Potential Complications of a New Celiac Disease Diagnosis

Malnutrition, Infertility Are Common in New Celiac Patients

If you've recently been diagnosed with celiac disease, you've certainly got your hands full learning the gluten-free diet. But you may not realize that you may have some additional medical worries that are common to newly diagnosed celiacs.

Here's a list of potential medical problems you may need to watch for and potentially treat. In addition, I recommend you peruse this list of questions to ask your doctor after your celiac disease diagnosis to get more information on your future medical needs.

You May Have Malnutrition

Woman reading nutritional label on container at grocery store

It doesn't matter how much healthy food you were eating prior to your diagnosis—when you have untreated celiac disease, your body simply can't absorb the nutrients in much of the food. Therefore, your body wasn't getting much of the fuel from the food you were eating, and you may suffer from malnutrition and deficiencies, especially in a few key vitamins and minerals. You're particularly likely to be deficient in iron, vitamin D, calcium, folate, and vitamin B-12.

Since your body should begin absorbing nutrients again once you start the gluten-free diet, you may resolve some of these deficiencies on your own, although this may take several months or more. Because of this, you also may want to talk to your healthcare provider about taking supplements to bring your levels up more quickly—just make sure you use only gluten-free vitamins.

You May Be at Risk for More Autoimmune Diseases

Ariel Skelley/Getty Images

You probably know that celiac disease is what's known as an autoimmune disease. That means it's a condition in which your own immune system, in the form of your own white blood cells, attacks your own tissue (in this case, the lining of your small intestine).

A few medical studies indicate that people with untreated celiac disease risk developing additional autoimmune conditions. The autoimmune conditions most closely associated with celiac include autoimmune thyroid disease, psoriasis, Sjögren's syndrome, type 1 diabetes, and rheumatoid arthritis, although others also may be related.

Research indicates that keeping to a strict gluten-free diet following your diagnosis may help reduce your risk of developing an additional autoimmune disease. In addition, some people find that adopting a gluten-free diet helps their already-diagnosed autoimmune conditions—for example, if you have chronic psoriasis, you may discover that it clears up or at least improves when you go gluten-free.

You May Suffer From Reproductive Problems

Empty crib with teddy bear next to it
Peter Dazeley/Getty Images

Many people with untreated celiac disease—both men and women—suffer from infertility. However, there's good news if you're one of these people—infertility seems to reverse, at least in some cases, after you follow the gluten-free diet for a while.

It's also pretty common for undiagnosed celiac women to have painful menstrual periods or to suffer from endometriosis (see my article on celiac disease and pelvic pain for more information). Again, in many cases, these symptoms improve or clear up completely on the gluten-free diet.

Finally, did you know that celiac disease can impact your sexuality? Well, it can, and research shows that sticking to your diet may help improve your sex life.

You May Have Elevated Liver Enzymes

Illustration of the liver organ

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It's not at all unusual for someone who's newly diagnosed with celiac disease to be told she has elevated liver enzymes. However, in most cases, these elevated enzymes, which usually are discovered as part of routine blood work, don't indicate a serious problem with your liver. They should revert to normal once you've been gluten-free for a while.

A few celiacs have more serious liver diseases, including non-alcoholic fatty liver disease and autoimmune hepatitis. Although research is scanty, there's some evidence that—guess what?—going gluten-free and sticking to the diet can halt or even reverse these serious liver conditions.

You May Feel Depressed

Woman hunched over in her bed
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People with celiac disease suffer from symptoms of depression at a much higher rate than the general population. It's not entirely clear why, although it's possible the culprit could be intestinal malabsorption that leads to deficiencies in key nutrients in your neurological system.

Many people find their mood improves dramatically as soon as they adopt a gluten-free diet. However, studies show that you need to follow the diet strictly in order to keep your mood up, and it's not uncommon for diagnosed celiacs—even those who have been on the diet for a long time—to suffer from recurrent depression when they get glutened. If you find after some time on the diet that this happens to you, it may help you to look for places where gluten cross-contamination may be sneaking in.

You May Have (Temporary) Lactose Intolerance

Glass of milk with a caution tape wrapped around it
Colleen Butler/Getty Images

Lactose intolerance is extremely common in people who have just been diagnosed with celiac disease. That's because the tips of our villi—those tiny, finger-like projections in our small intestines—digest lactose, or milk sugar. Those villi tips are the first things to erode away as celiac disease destroys our intestinal linings.

In fact, many of us knew we were lactose intolerant long before we were diagnosed with celiac disease; lactose intolerance frequently represents an early sign of celiac disease.

There's good news, though: it's possible—even likely—that your tolerance of lactose will return once your intestinal lining starts to heal on the gluten-free diet. That doesn't mean you should run out and buy a gallon of milk to drink right away; instead, try to take it slowly and experiment with small amounts of lactose in your diet to see how much you can tolerate.

You Almost Certainly DON'T Have Cancer

Woman looking with doctor on laptop
Dan Dalton/Getty Images

Cancer is a frightening specter, and it's one that can come to mind easily when you're ill and don't know what's wrong. Once you're diagnosed with celiac disease, you'll hear that having untreated celiac disease raises the risk of certain cancers, most notably lymphoma but also other types of cancer and many new celiacs fear developing these cancers.

Still, the risk of cancer in people with celiac disease actually is really small (even though it's greater than the risk of the general population). In addition, once you've been following the gluten-free diet for five years, your risk reverts to that of the general population, meaning you're no more or less likely to be diagnosed with cancer as anyone else.

However, lack of adherence to the gluten-free diet may increase your risk of cancer. As well as increasing the of risk of some of the other potential health problems I've mentioned. Therefore, if there's one bit of advice I'd like to give you as a new celiac, it's: Please Don't Cheat. Cheating can really impact your health.

11 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. Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patientsNutrients. 2013;5(10):3975–3992. doi:10.3390/nu5103975

  2. Celiac Disease Foundation. Autoimmune disorders.

  3. Lauret E, Rodrigo L. Celiac Disease and Autoimmune-Associated ConditionsBioMed Research International. 2013;2013:1-17. doi:10.1155/2013/127589

  4. Freeman HJ. Reproductive changes associated with celiac diseaseWorld J Gastroenterol. 2010;16(46):5810–5814. doi:10.3748/wjg.v16.i46.5810

  5. Stephansson O, Falconer H, Ludvigsson JF. Risk of endometriosis in 11 000 women with celiac diseaseHuman Reproduction. 2011;26(10):2896-2901. doi:10.1093/humrep/der263

  6. Zingone F, Siniscalchi M, Carpinelli L, Iovino P, Zingone L, Ciacci C. The Celiac Disease Patients’ Ability to Experience PleasureGastroenterology Research and Practice. 2019;2019:1-5. doi:10.1155/2019/2030751

  7. Kwiatek-Średzińska KA, Kondej-Muszyńska K, Uścinowicz M, Werpachowska I, Sobaniec-Łotowska M, Lebensztejn D. Liver pathology in children with newly diagnosed celiac diseaseClin Exp Hepatol. 2019;5(2):129–132. doi:10.5114/ceh.2019.84783

  8. Zingone F, Swift GL, Card TR, Sanders DS, Ludvigsson JF, Bai JC. Psychological morbidity of celiac disease: A review of the literatureUnited European Gastroenterol J. 2015;3(2):136–145. doi:10.1177/2050640614560786

  9. Lerner Aaron, Wusterhausen Patricia, Ramesh Ajay, Matthias Torsten. Celiac Disease and Lactose IntoleranceInternational Journal of Celiac Disease. 2018;6(3):68-70.

  10. Han Y, Chen W, Li P, Ye J. Association Between Coeliac Disease and Risk of Any Malignancy and Gastrointestinal Malignancy: A Meta-AnalysisMedicine (Baltimore). 2015;94(38):e1612. doi:10.1097/MD.0000000000001612

  11. Caio, G., Volta, U., Sapone, A. Celiac disease: a comprehensive current reviewBMC Med. 2019;17. doi:10.1186/s12916-019-1380-z

Additional Reading

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