Are People With Celiac Disease More Prone to Early Death?

When you've just been told you've got celiac disease, a serious autoimmune condition, it's common (and normal) to question the condition's potential effects on your lifespan. In the vast majority of cases, celiac disease is not fatal in the way we normally think of fatal diseases—it won't progress and ultimately kill you.

According to the National Center for Advancing Translational Sciences, without diagnosis and treatment, celiac disease is ultimately fatal in 10-30% of people. However, this is very rare in modern times, because most people do well if they avoid gluten.

Here's what we know (and what we don't know) about your risk of early death if you have celiac disease.

Celiac Disease and Mortality Risk

A large research project that combined data from 17 different clinical studies concluded that people with celiac disease—including those diagnosed through an endoscopy and those diagnosed simply with positive celiac blood tests—were at a higher risk of early death from all causes, especially from non-Hodgkin lymphoma.

Celiac disease that doesn't respond to the gluten-free diet can progress to a particularly deadly type of lymphoma, so the finding that celiacs have a much higher-than-normal death rate from lymphoma isn't surprising. Overall, the risk of dying from any cause was only slightly higher than normal—but it was higher.

Generally speaking, people whose celiac disease is severe enough to put them in the hospital seem to fare worse overall.

A 2003 Swedish study published in the Archives of Internal Medicine found that, among 10,032 people hospitalized for celiac disease, there was a two-fold increased risk of early death compared to the general population. Those hospitalized for celiac alone had a 1.4-fold increased risk of early death.

The risks were highest in those hospitalized with additional diseases, including non-Hodgkin lymphoma, cancer of the small intestine, autoimmune diseases, allergic disorders such as asthma, inflammatory bowel diseases, diabetes, tuberculosis, pneumonia, and nephritis (a type of kidney disorder).

The researchers noted that this increased death risk may be due to reduced absorption of important nutrients, such as Vitamin A and Vitamin E. Still, when evaluating the results of this particular study, keep in mind that these people were much sicker than most people are at the time of diagnosis.

Interestingly, the study also found that babies and toddlers hospitalized with celiac disease before age 2 had a reduced death risk, possibly indicating a beneficial effect of starting the gluten-free diet very early.

Benefits of a Gluten-Free Diet

Benefits of a Gluten-Free Diet
Verywell / Ellen Lindner 

Not all studies contain bad news. In fact, two contain hints that following a very strict gluten-free diet could significantly reduce your risk of early death.

For example, one study found a lower-than-expected death rate in Finnish patients who had been diagnosed with dermatitis herpetiformis, a gluten-induced skin rash closely associated with celiac disease. The number of deaths should have totaled 110 over the course of the 39-year study; instead, only 77 people died.

In the study, most of those diagnosed with dermatitis herpetiformis also had villous atrophy (which means they had celiac disease in addition to their dermatitis herpetiformis).

There was one major difference in this study population when compared with other research: Some 97.7% of those included adhered strictly to the gluten-free diet, possibly because a super-strict diet is the only way to control the unbearable itching of dermatitis herpetiformis long-term.

Other studies have found far lower rates of diet adherence—ranging from 42% to 91%—in people with celiac disease (but not necessarily dermatitis herpetiformis).

The study didn't conclude that a strict gluten-free diet lowers death rates in people with celiac and dermatitis herpetiformis—it wasn't set up to answer that question. However, the authors speculated that a stricter diet may have played a role (and noted that the group's 97.7 percent diet adherence rate was exceptionally high).

Dietary Adherence and Health

Another study—this one from the Mayo Clinic College of Medicine—may indirectly back up the earlier hypothesis.

The Mayo research looked at 381 adults with the biopsy-proven celiac disease and found that those who were extremely careless or who cheated on their gluten-free diets had ongoing intestinal damage. Those whose small intestines had recovered (as confirmed by testing) had a lower death rate.

Cheating on the diet wasn't the only factor involved in ongoing damage and a higher death rate. Severe diarrhea and weight loss coupled with more severe intestinal damage at the time of diagnosis also appeared to play a role. In addition, the association between confirmed intestinal recovery and a reduced rate of death was only a weak one, the study reported.

Nonetheless, the researchers noted that ingestion of trace gluten—either through intentional cheating on the diet or gluten cross-contamination in supposedly "gluten-free" foods—could be to blame for ongoing intestinal damage in some people.

A Word From Verywell

Unfortunately, we can't conclude too much from these studies—there's a lot more research to be done before we can have firm answers on celiacs' death risks and how to improve the odds.

The studies do show a higher rate of early death among people with celiac disease, especially among those who were particularly sick at the time of diagnosis. Non-Hodgkin lymphoma, autoimmune diseases, and infections such as pneumonia accounted for many of those early deaths.

However, one or two studies hint that sticking to a super-strict gluten-free diet (strict enough to heal your intestinal villi or to abolish your dermatitis herpetiformis) may substantially lower your early death risk. Although the studies are far from definitive, this counts as one more good reason to faithfully follow your diet.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Center for Advancing Translational Sciences. Celiac disease.

  2. Tio M, Cox MR, Eslick GD. Meta-analysis: Coeliac disease and the risk of all-cause mortality, any malignancy and lymphoid malignancy. Aliment Pharmacol Ther. 2012;35(5):540-51. doi:10.1111/j.1365-2036.2011.04972.x

  3. Peters U. et al. Causes of death in patients with celiac disease in a population-based Swedish cohort. Archives of Internal Medicine. 2003 Jul 14;163(13):1566-72. doi:10.1001/archinte.163.13.1566

  4. Hervonen K, Alakoski A, Salmi TT, et al. Reduced mortality in dermatitis herpetiformis: a population-based study of 476 patients. Br J Dermatol. 2012;167(6):1331-7. doi:10.1111/j.1365-2133.2012.11105

  5. Rubio-tapia A, Rahim MW, See JA, Lahr BD, Wu TT, Murray JA. Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet. Am J Gastroenterol. 2010;105(6):1412-20. doi:10.1038/ajg.2010.10

Additional Reading

By Jane Anderson
Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet.