Celiac disease is one of a group of conditions classified as autoimmune disorders because the body’s immune system turns on itself. But instead of having a certain set of symptoms, it can manifest itself in a dizzying number of ways.
The problems start because the villi, tiny, finger-like projections in the small intestine that act as guardians into the digestive system’s inner sanctum, do not distinguish between gluten and other nutrients crucial to your health.
The damage is exacerbated because it often takes years for celiac disease to be definitely diagnosed. Happily, in some of the cases, symptoms can be reversed or at least relieved. Some of the more common conditions associated with celiac disease include:
Dermatitis Herpertiformis
Do you have a red, itchy, burning rash on your elbows, knees or buttocks? Or maybe it is on the nape of your neck, your upper back or in your scalp? Dermatitis Herpertiformis, or DH, is often misdiagnosed as herpes, eczema, hives, psoriasis or contact dermatitis.
DH affects about 10 per cent of people with celiac disease, or about one in every 1,000 and tends to occur between the ages of 20 to 45. But it is hard to catch because many sufferers have few or none of the bowel problems normally associated with celiac disease.
In fact, the only way to diagnose DH is through a biopsy from clear skin near the blisters or lesions. If that test proves positive, it is not necessary to confirm the finding though a biopsy on the small intestine, usually the final step before celiac disease is diagnosed. Although an antibiotic is used to relieve the symptoms, the only treatment to stem and reverse the damage being done inside your body is to go on a gluten-free diet.
Infertility
You’re trying to get pregnant but nothing works. Your doctor says everything seems normal and to be patient, or that maybe it is time for you to consider in vitro fertilization and other options.
Stop; before you go there, have you been screened for celiac disease? Although the link between infertility and celiac disease is still under study, a growing body of research supports the view that celiac disease can actually cause infertility.
The situation is thought to be reversible after patients go gluten-free. Consider the story of Elisabeth Hasselbeck, who spent two years trying to pregnant; she’d had longstanding health problems but it wasn’t until after she became a patient of Dr. Peter Green of The Celiac Disease Center in New York City that things changed. He diagnosed her celiac disease and showed her where sneaky gluten could hide.
Now, she is a mom three times over and an example for an untold number of others in a similar position.
Osteoporosis
Think of osteoporosis and you tend to think of it as a disease of the elderly, with bones that have become fragile and are easily broken. You think of that great aunt who broke her hip after a simple fall against the kitchen counter, or the granddad who fractured his elbow after a slip in the bath. But due to a triple autoimmune whammy, osteoporosis can strike much earlier if you have celiac disease.
First, the disease affects the absorption rate into the body of fat, carbohydrates, vitamins and minerals that are vital for bone growth and the ability to heal. Second, damage to the small intestine means that more cytokines (small proteins) are released into the bloodstream, which happens to encourage bone loss.
Finally, studies indicate that the immune system’s attacks may be targeting both the small intestine and the bones. What to do? If celiac disease is diagnosed during childhood, switching to a gluten-free diet may be enough to prevent further bone loss and allow for bone growth to meet skeletal needs later in life.
If the diagnosis is later, it is not clear if full bone recovery is possible. But you can probably increase your bone mass as long as you go gluten-free. Consult with your doctor about incorporating drugs and/or calcium supplements and vitamins into your diet.
Type 1 diabetes
Type 1 diabetes, long known as juvenile diabetes, is an autoimmune disorder that occurs when the immune system destroys insulin-producing cells in the pancreas. According to statistics from the American Diabetes Association, an estimated one in every 20 people with type 1 diabetes also has celiac disease. Compare that to the rate in the general population, which is only one in 100!
One theory, presented in a study published in the New England Journal of Medicine in 2008, is that almost every gene associated with celiac disease is also implicated in type 1 diabetes.
Another school of thought is that some people may have undiagnosed cases of celiac disease that lead to the development of type 1 diabetes. Whatever the link, it is not easy to adapt a regime to keep one’s blood sugar levels in line with a gluten-free diet.
Make sure you consult with a dietitian well-versed in celiac disease because the level of carbohydrates, proteins and fats in gluten-free foods can differ greatly from those made with wheat products. And make sure you follow up with the dietitian on a regular basis, since this is not an easy combination of conditions to manage.
Neurological/psychological disorders
Celiac disease affects the central nervous system, which means that sometimes, the symptoms are not what you would expect. You could be extremely irritable or depressed. You may exhibit schizophrenic-like behavior.
In children, the symptoms can be mistaken for autism, as in the case of a 5 year-old Alberta boy whose physical and behavioral development had been normal until he was 2, when he changed. He struck out, was picky with food, had problems communicating, was tired and suffered from itchiness and painful bloating. But his parents refused to accept the initial diagnosis of severe autism.
They brought him to an Edmonton specialist who noticed the boy ate a diet high in wheat products and ordered a nutritional assessment. It turned out the boy was deficient in vital, fat-soluble vitamins such as A, D and E, in omega-3 fatty acids and polyunsaturated omega-6 fatty acids, in coenzyme Q10, necessary for the basic functioning of cells, and in folate, a lack of which of which can lead to depression, weight loss and other behavioral disorders.
Further blood tests for antibodies indicative of celiac disease proved positive. After gluten was eliminated from his diet, his behavior rapidly changed and he was integrated into a regular school class. The moral of this story? Keep an open mind.
