Celiac Disease

Common Celiac Disease Symptoms

Celiac Disease Symptoms

The best-known (but not necessarily most common) symptoms of celiac disease include smelly diarrhea, abdominal pain, weight loss, and fatigue. However, celiac disease can affect just about every system in your body, including your skin, your hormones, and your bones and joints, and can cause symptoms you might never think to associate with the condition.

People with celiac disease might suffer from constipation instead of diarrhea, experience weight gain instead of weight loss, and endure heartburn instead of (or in addition to) stomach pain.

They might also have absolutely no symptoms at all, or they might appear at their doctor's office with one seemingly unrelated symptom, such as unexplained anemia.

Watch the villi in your gut erode from gluten contact.

In fact, it's doubtful that there's a truly "typical" case of celiac disease; the condition can affect too many body systems for any one set of symptoms to be considered typical. Women, men, babies, and children are likely to experience celiac disease in quite divergent ways.

And sometimes, you might have full-blown celiac but not have any symptoms at all.

Here's a breakdown of celiac disease symptoms and related conditions, categorized by the body system they affect.

Digestive Symptoms of Celiac Disease

Not everyone who's diagnosed with celiac disease experiences digestive symptoms, but many do. For example, one study found such symptoms in about three-quarters of people who had just been diagnosed with the condition.

Chronic diarrhea is one hallmark symptom of celiac disease, and it appears to affect half or more of those newly diagnosed. Frequently, the diarrhea is watery, smelly, and voluminous, and floats rather than sinks.

However, plenty of people with celiac disease tend to have constipation rather than diarrhea, and some see their symptoms alternate between the two.

In addition, other types of digestive symptoms can appear. For example, flatulence and excessive gas are common, as is abdominal bloating (many people describe themselves as looking "six months pregnant"). It's also common to have abdominal pain, which can be severe at times.

Additional digestive symptoms of celiac disease can include heartburn and reflux (some people already have been told they have gastroesophageal reflux disease, or GERD), nausea and vomiting, and lactose intolerance. Undiagnosed celiacs sometimes develop pancreatitis or gallbladder disease, and many already have been diagnosed with irritable bowel syndrome (those IBS symptoms often lessen or disappear completely following a celiac disease diagnosis).

In addition, not everyone loses weight as an undiagnosed celiac. In fact, many people find they gain weight prior to diagnosis.

Some people report being absolutely unable to shed excess pounds, no matter how much they diet and exercise. In my experience, weight gain or being overweight frequently is coupled with constipation (not diarrhea) as the person's primary digestive symptom.

Neurological Celiac Disease Symptoms

Many people with undiagnosed celiac experience extreme fatigue that prevents them from performing everyday tasks and impacts their quality of life. Generally, fatigue seems to creep up on you, making it easy to blame it on getting older (as opposed to a treatable medical condition).

At the same time, insomnia and other sleep disorders are very common in people with celiac. In fact, one study compared celiacs at diagnosis and on the gluten-free diet with non-celiac controls, and found that all those with celiac disease—regardless of whether they were gluten-free or not—fared worse on measures of sleep quality.

It's the worst of both worlds: You're exhausted during the day but can't fall asleep or stay asleep at night.

In addition, many people with celiac disease get "brain fog" due to gluten. When you have brain fog, you have trouble thinking clearly—it literally feels as if your brain is operating in a fog. You might have trouble coming up with the right words to carry on an intelligent conversation, or you might misplace your car keys or fumble other common household tasks.

Some newly diagnosed celiacs already have diagnoses of migraine headaches; in many cases (but not all), these headaches will lessen in severity and frequency or even clear up completely once you adopt a gluten-free diet.

Psychological symptoms such as depression, anxietyattention-deficit hyperactivity disorder, and irritability occur frequently in people with undiagnosed celiac disease. In fact, long-diagnosed celiacs often can tell they've been exposed to gluten through their irritability—that symptom can appear within hours of exposure and linger for several days. In small children with celiac disease, sometimes irritability is the only symptom.

Peripheral neuropathy, in which you experience numbness, a sensation of pins and needles, and potentially weakness in your extremities, is one of the most frequently reported neurological symptoms of celiac disease. In addition, some people are diagnosed with gluten ataxia, which is brain damage characterized by the loss of balance and coordination that's due to gluten consumption.

Restless leg syndrome even has been reported as a common symptom of celiac disease. In one study, 31 percent of celiacs had restless leg syndrome, compared with just 4 percent of people without celiac disease.

Celiac Disease and Your Hormones

Celiac disease can affect your hormones and other functions of your endocrine system, which controls everything from your reproductive system to your moods. In fact, celiac disease is found in 2 to 5 percent of patients with either thyroid disease or type 1 diabetes, and also appears frequently in patients with Sjogren's syndrome (an autoimmune condition in which your mouth and eyes become extremely dry).

Patients with Addison's disease (when your adrenal glands fail to produce enough of two essential hormones), hypophysitis (inflammation of your pituitary gland), or multiple endocrine diseases all carry a higher risk for celiac disease.

Reproductive health issues, including infertility in both women and menskipped periodslate puberty, and early menopause also can signal the possibility of celiac disease (although, again, there are other potential reasons for these symptoms). Women with celiac are significantly more likely than other women to experience pregnancy problems and repeated miscarriages.

And, celiac can affect your sexuality, too.

Skin Disorders Linked to Celiac Disease

You might see signs of celiac disease in your largest organ: your skin.

Up to one-fourth of people with celiac suffer from dermatitis herpetiformis (a.k.a. "the gluten rash"), an intensely itchy skin rash. If you have dermatitis herpetiformis plus positive celiac blood tests, you have celiac disease—no further testing required.

However, people with celiac also suffer from a variety of other skin problems, including psoriasis, eczema, alopecia areata (an autoimmune condition where you lose your hair), hives, and even such common problems as acne and dry skin.

Although there's no firm evidence that gluten ingestion causes or contributes to these skin problems, the gluten-free diet helps clear them up in some cases.

Celiac Symptoms Related to Your Bones and Joints

Although you might not connect your bones and joints to what's considered a digestive disorder, celiac disease can seriously impact those parts of your body, too. 

Osteoporosis, in which your bones become thin and weak, frequently appears in concert with celiac disease, since when you have celiac you can't absorb the nutrients needed to keep your bones strong.

But other bone and joint issues, such as joint pain, bone pain, rheumatoid arthritis, and fibromyalgia also occur with regularity in those with celiac disease, too. It's not clear what the connection is; it may involve nutritional deficiencies related to the fact that celiac causes intestinal damage, which makes it difficult for you to absorb vitamins and minerals.

In some cases, the gluten-free diet can alleviate pain from these conditions.

Children with undiagnosed celiac disease often fall behind the growth curve, and this delayed growth or "failure to thrive" may be the only symptom of celiac disease in a child. If the child gets diagnosed prior to puberty and begins a strict gluten-free diet, she often can make up some or all of the height. Adults with longstanding undiagnosed celiac disease often are quite short.

Celiac Disease and Dental Issues

People with celiac disease often have terrible teeth and problematic gums.

In adults with undiagnosed celiac disease, frequent cavities, eroding enamel, and other recurring dental problems can signal the condition. Children with undiagnosed celiac might have spots on their new teeth with no enamel, delayed eruption of their teeth (either baby or adult), and multiple cavities.

Canker sores (also known as aphthous ulcers) occur in both adults and children with undiagnosed celiac disease (and in those already diagnosed who ingest gluten accidentally). These painful mouth sores frequently crop up on the inside of your lips in areas where you've had a very minor injury (such as a scratch from a sharp piece of food, a utensil, or your teeth). Once they start, they can take up to a week to subside.

It's also not unusual to find celiac disease in a person who has periodontal disease or badly receding gums. In some cases, the gluten-free diet can help to reverse some of the damage that's been done.

Cancer and Celiac Disease

In very unusual cases, the first obvious sign that a patient has unrecognized celiac is the frightening diagnosis of a particular type of lymphoma that's strongly linked to celiac disease. Fortunately, this type of cancer is very rare, even in people who have had celiac symptoms for years but remained undiagnosed.

Beyond lymphoma, the effects of celiac disease on your cancer risk are mixed: Celiac can raise your risk for certain types of cancer, but it may actually lower your risk for others.

For example, people with celiac disease have a higher risk for cancer of the small intestine (a rare type of cancer), carcinoid tumors (a rare, slow-growing type of cancer that can occur in the digestive tract), and gastrointestinal stromal tumors (another rare form of cancer).

Symptoms of these types of cancer include abdominal pain and unexplained weight loss—two symptoms that also can signal celiac disease. However, even if you have those two symptoms, you shouldn't worry. It's extremely unlikely that you have one of these cancers, which are not at all common.

It's not clear whether people with celiac disease (either diagnosed or undiagnosed) suffer from an increased risk for colon cancer, although one study found that celiacs are no more likely than those without the condition to be diagnosed with colon polyps, considered a precursor to colon cancer.

Despite earlier research showing celiac disease may heighten the risk for the skin cancer melanoma, more recent research has shown no link between the two conditions.

And, there's evidence that having celiac may in fact reduce your risk of breast cancer, possibly because celiac disease seems to cause lower levels of certain reproductive hormones that may be linked to breast cancer development. This reduction in risk may also extend to ovarian and endometrial cancers, two other types of cancer that are influenced by hormones.

Bottom Line: Celiac Symptoms Are a Guide, But Not Definitive

Celiac disease can masquerade as many, many other conditions (for example, I've heard of more than one person misdiagnosed with  multiple sclerosis when in fact they actually had celiac disease). However, just because you have any of these symptoms (or even lots of them), it doesn't mean you necessarily have celiac disease—it just means you should consider being tested for the condition.

Because every person exhibits celiac disease symptoms differently, it's also a very difficult condition for doctors to diagnose correctly. In fact, although celiac disease awareness and diagnosis rates appear to be improving, in years past someone could go for up to 10 years before getting diagnosed, even with severe and even debilitating symptoms.

Of course, keep in mind that all of these potential celiac disease symptoms can be caused by other medical conditions, possibly including non-celiac gluten sensitivity, which is thought to be a separate condition. That's another major reason this diagnosis is so difficult to make.

The only way you can tell for certain that you have celiac is to have an intestinal biopsy that shows villous atrophy, which is the intestinal damage found in celiac disease.

Once you're diagnosed with celiac disease, it's for life. To avert long-term complications (including those cancers linked to celiac disease), you must follow a strict gluten-free diet. However, you'll probably be pretty happy to learn that following a strict gluten-free diet generally resolves most or all of your symptoms.

In fact, while you'd expect the diet to resolve your digestive symptoms—and in most cases it will improve or fix them—it's actually very common to experience marked improvement in other, minor ailments you never would have imagined were related to celiac disease.

So the good news is, you may notice many minor health complaints disappearing once you're diagnosed and on the gluten-free diet.


Collin P et al. Endocrinological Disorders and Celiac Disease. Endocrine Reviews. 2002 Aug;23(4):464-83.

National Institute of Diabetes and Digestive and Kidney Disease. Celiac Disease. Accessed July 17, 2016.

National Institutes of Health Consensus Development Conference on Celiac Disease, June 28-30, 2004.

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