Symptoms Associated with Celiac Disease
Depending on the degree of malabsorption, the signs and symptoms of celiac disease vary among individuals, ranging from no symptoms, few or mild signs and symptoms, to many or severe signs and symptoms. There are two categories of signs and symptoms: 1) those due to malabsorption, and 2) those due to malnutrition including vitamin and mineral deficiencies.
According to the experts…
1. Signs and symptoms of malabsorption
The three major categories of dietary nutrients are carbohydrates, proteins, and fat. Absorption of all of these nutrients can be reduced in celiac disease; however, fat is the most commonly and severely affected nutrient. Most of the gastrointestinal symptoms and signs of celiac disease are due to the inadequate absorption of fat (fat malabsorption). Gastrointestinal symptoms of fat malabsorption include diarrhea, flatulence (foul-smelling gas), abdominal bloating, and increased amounts of fat in the stool (steatorrhea). The unabsorbed fat is broken down by intestinal bacteria into fatty acids, and these fatty acids promote secretion of water into the intestine, resulting in diarrhea.
2. Signs and symptoms of malnutrition and vitamin or mineral deficiencies
Symptoms of malnutrition and vitamin or mineral deficiencies include: weight loss, fluid retention, anemia, osteoporosis, bruising easily, peripheral neuropathy (nerve damage), infertility, and muscle weakness.
- Weight loss and fluid retention: Weight loss is the direct result of inadequate absorption of carbohydrates, proteins, and fat. However, weight loss may not always occur because patients with celiac disease often have enormous appetites that compensate for the reduced absorption of nutrients. Moreover, weight loss can be masked by fluid retention. Fluid retention occurs in advanced malnutrition because the reduced absorption of protein results in low protein levels in the blood. High protein levels in the blood are necessary to keep fluid from leaking out of blood vessels and into the body’s tissues. When blood protein levels fall — as in celiac disease — fluid leaks into many tissues (edema) but particularly the ankles and feet, which then swell.
- Anemia: Lack of absorption of vitamin B12 and iron can lead to anemia.
- Osteoporosis: Lack of absorption of vitamin D and calcium can lead to osteoporosis and bone fractures.
- Easy bruising: Lack of absorption of vitamin K can lead to diminished ability of blood to clot and hence to easy bruising or excessive bleeding.
- Peripheral neuropathy (nerve damage): Vitamin deficiencies of B12 and thiamine may contribute to nerve damage with symptoms of poor balance, muscle weakness, and numbness and tingling in the arms and legs.
- Infertility: Untreated celiac disease can lead to infertility in women, lack of menstruation, spontaneous abortions, and low birth weight infants.
- Muscle weakness: Lack of absorption and low levels of potassium and magnesium can lead to severe muscle weakness, muscle cramps, and numbness or tingling sensations in the arms and legs.
So let’s say you’ve tried a gluten-free diet, and you’re still having symptoms? Well, unfortunately, you’re not alone. This is a common occurrence for those of with gluten intolerances…
What if All Your Symptoms Don’t Improve on a Gluten-free Diet?
For many people, eliminating gluten is often just the first part of the treatment. Some of us improve dramatically by just simply removing gluten from our diets, but more often the improvement, while good, is not enough to make us feel as good as we believe we should. And truly, if you have removed gluten from your diet and you’re still having symptoms, there are most likely other cross reactive foods which you will need to explore that are potentially creating additional immune responses.
Remember, gluten has a powerfully destructive effect on the immune system, and because of the fact that it often takes up to 11 years to accurately diagnose gluten intolerances, several problems can still occur on a gluten-free diet.
• Infections can develop in the intestine that, while “silent” symptom–wise, are preventing the intestine from completely healing.
• In addition, gluten creates a “leakiness” of the intestine that compromises absorption of nutrients, inflames the immune system, and allows problems to develop in many other systems of the body. This “leaky gut” syndrome is thought to be a major contributor to the long list of problems that can occur secondary to gluten.