Hidden Symptoms of Celiac Disease

Medically reviewed on Sept 20, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• 1. Weight Loss
• 2. Mood Fluctuations
• 3. Persistent Fatigue
• 4. Iron Deficiency
• 5. Headaches
• 6. Joint Pain
• 7. Skin Rashes
• 8. Abnormal Stool
• Long-Term Health Risks of Celiac Disease
• Diagnosing Celiac Disease
• Get Clear on Your Celiac Disease Status with Everlywell
• Related Content

Current clinical research into celiac disease indicates that rates of the autoimmune condition are unreported and on the rise. [1]

Because celiac disease symptoms are treated with a gluten-free celiac disease diet plan, celiac disease is most commonly associated with gastrointestinal symptoms like abdominal pain and digestive distress. However, many people with celiac disease don’t experience or notice digestive disturbances. Instead, they may present with “hidden” or extraintestinal symptoms that affect other body regions. These hidden celiac disease symptoms can easily be overlooked, appear isolated, or can be attributed to another health condition.

For this reason, many people don’t know they have celiac disease until they undergo serological testing. If you’ve been experiencing a confusing complex of health concerns, gastrointestinal symptoms, gluten sensitivity, or gluten intolerance, it’s worth getting a handle on the hidden symptoms of celiac disease. Let’s explore 8 of the most common below.

1. Weight Loss

Sudden weight loss, or the inability to keep on weight, is very common in people with celiac disease. [2] Often, unexplained weight loss is misattributed to “natural” causes. Or, if a person struggles with being overweight and has been trying to lose weight, it could be attributed to weight loss efforts.

Celiac disease can cause weight loss for several reasons:

• Your appetite may decline, or frequent digestive distress may diminish your desire to eat
• Small intestinal damage can reduce your ability to absorb nutrients from food sources
• Diarrhea and other bowel changes may cause you to lose more fluids than usual

That said, there are people with celiac disease who don’t lose weight as a result of this condition. But, if you experience sudden, unintentional weight loss, it’s important to check in with a healthcare provider to explore possible causes.

2. Mood Fluctuations

Sudden mood swings or emotional flare-ups happen to all of us, but if they occur frequently along with digestive discomfort, they may point to another causal factor. Celiac disease can contribute to an unstable mood by [2]:

• Compromising overall cognitive function
• Interfering with nervous system function

Moreover, difficulty absorbing nutrients can lead to malnutrition. Not being nourished can make it very challenging to regulate emotional responses, as well as normal physical functioning.

Likewise, individuals living with depression or anxiety may notice an exaggeration in their low mood or stress levels.2 Fortunately, the primary treatment for celiac disease—a gluten-free diet—has been shown to significantly improve depressive and anxious symptoms after just one year of adherence. [3]

3. Persistent Fatigue

Fatigue is often cited as one of the more common symptoms of celiac disease. But because fatigue has so many possible causes, it may easily be overlooked.

With celiac disease, fatigue can occur for two key reasons:

• Increased inflammation – If your immune system is regularly being triggered by gluten, it can drive up inflammation levels throughout the body. A highly reactive immune system and chronically high levels of inflammation can require a lot of energy from a metabolic standpoint for your body to keep up with. [4]
• Nutrient malabsorption – If you’ve sustained small intestinal damage, you may not achieve your daily energy needs due to malabsorption. Malabsorption can significantly limit your ability to enact both fundamental functions (like walking) and sophisticated ones (like cognitive tasks).

Moreover, frequent digestive distress can often compromise sleep quantity and quality, making you feel tired. If you’re frequently experiencing feelings of mental, physical, or even emotional tiredness, it’s a good idea to reach out to your healthcare provider.

4. Iron Deficiency

Closely related to chronic feelings of tiredness, anemia is another common but often ignored consequence of celiac disease. [1] People who are anemic have iron deficiencies that can result in:

• Persistent fatigue
• Physical and muscle weakness
• Difficulty focusing or completing other mental tasks
• Feeling faint or losing consciousness

5. Headaches

Headaches and migraines are highly common in both children and adults with celiac disease. [5] This symptom is associated with:

• General nervous system dysfunction [2]
• Peripheral neuropathy, which damages nerves outside the brain [5]

Overall, people with celiac disease tend to get headaches more frequently than people without it. [5] Fortunately, diagnosing celiac disease early and sticking to a strict gluten-free diet can help minimize headache and migraine frequency in most patients.

6. Joint Pain

Arthritis, also referred to as celiac arthritis, is a common comorbidity of untreated celiac disease.6 It can cause soreness or stiffness of the joints, as well as swelling or a limited range of motion. [6]

About 30% of people with celiac disease may see an improvement in joint pain upon following a gluten-free diet. However, arthritis can get worse if celiac disease is not treated.6 Without proper management of celiac disease, other related and more severe rheumatological and musculoskeletal problems can arise. [6]

For instance, malabsorption of nutrients often results in bone density loss.6 For this reason, celiac disease patients may be more likely to fracture their bones and even develop osteopenia or osteoporosis down the line. [7]

7. Skin Rashes

Both celiac disease and gluten sensitivity can carry symptoms that adversely affect the skin.8 Because they may or may not appear alongside digestive discomfort or weight loss, they’re often mistaken for isolated dermatological conditions.

Dermatitis herpetiformis is one common skin condition that’s typical in people with celiac disease. [2] It tends to appear on the elbows, knees, buttocks, or scalp. [8] Dermatitis herpetiformis can cause [8]:

• Itchiness
• Papules (bumps on the skin)
• Discoloration
• Blisters

It’s possible to develop dermatitis herpetiformis without having celiac disease.8 Screening for markers of celiac disease is one way to determine whether your skin rashes could result from an underlying autoimmune condition.

8. Abnormal Stool

Many illnesses that impact digestion can change your bowel habits, but they can also cause stool to change in color and consistency. Some people with celiac disease, especially children, notice [9]:

• A yellow color
• A foul odor
• A viscous, slick texture

Stool that carries these traits may indicate large amounts of fat in the stool that comes from gluten that wasn’t processed by the digestive system. [9] Changes in stool may be easy to ignore, but they can also be important markers of an underlying illness.

Long-Term Health Risks of Celiac Disease

Whenever normal digestive processes are jeopardized, it can be very difficult for the body to perform normal physical functioning. As such, untreated celiac disease can have a cascade of long-term consequences, among them:

• Fertility challenges – Pregnant people need certain nutrients, like calcium and vitamin D, to support healthy pregnancy and fetal development. [10] If untreated celiac disease has resulted in villous atrophy of the small intestine, malabsorption issues may increase your risk of miscarriage or infertility. [10]
• Certain cancers – While rare, untreated or poorly managed celiac disease can increase your risk of lymphoma and Hodgkin lymphoma. [11] These cancers originate in the lymphatic system and can be dangerous, particularly if you develop refractory celiac disease. [12] The risk of developing lymphoma decreases significantly by sticking to a gluten-free diet. [11]

It’s important to understand that you can lower many of the long-term health risks associated with celiac disease by following and maintaining a gluten-free diet.

See related: Can Celiac Disease Go Away On Its Own?

Diagnosing Celiac Disease

Celiac disease symptoms tend to be diverse and distributed widely throughout the body. For this reason, healthcare professionals use various methods to diagnose it and rule out other potential conditions.

The first step is to inform your healthcare provider of any symptoms you may have noticed—even if they appear unrelated.

After your evaluation, your healthcare provider may order [13]:

• Serological testing – Serological testing refers to blood tests that look for certain antibodies in your bloodstream. Why? People with celiac disease tend to have a higher-than-average volume of tissue transglutaminase (tTG) antibodies after consuming gluten. To ensure the accuracy of serological testing, you will need to continue eating gluten before you’re tested.
• Endoscopy – During an endoscopy, your healthcare provider will retrieve a small sample of tissue from your small intestine. This sample will be biopsied to screen for signs of damage to the villi—small, finger-like structures that help your small intestine retrieve nutrients from food. If your sample appears to be damaged, you’re more likely to be given a celiac disease diagnosis.
• Genetic testing – People with celiac disease usually have genetic mutations that are high indicators of developing celiac disease. [14] Because genetic testing can be more expensive, it’s usually one of the last diagnostic tools to screen for celiac disease. However, it can be an effective method for diagnosing celiac disease early, especially in children. [14]

Treatment is an important part of understanding how celiac disease affects a given individual.

When you begin a strict gluten-free diet, you may be relieved of symptoms you didn’t previously notice. Some people even see an improvement within days or weeks after eliminating gluten from their diet—a fresh start to a healthier, more fulfilling life. [15]

Get Clear on Your Celiac Disease Status with Everlywell

Celiac disease can be a complex condition, but it’s usually manageable by sticking to a gluten-free diet. Knowing your status is the best way to avert long-term health effects, and today, you can test at home with the Everlywell Celiac Disease Screening Test.

With CLIA-certified lab results and a broad network of certified healthcare professionals, Everlywell plugs you into reliable testing and supportive care if you need further treatment.

Find out more about convenient, affordable at-home testing options by reaching out to Everlywell today.

Related Content

Celiac Diet Plan: Benefits and How To Create One

Can Celiac Disease Go Away?

Silent Celiac Disease: Symptoms & Causes

Understanding Refractory Celiac Disease

Wheat Allergy vs. Celiac Disease: How Are They Different?

References

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2. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Celiac Disease | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Published March 15, 2019. URL. Accessed Aug 4, 2023.
3. Busby E, Bold J, Fellows L, Rostami K. Mood Disorders and Gluten: It’s Not All in Your Mind! A Systematic Review with Meta-Analysis. Nutrients. 2018;10(11):1708. doi:https://doi.org/10.3390/nu10111708 URL. Accessed Aug 4, 2023.
4. Bishop S. Left Untreated, Celiac Disease Can Result in Serious Complications. https://newsnetwork.mayoclinic.org. Published 2012. URL. Accessed Aug 4, 2023.
5. is P, Julian T, Hadjivassiliou M. Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(10):1445. doi:https://doi.org/10.3390/nu10101445 URL. Accessed Aug 4, 2023.
6. Zylberberg HM, Lebwohl B, Green PHR. Celiac Disease-Musculoskeletal Manifestations and Mechanisms in Children to Adults. Current Osteoporosis Reports. 2018;16(6):754-762. doi:https://doi.org/10.1007/s11914-018-0488-y URL. Accessed Aug 4, 2023.
7. Bone Density and Celiac Disease» Mayo Clinic Connect. Mayo Clinic Connect. Accessed September 29, 2023. URL. Accessed Aug 4, 2023.
8. Dermatitis Herpetiformis (DH): Definition, Causes & Treatment. Cleveland Clinic. URL. Accessed Aug 4, 2023.
9. Picco MF. Stool color: When to worry. Mayo Clinic. Published 2019. URL. Accessed Aug 4, 2023.
10. Celiac Disease - Symptoms and Causes. Mayo Clinic. Published August 10, 2021. URL. Accessed Aug 4, 2023.
11. NHS Choices. Complications - Coeliac disease. NHS. Published 2019. URL. Accessed Aug 4, 2023.
12. Non-Responsive and Refractory Celiac Disease | BeyondCeliac.org. Beyond Celiac. Accessed September 29, 2023. URL. Accessed Aug 4, 2023.
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14. Celiac Disease Testing | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Published February 2021. URL. Accessed Aug 4, 2023.
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