Symptoms - Working
"It's now clear that the text book description of this once-obscure ailment is woefully incomplete and describes only a minority of cases. Below the tip of the so-called celiac iceberg is a diverse world of illness that may include thousands of people suffering from various, seemingly unrelated conditions, such as anemia, osteoporosis, infertility, irritable bowel syndrome and chronic fatigue." - The Washington Post, February 11, 2003
List of CD Symptoms from :
Harvard University
University of Chicago
Columbia University
Go to the bottom of the Columbia University page to find a table of indications for screening
for CD.
Note: A person with CD may have only ONE of these symptoms. So, someone with anemia who has no digestive problems, could have CD. Likewise, someone with digestive problems who has never been anemic, could also have CD! Celiac Disease "runs in the family", so you may see symptoms in family members as well (that are different than yours).
How to make sense of all those symptoms
It has been estimated that there are 208 signs and symptoms of Celiac Disease! Ultimately, all of these are interrelated, and are the result of the autoimmune reaction to gluten, which may affect the entire body.
Since it is difficult to communicate or remember so many symptoms, it is useful to categorize these in the "big three" areas of Malabsorption, Autoimmune and Digestive symptoms. (You can remember this with the acronym M.A.D., as in "I'm MAD that gluten does this to people"!)
Malabsorption: the result of inadequate absorption of nutrients from the damaged small intestine. The symptoms can range from mild to severe, and include:
iron deficiency anemia, fatigue, B-12 and folate deficiency, osteopenia, osteoporosis, "failure to thrive" in children, short stature, dental enamel defects, protein calorie malnutrition, unintended weight loss, steatorrhea.
Autoimmune symptoms and diseases. This is a large category. Common symptoms of autoimmunity, such as joint pain, fatigue, and hair loss, can be caused by Celiac Disease. The joint pain is often misdiagnosed as Fibromyalgia. The fatigue may be diagnosed as chronic fatigue syndrome, or simply as stress.
Up to 10% of people with Type 1 Diabetes have Celiac Disease, and it is recommended that anyone with Type 1 Diabetes should be screened for CD. CD is strongly associated with autoimmune thyroid disease and Sjogren's Syndrome. It is also associated with alopecia, psoriasis, lupus, Addison's Disease, and cardiomyopathy. There is some evidence that gluten may cause autoimmune diseases.
CD is also believed to cause nerve damage of autoimmune origin, such as peripheral neuropathy, small-fiber neuropathy, ataxia, and symptoms that may be misdiagnosed as multiple sclerosis.
There are other effects from CD that are harder to categorize, but may fall into the autoimmune category, such as dermatitis herpetiformis, and effects on blood vessels and circulation.
See this pamphlet for a description of the autoimmune diseases associated with Celiac Disease.
Digestive symptoms. A number of common digestive problems may be caused by gluten, such as diarrhea and constipation (frequently misdiagnosed as Irritable Bowel Syndrome), vomiting, bloating, gas, reflux, lactose intolerance, and dyspepsia. The symptoms can range from mild to severe.
CD can also cause many less common problems in the digestive system, such as motility disorders and intestinal cancers, elevated liver enzymes, and S.O.D., or Sphincter of Oddi dysfunction (which can cause blockage of the bile and pancreatic ducts, gallbladder-type pain, and pancreatitis).
Below is a list of signs, symptoms, associated disorders and typical misdiagnoses of Celiac
Disease, with selected references (this is a work in progress):
Abdominal pain (Naspghan pediatric guidelines)
Addison's Disease (1, 2, 3)
Alopecia
Anemia (Grisolano, SW)
Anorexia (Naspghan pediatric guidelines)
Apthous ulcers ie, mouth sores
Arthritis (Stagi S)
Arthropathy
Ataxia (Hadjivassiliou, Hadjivassiliou)
Atrial Fibrillation (Candelli M)
Cardiomyopathy (Goel,NK)
Constipation (Naspghan pediatric guidelines)
Crohn's Disease (Tursi A)
Delayed Puberty (Naspghan pediatric guidelines)
Depression (Pynnonen P)
Dental Enamel Defects (Aine L)
Dermatitis Herpetiformis
Diabetes, Type 1 (Mahumd F, Picarelli)
Diarrhea
Down's Syndrome
Elevated liver enzymes (hypertransaminasemia) (Duggan)
Epilepsy
Graves Disease
Growth Hormone Deficiency (Salardi S)
Hair loss (not male pattern baldness)
Heart Problems (Cardiomyopathy, Myocarditis, Ventricular Arrythmia)
Hepatitis
Hives (urticaria) (Caminiti, Meneghetti)
Hashimoto's Thyroiditis
Hyposplenism (ie, poor function of spleen increasing risk of infection) (Di Sabatino)
Hypertransaminasemia (ie, elevated liver enzymes)
Infertility, male or female
Irritability
Irritable Bowel Syndrome
Kawasaki Disease (Stagi)
Lactose Intolerance (Ojetti)
Lupus (Hadjivassiliou)
Lymphoma
Migraines (Gabrielli)
Myelopathy
Myocarditis (Frustaci)
Multiple Sclerosis
Nystagmus (Mohn A)
Osteopenia
Osteoporosis (1)
Pancreatitis (1, 2 3)
Peripheral Neuropathy
Primary Biliary Cirrhosis
Psoriasis
Pulmonary (lung) inflammation (Brightling)
Reflux
Schizophrenia (Kalaydjian)
Seizures
Short Stature (Salardi S)
Sjogren's Syndrome (Luft)
Sphincter of Oddi dysfunction, aka papillary stenosis (Patel RS)
Steatorrhea
Thyroid Disease, Autoimmune
Turner Syndrome
Ventricular Arrythmia (Frustaci)
Vertigo (Mohn A)
Vomiting
Weight Loss (unintentional)
Weight Gain (from increased appetite)
Williams Syndrome
List of CD Symptoms from :
Harvard University
University of Chicago
Columbia University
Go to the bottom of the Columbia University page to find a table of indications for screening
for CD.
Note: A person with CD may have only ONE of these symptoms. So, someone with anemia who has no digestive problems, could have CD. Likewise, someone with digestive problems who has never been anemic, could also have CD! Celiac Disease "runs in the family", so you may see symptoms in family members as well (that are different than yours).
How to make sense of all those symptoms
It has been estimated that there are 208 signs and symptoms of Celiac Disease! Ultimately, all of these are interrelated, and are the result of the autoimmune reaction to gluten, which may affect the entire body.
Since it is difficult to communicate or remember so many symptoms, it is useful to categorize these in the "big three" areas of Malabsorption, Autoimmune and Digestive symptoms. (You can remember this with the acronym M.A.D., as in "I'm MAD that gluten does this to people"!)
Malabsorption: the result of inadequate absorption of nutrients from the damaged small intestine. The symptoms can range from mild to severe, and include:
iron deficiency anemia, fatigue, B-12 and folate deficiency, osteopenia, osteoporosis, "failure to thrive" in children, short stature, dental enamel defects, protein calorie malnutrition, unintended weight loss, steatorrhea.
Autoimmune symptoms and diseases. This is a large category. Common symptoms of autoimmunity, such as joint pain, fatigue, and hair loss, can be caused by Celiac Disease. The joint pain is often misdiagnosed as Fibromyalgia. The fatigue may be diagnosed as chronic fatigue syndrome, or simply as stress.
Up to 10% of people with Type 1 Diabetes have Celiac Disease, and it is recommended that anyone with Type 1 Diabetes should be screened for CD. CD is strongly associated with autoimmune thyroid disease and Sjogren's Syndrome. It is also associated with alopecia, psoriasis, lupus, Addison's Disease, and cardiomyopathy. There is some evidence that gluten may cause autoimmune diseases.
CD is also believed to cause nerve damage of autoimmune origin, such as peripheral neuropathy, small-fiber neuropathy, ataxia, and symptoms that may be misdiagnosed as multiple sclerosis.
There are other effects from CD that are harder to categorize, but may fall into the autoimmune category, such as dermatitis herpetiformis, and effects on blood vessels and circulation.
See this pamphlet for a description of the autoimmune diseases associated with Celiac Disease.
Digestive symptoms. A number of common digestive problems may be caused by gluten, such as diarrhea and constipation (frequently misdiagnosed as Irritable Bowel Syndrome), vomiting, bloating, gas, reflux, lactose intolerance, and dyspepsia. The symptoms can range from mild to severe.
CD can also cause many less common problems in the digestive system, such as motility disorders and intestinal cancers, elevated liver enzymes, and S.O.D., or Sphincter of Oddi dysfunction (which can cause blockage of the bile and pancreatic ducts, gallbladder-type pain, and pancreatitis).
Below is a list of signs, symptoms, associated disorders and typical misdiagnoses of Celiac
Disease, with selected references (this is a work in progress):
Abdominal pain (Naspghan pediatric guidelines)
Addison's Disease (1, 2, 3)
Alopecia
Anemia (Grisolano, SW)
Anorexia (Naspghan pediatric guidelines)
Apthous ulcers ie, mouth sores
Arthritis (Stagi S)
Arthropathy
Ataxia (Hadjivassiliou, Hadjivassiliou)
Atrial Fibrillation (Candelli M)
Cardiomyopathy (Goel,NK)
Constipation (Naspghan pediatric guidelines)
Crohn's Disease (Tursi A)
Delayed Puberty (Naspghan pediatric guidelines)
Depression (Pynnonen P)
Dental Enamel Defects (Aine L)
Dermatitis Herpetiformis
Diabetes, Type 1 (Mahumd F, Picarelli)
Diarrhea
Down's Syndrome
Elevated liver enzymes (hypertransaminasemia) (Duggan)
Epilepsy
Graves Disease
Growth Hormone Deficiency (Salardi S)
Hair loss (not male pattern baldness)
Heart Problems (Cardiomyopathy, Myocarditis, Ventricular Arrythmia)
Hepatitis
Hives (urticaria) (Caminiti, Meneghetti)
Hashimoto's Thyroiditis
Hyposplenism (ie, poor function of spleen increasing risk of infection) (Di Sabatino)
Hypertransaminasemia (ie, elevated liver enzymes)
Infertility, male or female
Irritability
Irritable Bowel Syndrome
Kawasaki Disease (Stagi)
Lactose Intolerance (Ojetti)
Lupus (Hadjivassiliou)
Lymphoma
Migraines (Gabrielli)
Myelopathy
Myocarditis (Frustaci)
Multiple Sclerosis
Nystagmus (Mohn A)
Osteopenia
Osteoporosis (1)
Pancreatitis (1, 2 3)
Peripheral Neuropathy
Primary Biliary Cirrhosis
Psoriasis
Pulmonary (lung) inflammation (Brightling)
Reflux
Schizophrenia (Kalaydjian)
Seizures
Short Stature (Salardi S)
Sjogren's Syndrome (Luft)
Sphincter of Oddi dysfunction, aka papillary stenosis (Patel RS)
Steatorrhea
Thyroid Disease, Autoimmune
Turner Syndrome
Ventricular Arrythmia (Frustaci)
Vertigo (Mohn A)
Vomiting
Weight Loss (unintentional)
Weight Gain (from increased appetite)
Williams Syndrome
