Coeliac disease is an autoimmune condition where eating gluten (a protein in wheat, barley and rye) triggers an immune response that damages the lining of the small intestine. That damage can stop your body properly absorbing nutrients, leading to a range of symptoms that don’t always scream “gut problem” and for some people no symptoms at all. It’s more common in women than men and can show up at any age and affects people of all ages.
Getting an accurate diagnosis matters. Treating coeliac disease with a strict gluten‑free diet prevents ongoing gut damage, reduces long‑term risks (like low bone density, infertility and nutrient deficiencies), and often helps symptoms that affect daily life — fatigue, fertility issues, skin problems, mood changes and more. Importantly, you should be tested before you start a gluten‑free diet; stopping gluten can make tests unreliable.
Here are six signs that might point to coeliac disease.
1. Low Iron Could Be a Sign of Coeliac Disease
What you might notice: Tiredness, low immune system, bruising easily, dark circles under eyes, irregular period, shortness of breath doing simple things, pale skin or weak nails.
Why it’s linked: The upper small intestine is where iron is absorbed. Damage from untreated coeliac disease often reduces iron absorption, so iron deficiency can be one of the first clues - sometimes the only clue.
What to do: If you have unexplained iron deficiency, ask your GP to check for coeliac disease. Don’t start a gluten‑free diet before testing.
2. How Coeliac Disease Can Affect Bone Density and Osteoporosis/Osteopenia Risk
What you might notice: No immediate symptoms until a fracture happens; generalised low bone density on a DEXA scan, or fractures with minimal trauma.
Why it’s linked: Malabsorption of calcium and vitamin D, chronic inflammation and delayed diagnosis all increase risk. Women are already at higher risk of osteoporosis, so coeliac disease can accelerate bone loss.
What to do: If you have unexplained low bone density, especially at a younger age than expected, ask about coeliac screening. Management may include a strict gluten‑free diet, ensuring adequate calcium and vitamin D, and liaising with your GP or endocrinologist about bone protection.
3. Persistent Bloating and Gut Symptoms? It Could Be Coeliac Disease
What you might notice: Recurrent bloating, diarrhoea, constipation, wind, stomach pain or abdominal pain. Symptoms may come and go and might be triggered by particular foods.
Why it’s linked: The intestinal damage and inflammation in coeliac disease commonly cause gut symptoms. Because IBS is common, coeliac can be missed unless specifically tested for.
What to do: If gut symptoms persist for weeks to months, or if they’re accompanied by weight loss, low iron or family history of coeliac disease, ask for coeliac serology. Again — stay on gluten until testing is complete.
4. Could Coeliac Disease Be Affecting Fertility and Pregnancy?
What you might notice: Difficulty conceiving, early pregnancy loss, irregular periods or other reproductive issues without an obvious cause.
Why it’s linked: Nutrient deficiencies (iron, folate, selenium), chronic inflammation and autoimmune associations can affect fertility and pregnancy outcomes. Some women see improvement in conception and pregnancy health after diagnosis and treatment.
What to do: If you’re having unexplained fertility problems or recurrent miscarriage, talk to your GP or fertility specialist about coeliac screening as part of the workup.
5. Fatigue, Brain Fog and Low Mood: Hidden Symptoms of Coeliac Disease
What you might notice: Ongoing tiredness, brain fog, low mood or anxiety that doesn’t improve with sleep or lifestyle changes.
Why it’s linked: Nutrient deficiencies (iron, B12, folate), chronic inflammation and the impact of chronic illness all contribute to fatigue and mood changes in coeliac disease. Symptoms can be subtle and attributed to stress or busy life, particularly in women juggling work and family.
What to do: If fatigue is persistent despite reasonable sleep, activity and diet, include coeliac testing in your bloodwork. Treating the underlying condition often significantly improves energy and mental well‑being.
6. Unexplained Weight Loss and Coeliac Disease: What to Look For
What you might notice: Losing weight without trying — clothes becoming looser, a drop on the scales over weeks or months despite no deliberate diet or increased activity.
Why it’s linked: Damage to the small intestine reduces nutrient and calorie absorption. Persistent diarrhoea, malabsorption of fats and proteins, and reduced appetite from ongoing gut symptoms can all cause gradual weight loss.
What to do: If you’ve lost weight unintentionally, especially alongside gut symptoms, fatigue or nutrient deficiencies, ask your GP for coeliac disease. Don’t start a gluten‑free diet before testing. If diagnosis is confirmed, a dietitian can help restore healthy weight and correct nutrient deficits while you follow a gluten‑free plan.
A few practical notes
- Family history: First-degree relatives (parents, siblings, or children) of someone with coeliac disease have a significantly higher risk, with about a 1 in 10 (10%) chance of developing the condition themselves. Get tested if a family member is diagnosed.
- Testing: The usual first step is blood tests —Don’t remove gluten from your diet before testing, as this can cause false‑negative results.
- If you’re already on a gluten‑free diet: Testing can be tricky. If you can’t reintroduce gluten, discuss specialist testing options with your doctor
- Management: The only current treatment is a lifelong strict gluten‑free diet. A dietitian experienced with coeliac disease can help with safe food choices, preventing nutrient gaps and navigating eating out or social situations.
- When to see someone: See your GP if you have any of the signs above, a close family member with coeliac disease, or multiple unexplained blood test abnormalities (iron, B12, low calcium or vitamin D).
Coeliac disease can look very different from person to person. If you’ve had persistent digestive symptoms, unexplained iron deficiency, unintentional weight loss, skin rash, fatigue or other unexplained signs on the list above, make an appointment with your GP and ask about coeliac disease testing. Early diagnosis helps protect your long‑term health and can get you feeling better sooner. It is recommended to see a dietitian as soon as you are diagnosed to help you navigate a healthy and nutritionally balanced gluten-free diet.
