosis is crucial because untreated celiac disease can lead to severe complications.
Diabetes
The link between type 1 diabetes and celiac disease was established in the 1960s, with an estimated prevalence of celiac disease in type 1 diabetic patients of approximately 6%. Type 1 diabetes is an autoimmune disease where the body's immune system attacks and destroys specialised cells in the pancreas that produce insulin. This results in high glucose levels in the blood (hyperglycaemia), causing blood vessel and nerve damage, and increasing the risk of stroke, heart disease, kidney disease, and amputation.
While there is no established link between type 2 diabetes and celiac disease, the gluten-free diet often recommended for celiac disease may impact blood sugar control. This is because gluten-free diets can be low in fibre and have a higher glycemic index, increased fat, and less protein, potentially affecting weight management.
Balding
Celiac disease is associated with other autoimmune diseases, and having one autoimmune disease increases the likelihood of developing another. Alopecia areata is an autoimmune disease where the immune system attacks hair follicles, leading to hair loss. This can progress to full-body hair loss, known as alopecia universalis. Hashimoto's thyroiditis, another autoimmune disease linked to celiac disease, can also cause hair loss.
Cystic Acne
Celiac disease can cause skin conditions like acne due to links with malabsorption and hormonal imbalances. The disruption of normal hormone function caused by gluten intolerance can lead to acne. A gluten-free diet may help improve acne symptoms.
Delayed Puberty
Celiac disease can cause delayed puberty, short stature, and impaired linear growth. This is often accompanied by other symptoms like anaemia, constipation, and fatigue.
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Frequently asked questions
If you have been diagnosed with celiac disease, it is important to follow a strict gluten-free diet for life. Not doing so can lead to serious health complications, even if you don't experience any symptoms. The small intestine may continue to be damaged, leading to vitamin and mineral deficiencies, and increasing the risk of osteoporosis, infertility, nerve damage, and even certain cancers.
Celiac disease can manifest in a variety of ways, including gastrointestinal issues such as diarrhea, abdominal pain, bloating, and weight loss. Some people may also experience skin rashes, headaches, fatigue, joint pain, or iron-deficiency anemia. In children, it may cause weak tooth enamel, delayed puberty, and a condition called intussusception, where the intestines fold in on themselves.
Maintaining a gluten-free diet can be challenging, as gluten is found in many common foods, including bread, pasta, cookies, and pizza crusts. However, there are plenty of naturally gluten-free options, such as meats, chicken, fish, eggs, cheese, fruits, vegetables, potatoes, rice, and gluten-free oats. Gluten-free substitutes for baked goods, pasta, and bread are also widely available.
