Celiac Disease and Asthma

The Roles of Inflammation and Management

Celiac disease and asthma may seem unrelated. Though their connection is tenuous, they do share an association with overactive inflammation. While neither condition has been shown to cause the other, research suggests that there's a 1.5-fold higher risk of asthma in people with celiac disease. And having asthma increases your chances of having celiac disease as well.

Better management of celiac disease rarely has a major direct impact on asthma, and vice versa. But it can alleviate the overall burden on your health—therefore, helping to improve both conditions.

Young boy using inhaler
Jose Luis Pelaez / Getty Images

Possible Connections

Asthma is a lung illness and celiac disease is a gastrointestinal disorder, and experts agree that there are many unanswered questions when it comes to the reason behind their curious, albeit fairly weak relationship.

There are several possible explanations, including genetic susceptibility and an overactive immune system. Recognition of possible co-existing illnesses can guide your healthcare providers to screen for symptoms and catch them early.


Asthma and celiac disease are correlated with similar genetic variations, and having these alterations may increase the risk of having both disorders together, especially during childhood.

Gene testing isn't a customary part of the diagnosis of either disease, so it's unlikely that an individual diagnosed with asthma or celiac disease would know they are at increased risk of the other.

Inflammatory and Autoimmune Disorders

Increased general inflammation in the body and a tendency toward autoimmunity is thought to play a role in both conditions and their association with one another. In fact, allergies and inflammatory diseases like diabetes and thyroid disease occur more frequently when you have celiac disease or asthma.

Asthma and celiac disease themselves are sometimes considered autoimmune conditions, in which the body's immune system attacks its own healthy tissue. Asthma is associated with an increased incidence of other autoimmune conditions, including celiac disease.

Some genetic variations that are associated with asthma and celiac disease specifically direct certain components of the immune system.

Interestingly, attention deficit hyperactivity disorder (ADHD) is also associated with an increased risk of celiac disease or asthma—but the reason isn't known.

Compounding Effects of Fatigue

The symptoms of celiac disease and asthma are different. But when you have both celiac disease and asthma, you can experience substantial fatigue, especially if neither of them is well controlled.

Asthma is characterized by shortness of breath, wheezing, chest tightness, and a chronic cough. When your asthma symptoms worsen, you can feel tired due to the increased effort of breathing, sleep disturbance, and low oxygen.

Celiac disease symptoms include abdominal discomfort, diarrhea, weight loss, and more. Aside from feeling depleted as a result of these symptoms, celiac disease can cause poor absorption of nutrients, leading to fatigue from malnutrition.

Add to this the burden of dealing with severe asthma or refractory celiac disease while managing other aspects of your health and it's easy to picture just how significant the resulting fatigue can be.

Feeling tired and out of energy can be a sign that your celiac disease, your asthma, or both are either flaring and/or poorly controlled.

Impact of Dietary Management

Since celiac symptoms result from an immune reaction to gluten—a protein found in most grains—the disease is primarily treated with a gluten-free diet.

While asthma is treated with medication, avoiding triggers is also important. If some of your asthma triggers are dietary, steering clear of them can help prevent asthma exacerbations.

The inflammation underlying both asthma and celiac disease is at the heart of using diet as a prevention strategy for both.

This does not mean that keeping one condition in check directly impacts the other (e.g., it's possible for your asthma, but not your celiac disease, to be well-controlled). Rather, by tempering inflammation tied to your asthma or celiac, you may be reducing the overall impact of inflammation and its other effects on the body.

Gluten-Free Diet

Staying gluten-free means completely eliminating gluten in the form of wheat, rye, barley, and sometimes oats. However, those with celiac disease don't need to automatically avoid rice, corn, millet, sorghum, quinoa, and certain other grains.

Asthma is not associated with gluten, but when you have celiac disease, gluten causes diarrhea, stomach upset, and inflammation. While lung inflammation is a trigger of asthma symptoms, researchers have suggested that gastrointestinal inflammation might be to a limited extent as well, although that hasn't been confirmed.

And the stress of gluten-induced celiac disease symptoms can worsen your asthma because stress contributes to asthma.

It is crucial that you avoid foods that exacerbate your celiac disease. If you have asthma or another a co-existing illness along with your celiac disease, gastrointestinal issues can worsen your other condition.


Sometimes asthma can be triggered or exacerbated by allergens, including food. Asthma triggers of any kind induce airway inflammation and bronchoconstriction (narrowing of the airways).

Resulting inflammation may not be restricted to your respiratory system in terms of its effects. When a food also causes an inflammatory intestinal response, it can trigger an upset stomach and diarrhea—only adding to the effects of celiac disease.

Avoid foods that provoke your asthma or your celiac disease, even if they aren't on a list of common triggers.

It's also worth pointing out that any food allergy, like a gluten allergy, can cause problems like wheezing and difficulty breathing. That is, you could experience respiratory issues due to your celiac disease that are not indicative of asthma.

You should talk to your healthcare provider about any serious food reaction that you experience so you know what you need to do if it happens again.

Nutritional Supplementation

Even with your best attempts at managing your celiac disease with dietary restriction, you might have persistent intestinal changes and issues with malabsorption. Malnutrition has a number of negative consequences for your overall health, and there may also be a link between asthma and inadequate nutrition.

Vitamin D deficiency, for example, is associated with asthma. And some of the nutritional deficits that result from celiac disease can cause illness or might make it hard for you to fight infections—and this could worsen your asthma.

The key is to talk to your healthcare provider about your nutrition. If you need supplements to augment the nutrients you're getting from your diet, your practitioner might prescribe or recommend specific vitamins to compensate for those you are lacking.

A Word From Verywell

Living with two chronic diseases isn't easy. You or your child might be diagnosed with asthma and celiac disease. Each of these conditions produces a variety of symptoms and both lead to low energy. It can be a huge challenge when the effects are compounded. Managing celiac disease and asthma together requires following medical advice and being mindful of your own triggers and exacerbating factors.

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