VIDA LAB by Rowan Albritton
Sign in
Back to Library
gastrointestinal

Celiac Disease

An autoimmune response to gluten that damages the small intestine and impairs nutrient absorption.

Save to favorites
In this report
  1. Overview
  2. Symptoms
  3. Diagnosis
  4. Treatments
  5. Medical Resources
  6. Your Care Plan

Overview

Celiac disease is a serious autoimmune condition in which eating gluten — a protein found in wheat, barley, and rye — triggers an immune response that damages the lining of the small intestine. Specifically, the immune system attacks the villi, the tiny finger-like projections that line the intestine and absorb nutrients. Over time, this damage leads to malabsorption of nutrients.

Celiac disease affects about 1% of the population and can develop at any age. It is strongly associated with other autoimmune conditions, particularly type 1 diabetes and autoimmune thyroid disease. It is a genetic condition — you must have the HLA-DQ2 or HLA-DQ8 gene to develop it, though having the gene doesn't guarantee you will.

The only treatment is a strict, lifelong gluten-free diet. Even small amounts of gluten can trigger intestinal damage, even if symptoms aren't immediately noticeable. With strict dietary adherence, the intestine typically heals and symptoms resolve.

Symptoms

  • Digestive symptoms: bloating, gas, diarrhea, constipation, or alternating patterns
  • Unexplained weight loss
  • Fatigue and weakness
  • Iron-deficiency anemia that doesn't respond to iron supplements
  • Bone or joint pain
  • Dermatitis herpetiformis — an intensely itchy, blistering skin rash
  • Mouth ulcers
  • Headaches
  • Tingling or numbness in hands and feet
  • Depression or anxiety
  • Unexplained infertility or recurrent miscarriages
  • In children: failure to thrive, delayed puberty, short stature

Diagnosis

  1. Blood tests for celiac antibodies — tTG-IgA (tissue transglutaminase IgA) is the primary test; also EMA (endomysial antibodies) for confirmation
  2. Total IgA level — to rule out IgA deficiency, which can cause false-negative tTG-IgA results
  3. Upper endoscopy with intestinal biopsy — the gold standard for diagnosis; shows villous atrophy and other characteristic changes
  4. Genetic testing — HLA-DQ2/DQ8 can rule out celiac if negative, but can't confirm it

Important: Do not start a gluten-free diet before testing, as it can cause false-negative results.

A gastroenterologist performs the endoscopy and biopsy.

Treatments

  • Strict lifelong gluten-free diet — the only treatment; eliminates all wheat, barley, rye, and their derivatives
  • Dietitian consultation — to learn hidden sources of gluten, cross-contamination prevention, and balanced nutrition
  • Vitamin and mineral supplementation — to correct deficiencies (iron, calcium, vitamin D, B vitamins, folate)
  • Dermatitis herpetiformis treatment — dapsone medication may be needed for the skin rash alongside the gluten-free diet
  • Bone density scan — to check for osteoporosis or osteopenia, which can result from long-standing malabsorption
  • Regular follow-up — antibody levels should normalize on a strict gluten-free diet; persistent elevation suggests ongoing gluten exposure
  • First-degree relative screening — parents, siblings, and children should be tested due to genetic predisposition

Your Care Plan

A step-by-step guide to navigating your condition, from finding the right doctors to advocating for the care you deserve.

Step 1: Doctors to See

Start with: Your primary care physician for blood tests (tTG-IgA and total IgA).

Then seek: A gastroenterologist for endoscopy and biopsy to confirm the diagnosis.

Build your team:

  • Gastroenterologist — for diagnosis and ongoing monitoring
  • Registered dietitian — specializing in celiac disease for dietary guidance
  • Dermatologist — if dermatitis herpetiformis is present
  • Endocrinologist — to screen for associated thyroid disease or type 1 diabetes

Step 2: Advocate for Yourself

Do not start a gluten-free diet before blood tests and biopsy — it will cause false-negative results. If your blood test is positive but your doctor doesn't recommend a biopsy, ask for a gastroenterology referral — biopsy is the gold standard. If you've been gluten-free for a while and want to be tested, you may need a 'gluten challenge' (eating gluten for 2–8 weeks before testing) — discuss this with a gastroenterologist.

Step 3: Your Action Plan

  1. Get blood tests (tTG-IgA and total IgA) BEFORE starting a gluten-free diet.
  2. If positive, see a gastroenterologist for an endoscopy and biopsy.
  3. Once confirmed, meet with a dietitian who specializes in celiac disease.
  4. Begin a strict gluten-free diet and learn to read labels for hidden gluten.
  5. Get baseline vitamin and mineral levels checked; supplement as needed.
  6. Request a bone density scan to check for osteoporosis.
  7. Encourage first-degree family members to get tested.
  8. Recheck antibody levels after 6–12 months on the diet to confirm healing.

Important: This report is educational information, not medical advice. Always consult a qualified healthcare professional for diagnosis and treatment decisions.

Have questions about your condition?

Talk to Vida.

She can explain research, symptoms, and terminology in plain language — and point you toward VIDA LAB explainers.

Ask Vida →