The Most Common Signs of Gluten Intolerance

Symptoms of celiac disease

Celiac disease is the most severe gluten-related disorder. It’s an autoimmune disease that affects about 1% of the population. Without strict gluten avoidance, it can have serious effects.

Here are a few of the most common symptoms of celiac disease.

Diarrhea, constipation, and smelly feces

Individuals with celiac disease experience inflammation in the small intestine after eating gluten. This damages your gut lining, leading to:

• pain
• bloating
• constipation
• diarrhea

People with celiac disease may also have pale and foul-smelling feces, or steatorrhea.

Skin reactions

Dermatitis herpetiformis (DH) is one manifestation of celiac disease. It causes extremely itchy bumps and blisters. For some people with celiac disease, DH is their only symptom.

Fatigue

Many people with autoimmune disorders, including celiac disease, often feel tired. Several factors may contribute, including:

• chronic pain
• inflammation
• sleep disruption
• psychological conditions, such as depression and anxiety

Celiac disease also raises the risk of iron deficiency anemia, which can also cause fatigue.

Iron deficiency anemia

Because celiac disease can affect nutrient absorption, it can also lead to iron deficiency.

Iron deficiency is the most common cause of anemia worldwide. It causes symptoms such as:

• fatigue
• shortness of breath
• dizziness
• weakness
• headaches
• pale skin
• hair loss
• low mood

Iron deficiency anemia may be among the first symptoms of celiac disease that a healthcare professional notices.

Depression and anxiety

Depression and anxiety are especially common among people with celiac disease. Scientists aren’t sure why, but there are several theories:

• Living with a chronic condition: Living with a chronic condition can be stressful, especially when it requires constant management. Avoiding certain activities may lead to feelings of loneliness or missing out, while a fear of potential attacks or complications could also lead to anxiety.
• Vitamin deficiency: This can occur when the body cannot properly absorb nutrients, leading to malabsorption or hyperhomocysteinemia. This, in turn, can affect mood.
• Microbiome changes: There is some evidence that celiac disease may alter gut bacteria, though more research is needed. A 2020 review found a strong link between the microbiome and mental health.
• Gluten exorphins: These peptides form during the digestion of certain gluten proteins. Some scientists theorize that they may interfere with the central nervous system, raising your risk of depression.
• Chronic cerebral hypoperfusion: This occurs when not enough blood reaches the brain, leading to a lack of oxygen.

Unexplained weight loss

Unexplained weight loss can be an effect of undiagnosed celiac disease. In children, this may result in failure to thrive due to the effects of weight loss on growth and development.

Joint and muscle pain

People with celiac disease can experience joint and muscle pain due to inflammation. Over time, untreated celiac disease can also affect bone health, raising the risk of osteoporosis.

Neurological symptoms

Another surprising symptom of gluten intolerance is neuropathy, which involves numbness or tingling in your arms and legs.

This can stem from celiac disease itself or from vitamin B12 deficiency due to nutrient absorption problems.

Another neurological manifestation of celiac disease is gluten ataxia, which affects movement. People with gluten ataxia may have more difficulty with fine motor skills, precise arm and leg movement, and balance.

Symptoms of NCGS

Although celiac disease is the most severe form of gluten intolerance, 0.5% to 13% of people may have NCGS, which is milder and not an autoimmune disorder.

Scientists are still trying to understand what causes NCGS. Currently, there are no specific symptom criteria, making diagnosis difficult.

Here are some of the symptoms of NCGS.

Bloating, pain, and diarrhea

Occasional diarrhea or bloating is common, but it may be a cause for concern if it happens regularly.

A 2019 review found that abdominal pain, bloating, flatulence, and diarrhea were the most common digestive symptoms of NCGS.

For people with NCGS, eating gluten-containing foods may trigger these digestive issues. However, if a person also experiences these symptoms after eating other foods, another cause may be at work.

Headaches and migraine

Many people experience headaches from time to time. Migraine is also a common condition.

But according to a 2021 article summarizing previous research, both headaches and migraine are more common in those with NCGS. A 2019 review also notes that headaches are among the most common nondigestive symptoms.

Fatigue

People with gluten intolerance are prone to fatigue and tiredness, especially after eating gluten-containing foods.

Depression and anxiety

Anxiety and depression are some other symptoms that those with NCGS report. If NCGS is the direct cause, avoiding gluten or wheat may improve any mood changes.

However, scientists are still trying to understand the link between gluten disorders and mental health.

Muscle or joint pain

Some people with NCGS report having chronic pain beyond the digestive system, such as in the muscles or joints.

Brain fog

“Brain fog” refers to the feeling of being unable to think clearly. It is a commonly reported symptom of NCGS.

In one 2020 study, brain fog affected 48% of participants with non-celiac gluten intolerance. The exact mechanism behind this is unknown.

Potential neurological symptoms

In a 2020 study, 31% reported balance problems, while 19% reported tingling within 2 hours of gluten consumption. This is similar to the symptoms people with celiac disease can experience, and within a similar timeframe.

But scientists are unsure why this happens.

Symptoms of wheat or gluten allergy

Wheat allergy is a food allergy that causes your body’s immune system to react to certain proteins found in wheat, including gluten or other compounds.

Wheat allergy is more common in children than in adults, and approximately 65% of children outgrow it by the age of 12. The symptoms can include:

Hives or rashes

Wheat allergies often cause hives, a skin rash that causes raised, itchy bumps, or “wheals”. This allergy can also cause other types of skin rash.

Digestive symptoms

People with wheat allergies can experience digestive issues, such as:

• bloating
• pain
• nausea
• vomiting
• diarrhea

Nasal congestion

Sneezing, nasal congestion, and a runny nose may also be signs of a wheat allergy.

In some cases, a person with a wheat allergy who has nasal symptoms can develop baker’s asthma, a type of occupational asthma caused by frequent exposure to bread flour.

Headaches

Similarly to other GRDs, people with wheat or gluten allergies can also get headaches. This may be due to sinus inflammation or congestion.

Anaphylaxis

Anaphylaxis is a severe allergic reaction that can be life threatening. It causes swelling, hives, nausea, vomiting, and difficulty breathing after exposure to an allergen, such as wheat.

Treatment generally involves using epinephrine, a medication injected directly into your skin after the onset of anaphylaxis.

However, people who experience anaphylaxis should get emergency medical attention, even if they have self-administered epinephrine.

Which GRD do I have?

Below are some of the most distinctive symptoms of celiac disease, NCGS, and wheat allergy.

Remember that the symptoms of gluten intolerance, wheat allergy, and celiac disease often overlap, making it difficult to identify the cause. There are also many other conditions that can cause these symptoms.

The best way to get a diagnosis is to work closely with a doctor.

Getting a diagnosis

Since so many symptoms overlap between different GRDs, it can be difficult to determine which — if any — is responsible.

If you suspect you have one of these conditions, it’s helpful to first identify any links between your symptoms and specific foods you’re eating. Collecting information via a symptom diary is a good starting point.

You can make an appointment to discuss your findings with a doctor. Combining personal dietary insight with a comprehensive health exam may help lead to an accurate diagnosis.

Once you know your condition, you can make any diet changes knowing they are truly necessary.

The bottom line

Gluten-related disorders can cause a range of symptoms and are often difficult to identify. Know that you aren’t alone and that there are resources to help.

Speak with a doctor or dietitian for an accurate diagnosis, which will involve a comprehensive evaluation of your symptoms and potential testing. They can create a diet and lifestyle plan to help reduce your symptoms.

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