Beyond the Gut: 7 Symptoms That May Mean You Have Celiac Disease

Written by Jennifer Robertson, MD, MSEd, NBHWC | Reviewed by Patricia Pinto-Garcia, MD, MPH Published on December 15, 2022

Key takeaways:

• The best-known symptoms of celiac disease include diarrhea, stomach pain, weight loss, and bloating. 
• Celiac disease can cause symptoms beyond the gut. Most people with celiac disease experience additional symptoms, like headaches, rashes, mood changes, and difficulty getting pregnant.
• Some people with celiac disease never develop gut symptoms. These people often get diagnosed much later than people who experience classic celiac symptoms.

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You may be seeing more gluten-free foods on the shelves these days — and for good reason. The number of people diagnosed with celiac disease continues to increase.  

Medical experts have been sounding the alarm that many people with celiac disease experience symptoms that affect multiple parts of the body, not just the gut. The result is that more people are realizing some of their previously unexplained symptoms could be due to celiac disease. And they’re getting help.

Here are the most common symptoms of celiac disease — both in and beyond the gut. 

What are the classic symptoms of celiac disease?

The “classic” symptoms of celiac disease center around the gut.

Celiac disease is a condition where the immune system attacks the small intestine. This immune response starts when people with celiac disease eat gluten, which leads to intestine damage. So people can experience gastrointestinal symptoms, like:

• Abdominal pain
• Diarrhea
• Bloating and gassiness
• Nausea
• Vomiting 
• Constipation
• Greasy stools
• Heartburn (gastrointestinal reflux)

But you can have celiac disease even if you don’t have any of these symptoms. 

What are other common symptoms of celiac disease?

Growing research shows that celiac disease can affect the entire body, not just the gut. Medical experts and advocates are raising awareness of these symptoms so people don’t miss the warning signs of celiac disease. 

More than half of people with celiac disease experience symptoms that don’t involve the gastrointestinal tract.

Here are seven common symptoms of celiac disease.

1. Rashes

Dermatitis herpetiformis is a skin rash, and it’s one of the most common symptoms of celiac disease. It’s red and raised, and it can form blisters. It’s also extremely itchy. Dermatitis herpetiformis can come and go and doesn’t leave scars. The rash usually forms on the trunk, arms, or legs — especially around the elbows and knees. 

2. Fatigue

Studies show that 1 in 3 people with celiac disease report long-standing fatigue at the time of their diagnosis. Some people meet criteria for chronic fatigue syndrome, while others report that their fatigue comes and goes. 

There are several reasons celiac disease can lead to fatigue. Celiac disease is a known cause of iron-deficiency anemia, which can make people feel overly tired and sap them of energy. 

In one study, 11% of people diagnosed with iron-deficiency anemia were found to have celiac disease. Many experts recommend that people with iron-deficiency anemia get checked for celiac disease, especially if there’s not an obvious reason for their anemia or they don’t get better with iron supplements. 

There’s evidence that the same genes that cause people to develop celiac disease can also lead people to develop autoimmune thyroiditis. This condition leads to low thyroid levels, which  can make people feel overly tired and sluggish. 

3. Numbness and tingling

Many people with celiac disease report numbness, tingling, and burning in their hands and feet. This is called “peripheral neuropathy.” 

In one small study, 50% of people with peripheral neuropathy were found to have celiac disease. Most of these people never developed classic celiac symptoms. Another study found that people with celiac disease were more than three times as likely to develop peripheral neuropathy than those without celiac disease. 

4. Mood changes

There’s a link between mood changes and celiac disease. People with celiac disease report higher levels of depression, anxiety, and low mood. Some also experience brain fog and difficulty concentrating.

Children with celiac disease are more likely to experience symptoms of ADHD (attention-deficit hyperactivity disorder). Many people with celiac disease report improved mood and concentration when they start a gluten-free diet.

5. Mouth pain

Before starting a gluten-free diet, many people with celiac disease get frequent canker sores. They can also experience atrophic glossitis — a condition that causes burning and pain of the tongue.

Without treatment, people with celiac disease can develop weakened tooth enamel, which can lead to cavities and dental infections. 

6. Trouble getting pregnant

Studies show that people who have celiac disease and stick to a gluten-free diet have the same chances of getting and staying pregnant as everyone else. But without a gluten-free diet, there’s evidence that both males and females with celiac disease can have a hard time having a baby. 

While the data around celiac disease and fertility isn’t totally clear, celiac advocates recommend that people who are having a hard time getting pregnant talk to their healthcare providers about celiac testing. 

7. Weak bones

Celiac disease makes it hard for the intestines to absorb vitamins and minerals that keep the bones strong and healthy. This can lead to weaker bones (osteomalacia) and bone loss (osteoporosis). 

What should you do if you have symptoms of celiac disease?

If you’ve been experiencing any of these symptoms and aren’t sure what’s causing them, talk to your healthcare provider about whether you should have a celiac test. 

You can also check out the Symptom Assessment Tool from the Celiac Disease Foundation. This tool can help you decide how likely your symptoms are to be from undiagnosed celiac disease. 

The bottom line

Celiac disease can lead to gut inflammation and make it difficult for the body to absorb vitamins and nutrients. Classic symptoms of celiac disease include diarrhea, vomiting, stomach pain, and bloating. 

But growing research shows that most people with celiac disease have symptoms that go beyond the gut — from fatigue, anemia, and mouth pain to rashes and weakened bones. For many people, these other symptoms show up long before gastrointestinal symptoms. If you’re worried that your symptoms might be due to celiac disease, talk to your healthcare provider about getting tested for celiac disease.