Celiac Disease: What to Watch For and How to Manage It

Could gluten be the reason you feel tired, bloated, or have unexplained anemia? Celiac disease is an autoimmune reaction to gluten that damages the small intestine and can show up with lots of different signs. Some people have gut symptoms, others feel brain fog, joint pain, skin rashes, or mood changes. Knowing the common clues makes it easier to get the right tests and start treatment.

Common Symptoms and Who's at Risk

Typical symptoms include chronic diarrhea or constipation, bloating, gas, unintentional weight loss, and fatigue. Kids may have slow growth, delayed puberty, or irritability. Look out for iron-deficiency anemia that doesn’t respond to iron pills, unexplained bone loss, or dermatitis herpetiformis (an itchy, blistering skin rash). If you have type 1 diabetes, autoimmune thyroid disease, or a close family member with celiac, your chance is higher.

Not everyone looks sick. Some people have mild or no gut symptoms but still have intestinal damage. That’s why testing matters when symptoms or risk factors are present.

Tests, Diagnosis and What Not to Do Before Testing

Doctors usually start with blood tests that check celiac-specific antibodies (like tissue transglutaminase IgA). If blood tests suggest celiac, an endoscopy with a small intestine biopsy is often done to confirm the diagnosis. Genetic tests (HLA-DQ2/DQ8) can help rule it out if results are negative.

Important: do NOT start a gluten-free diet before testing. Removing gluten can make tests come back normal and hide the problem. If you've already cut gluten, talk to your doctor—there are ways to test safely, like gluten challenge protocols.

If you’re diagnosed, your main treatment is a strict, lifelong gluten-free diet. That means avoiding wheat, barley, rye, and any foods made with them unless labeled gluten-free.

Practical tips: always read labels, look for certified gluten-free marks, and watch for hidden gluten in sauces, processed foods, and supplements. Oats are tricky—choose oats labeled gluten-free, since regular oats can be cross-contaminated. When eating out, ask how food is prepared and whether they avoid cross-contact with shared fryers or cutting boards.

Follow-up matters. Your doctor will monitor symptoms, check for nutrient deficiencies (iron, B12, vitamin D), and may repeat blood tests to confirm the diet is working. A registered dietitian who knows celiac disease can make shopping and meal planning a lot easier.

Complications are rare when you follow a strict gluten-free diet, but untreated celiac can lead to ongoing nutrient problems, weaker bones, and higher risk for some other conditions. If symptoms persist despite a gluten-free diet, talk to your healthcare team—re-checking the diagnosis and looking for accidental gluten exposure are common next steps.

Bottom line: if you suspect celiac disease, get tested before you change your diet, work with your doctor and dietitian, and take small practical steps—label reading, safe oats, and asking the right questions at restaurants—to protect your gut and feel better.