Celiac disease is an autoimmune disease that affects the digestive system. People who have celiac disease cannot tolerate gluten, the protein found in wheat, rye, and barley. Gluten may also be in other products, such as medicines, vitamins, lip balm, and the glue on stamps and envelopes.

When people with celiac disease eat foods that contain gluten, the immune system  responds by attacking the lining of the small intestine. When this happens, the body can’t absorb all the nutrients it needs. Over time, this can lead to other autoimmune diseases, like type 1 diabetes³ and multiple sclerosis,⁴ anemia,⁵ and osteoporosis,⁶ and other problems, such as miscarriages.⁷

Women with gluten intolerance have a similar reaction to foods with gluten as women with celiac disease do, but it is not as serious. Women with gluten intolerance do not test positive for celiac disease. Gluten intolerance also does not affect or damage the small intestine as celiac disease does.

But women with gluten intolerance also need to limit or avoid foods with gluten. Gluten intolerance causes symptoms similar to those of celiac disease, such as gas and bloating. You may also get headaches, fatigue, and depression.⁸ But these symptoms get better when you stop eating foods with gluten.

Foods with gluten include:

• Wheat (including wheat bran, germ, and cracked wheat)
• Barley
• Rye
• Triticale (a cross between wheat and rye)

Gluten can be found in breads and cakes but also in foods you might not expect, including lunch meats and canned soups. Learn more about eating and nutrition for celiac disease.

Yes. Celiac disease is genetic, meaning it can run in families. You may be more at risk for celiac disease if you have a close family member (such as a mother or sister) with celiac disease.

Symptoms of celiac disease include:

• Gas, diarrhea, and stomach pain, although these are less common in adults
• Unexplained iron-deficiency anemia
• Extreme tiredness or fatigue
• Depression or anxiety
• Missed menstrual periods
• Weight loss
• A very itchy skin rash with blisters
• Infertility (not being able to get pregnant). Studies suggest that untreated celiac disease may cause fertility problems.⁹
• Miscarriages

See your doctor or nurse if you have these symptoms. The longer celiac disease goes untreated, the greater the risk for long-term health problems.

If you have symptoms of celiac disease or have a family member with the disease, talk to your doctor or nurse. Your doctor may do one or both of the following to test for celiac disease:

• Blood test. Women with celiac disease have higher-than-normal levels of certain autoantibodies in their blood. Autoantibodies are proteins that react against your body’s cells or tissues.
• Biopsy of the small intestine. During the biopsy, your doctor uses a long, thin tube called an endoscope to look at your small intestine. He or she will remove tiny pieces of tissue from your intestine to look for damage.

Currently, there is no way to diagnose gluten intolerance. Your doctor may ask you to stop eating foods with gluten to see whether your symptoms get better. But do not stop eating foods without gluten without first talking to your doctor or nurse.

The only treatment for celiac disease and gluten intolerance is to eat gluten-free foods.

Getting used to gluten-free eating may seem overwhelming at first. Work with a dietitian and your doctor, and consider joining a support group to help you with planning menus, shopping, and making choices when eating out.

Some health problems linked to celiac disease include:

• Infertility (not being able to get pregnant). Studies suggest that untreated celiac disease may cause fertility problems.⁹
• Iron-deficiency anemia
• Bone loss, which can lead to osteoporosis
• Migraines
• Asthma
• Menstrual problems 
• Depression

Most women following a gluten-free eating plan have healthy pregnancies and babies.

However, celiac disease has been linked to some pregnancy complications, including:¹⁰

• Miscarriages
• Low birth weight babies (less than 5½ pounds)
• Preterm birth (also called premature birth), or childbirth before 37 weeks of pregnancy

Most often, these problems happened in women who did not know they had celiac disease.

For more information about celiac disease and gluten intolerance, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:

• Celiac Disease Symptoms, Testing & Diet — Information from Beyond Celiac.
• Live Gluten-Free — Information from the Celiac Disease Foundation.
• Living With Celiac Disease — Information from Beyond Celiac. 
• What is celiac disease? — Information, symptom checklist, and recipes from the Celiac Disease Foundation.

1. Megiorni, F., Mora, B., Bonamico, M., Barbato, M., Montuori, M., Viola, F., et al. (2008). HLA-DQ and susceptibility to celiac disease: evidence for gender differences and parent-of-origin effects. American Journal of Gastroenterology; 103(4): 997-1003.
2. Martinez, S.W. (2013). Introduction of New Food Products With Voluntary Health- and Nutrition-Related Claims, 1989-2010. Economic Information Bulletin no. EIB-108. Washington, DC: U.S. Department of Agriculture, Economic Research Service.
3. Cohn, A., Sofia, M.A., Kupfer, S.S. (2014). Type 1 Diabetes and Celiac Disease: Clinical Overlap and New Insights into Disease Pathogenesis. Curr Diab Rep; 14(8): 517.
4. Rodrigo, L., Hernandez-Lahoz, C., Fuentes, D., Alvarez, N., et al. (2011). Prevalence of celiac disease in multiple sclerosis. BMC Neurology; 11:31.
5. Freeman, H.J. (2015). Iron deficiency anemia in celiac disease. World Journal of Gastroenterology; 21(31): 9233-9238.
6. Larussa, T., Suraci, E., Nazional, I., Abenavoli, L., Imeneo, M., Luzza, F. (2012). Bone Mineralization in Celiac Disease. Gastroenterology Research and Practice; 2012: 198025.
7. Moleski, S.M., Lindenmeyer, C.C., Veloski, J.J., Miller, R.S., Miller, C.L., Kastenberg, D., et al. (2015). Increased rates of pregnancy complications in women with celiac disease. Annals of Gastroenterology; 28(2): 236-240.
8. Zingone, F., Swift, G.L., Card, T.R., Sanders, D.S., Ludvigsson, J.F., Bai, J.C. (2015). Psychological morbidity of celiac disease: A review of the literature. United European Gastroenterology; 3(2): 136-145.
9. Casella, G., Organotti, G., Giacomantonio, L., Di Bella, C., Crisafulli, V., Villanacci, V., et al. (2016). Celiac disease and obstetrical-gynecological contribution. Gastroenterology and Hepatology from Bed to Bench; 9(4): 241–249.
10. Salvatore, S., Finazzi, S., Radaelli, G., Lotzniker, M., Zuccotti, G.V., Premacel Study Group. (2007). Prevalence of undiagnosed celiac disease in the parents of preterm and/or small for gestational age infants. American Journal of Gastroenterology; 102(1): 168-173.