15 Celiac Disease Symptoms to Have on Your Radar

Doctors explain how to know when gluten isn’t your friend.
Top view of woman laying on bed feeling discomfort
Celiac disease symptoms include abdominal pain and bloating.Maria Korneeva / Getty Images

Bloating. Diarrhea. Fatigue. These are the common celiac disease symptoms you’ve heard of, but they’re not the only ones to watch for. Reminder: Celiac disease is when your body can’t process gluten, a protein found in delicious foods like bread, cookies, and spaghetti. While the majority of people have no trouble digesting this little protein, if you’re one of the 2 million people in the United States with celiac disease, these gluten-containing foods are off the table if you want to avoid a host of symptoms (and trust us, you do).

The good news is there are tons of gluten-free options to choose from. But do really you need them? In other words, how do you know if you actually have celiac disease (or potentially, gluten intolerance)? Keep reading to learn the main celiac disease symptoms to look out for—beyond the ones you’ve already heard of.

What is celiac disease?

Celiac disease is an autoimmune digestive condition in which gluten, a protein commonly found in wheat, barley, and rye, causes the immune system to attack and damage the lining of the small intestine, according to Celiac Disease Foundation. This damages the villi, which are small, finger-like projections that help the body absorb nutrients. When the villi are damaged, your body can’t absorb nutrients as well, which can lead to a host of health issues including anemia, osteoporosis, chronic fatigue, and infertility.

“Most symptoms in celiac disease come from the destruction of the intestinal lining,” Jacqueline Jossen, MD, an assistant professor and pediatric gastroenterologist at the Celiac Disease Center at Columbia University, tells SELF. The only way to treat celiac disease is to follow a strict gluten-free diet, which will help keep your gut healthy.

Are there different types of celiac disease?

You might think celiac disease always looks a certain way—with symptoms like diarrhea and bloating at the top of the list—but it can actually vary widely from person to person. In fact, medical professionals categorize celiac disease into three distinct types that all show up a bit differently.

According to the World Gastroenterology Organization (WGO), the three primary types of celiac disease include:1

  • Classic (typical): People who have classic celiac disease often have all the symptoms that you probably associate with the condition, such as diarrhea, iron-deficiency anemia, and growth problems.
  • Non-classic (atypical): Those with non-classic celiac disease tend to have symptoms that aren’t always specific to the condition, such as chronic fatigue or frequent migraine attacks. With non-classic celiac disease, a person may not have any gastrointestinal symptoms at all.
  • Asymptomatic (silent): People with asymptomatic celiac disease usually have no symptoms of celiac disease, yet still present with lesions along the intestines, which are a hallmark of the condition.

It’s important to note that all three types of celiac disease can lead to long-term health problems if left untreated—whether you have symptoms or not.

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What are the early warning signs of celiac disease?

There are many potential symptoms of celiac disease, which makes it difficult to pinpoint one or two sure signs you have it. That said, there are a couple to watch out for. “Probably the two most common symptoms, traditionally, have been iron-deficiency anemia and diarrhea,” Brigid S. Boland, MD, a gastroenterologist and associate professor of medicine at the University of California, San Diego, tells SELF. Having these symptoms doesn’t guarantee you have celiac disease but it would be a good idea to see a doctor to find out.

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What are the symptoms of celiac disease?

First, it’s important to understand that there are two main groups of initial symptoms: intestinal and extraintestinal, Vahe Badalyan, MD, director of the Celiac Disease Program and gastroenterologist at Children’s National Hospital, tells SELF. Intestinal symptoms—like diarrhea and abdominal pain— are the result of inflammation and damage to the bowel. Extraintestinal symptoms arise from the poor absorption of nutrients and the inflammation that occurs in the body due to an overactive immune response.

Here’s a rundown of celiac disease symptoms to look out for:

Abdominal pain

When you have celiac disease, general abdominal discomfort is common. The exact mechanism of why celiac causes abdominal pain isn’t clearly understood and often the severity of symptoms does not correlate with the amount of internal damage from celiac.

Bloating

Eating even the smallest amount of gluten can cause bloating if you have celiac disease. One of the reasons is that untreated celiac disease may lead to changes in the way food travels through the digestive tract, according to a 2021 study published in the journal Clinical Gastroenterology and Hepatology.1 This can cause food to become backed up in the stomach, which leads to bloating.

Diarrhea

This can be a big problem for people with celiac disease. Diarrhea happens when the bowels have trouble absorbing liquids or excrete too much liquid.2 Malabsorption is what happens when the lining of the intestine is damaged preventing proper absorption of nutrients (cue all the diarrhea). You might notice a few other poop changes too, like appearing pale in color, fattier, or even more foul-smelling than usual—all of which are the result of damage to the gastrointestinal tract.

Unintentional weight loss

Unintentional weight loss is a common symptom of health conditions that cause malnutrition (when your small intestine can’t absorb enough nutrients)—and this is especially true with celiac disease. When gluten damages the lining of the intestinal tract, your body has trouble absorbing nutrients from carbohydrates, fats, and proteins, according to the Mayo Clinic. Without enough calories, it can be difficult for people with celiac disease to gain or maintain weight.

Iron-deficiency anemia

Iron-deficiency anemia can develop in people with celiac disease because the body is unable to adequately absorb iron (along with other nutrients), says Dr. Jossen. If you have iron-deficiency anemia, you may experience symptoms, such as pale skin, fatigue, shortness of breath, and heart palpitations, according to the American Society of Hematology. You might also notice other strange symptoms, such as ringing in the ears, itchy skin, hair loss, and an intense desire to chew on ice.

A super itchy, blistering rash

Known as dermatitis herpetiformis (DH or Duhring’s disease, this rash occurs when celiac disease manifests on your skin). It’s caused by the antibodies associated with celiac disease triggering an immune response in the skin, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The resulting inflammation leads to lesions, which commonly appear on the limbs and torso. Thankfully, only about 10% of people with celiac disease will get this rash, and you’ll know if you’ve had it. “It’s a pretty memorable, itchy, blistering rash,” notes Dr. Boland.

Chronic fatigue

Chronic fatigue with celiac disease often manifests as a feeling of tiredness and exhaustion that you just can’t seem to shake, says Dr. Badalyan. Although the exact cause for this symptom is still not known, according to a 2019 study published in the Journal of Human Genetics, it’s possible that inflammation from the autoimmune response is largely to blame.3

Weakness, numbness, and pain in your hands and feet

The result of something called peripheral neuropathy, this happens when the nerves of your peripheral nervous system (think the nerves outside your brain and spinal cord) become damaged. In people with celiac disease, nutritional deficiencies (especially vitamins B12, B6, and E, and metals like copper), antibodies, and even other underlying autoimmune disorders can impact the nervous system and lead to neuropathy. You’ll most likely notice uncomfortable sensations such as pain, tingling, or numbness in the feet (or on the face, in some cases).4

Osteoporosis

This one goes back to the pesky malabsorption issue that occurs with untreated celiac disease. The reason: Osteoporosis may occur if your small intestine can’t absorb vitamin D and calcium the way it’s supposed to, which leads to bones becoming weak, brittle, and more susceptible to breaking, per the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Symptoms of osteoporosis can include changes in your height and posture, unexplained back pain, and bone fractures.

Mood changes

Celiac disease can cause irritability, anxiety, and depression, according to a 2015 study published in the United European Gastroenterology Journal. The reason may be that celiac disease makes it hard for the body to absorb the nutrients necessary for brain health.5 On top of this, living with a chronic illness can impact your mental health in general. According to the National Institute of Mental Health (NIMH), people with chronic illnesses are at a higher risk of developing mental health conditions like depression.

Reproductive issues

When you have untreated celiac disease, nutritional deficiencies and an overactive immune system may lead to issues with your reproductive health. An older study published in the World Journal of Gastroenterology found that changes in menstruation are common in people with celiac, such as delayed, missed, or irregular periods, as well as decreased libido and changes in sperm health. The study also found that pregnant people with untreated celiac disease may also be at greater risk for premature delivery, low birth weight babies, and miscarriages, though more research is needed.6

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Are celiac disease symptoms in children different from adults?

Kids can develop celiac disease symptoms as soon as they start eating solid foods with gluten, per the Celiac Disease Foundation. “In children, we often see classic gastrointestinal symptoms including abdominal pain, diarrhea, abdominal distension and bloating, constipation, or vomiting,” Dr. Jossen says. However, children may experience other celiac disease symptoms that aren’t present in adults, including:

Growth problems

Children with celiac disease don’t always speak up when they are experiencing symptoms. That’s why some kids aren’t diagnosed until they fall significantly behind on their expected growth schedule. The reason for their stunted growth isn’t totally clear, but it may be the result of nutritional deficiencies and an overactive immune system, according to a 2015 study published in BMC Gastroenterology.7 “Any child who is falling off their growth curves needs to be screened for celiac disease regardless of the presence of gastrointestinal symptoms,” notes Dr. Jossen.

Delayed puberty

Delayed menstruation and abnormal hormonal patterns could indicate celiac disease in older children and adolescents —even if they have no other symptoms, says Dr. Badalyan. Again, this could be due to nutritional deficiencies or the autoimmune reaction occurring in the body, according to a study published in the journal Hormone Research.8

Tooth defects

You may not think that celiac disease would have any impact on dental health, but it turns out kids can develop defects in tooth enamel (the thin outer layer of teeth), says Dr. Jossen. A few celiac disease tip-offs include discolored or translucent teeth and pitting or banding on the incisors and molars, per the NIDDK. As with many of the other symptoms of celiac disease, these issues arise because of malnutrition.

Behavioral issues

Younger children with celiac disease are more susceptible to problems with anxiety, oppositional defiance (problems with listening and cooperating with people in authority), and aggressive behavior, according to a 2019 study published in Pediatrics. Researchers believe this may be linked to nutritional deficiencies and changes in the gut-brain axis (basically how your emotions impact the digestive tract and vice versa).9

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What’s the difference between celiac disease and gluten intolerance?

Celiac disease isn’t the only health condition linked to problems with gluten. Non-celiac gluten sensitivity (NCGS) and wheat allergy are also related to gluten issues and are sometimes collectively called gluten intolerance.

The gastrointestinal symptoms can be similar in celiac disease and NCGS (though no damage is done to the small intestine in the latter). Symptoms may include abdominal pain, diarrhea, and bloating, per the American Academy of Allergy Asthma and Immunology.

Wheat allergies cause different symptoms, such as shortness of breath, hives, lightheadedness, and vomiting. With wheat allergies, the body has an abnormal reaction to the proteins contained in wheat. It is not an autoimmune condition, but instead, an allergic reaction, and the timing of symptoms is minutes to hours after ingestion of the wheat. 

The bottom line: Celiac disease and gluten intolerance are different health issues but the symptoms for all of them can be controlled by sticking to a gluten-free diet.

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How to live well with celiac disease

Switching to a gluten-free diet in order to manage your celiac disease symptoms can be challenging. “It can be a big burden on people and their families for many reasons,” Shayna Coburn, PhD, a psychologist at Children’s National Hospital, tells SELF, noting that for some, it can be a complicated, stressful, and expensive change.