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Silent Celiac Disease: Symptoms & Causes

Medically reviewed on Sept 30, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


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Celiac disease is an immune disorder triggered by gluten consumption that damages the digestive system, the small intestine specifically. Two million Americans are estimated to have it, but research suggests celiac is underreported as few people are familiar with the symptoms of untreated celiac disease (and symptoms themselves can be unevenly distributed between cases). [1]

Interestingly, there’s also a type of celiac disease known as “silent” celiac disease. [2] This is a generic term for celiac disease that does not present with any observable symptoms. Typically, people with silent celiac disease don’t discover they have the condition until they’re clinically tested.

Healthcare providers may also refer to silent celiac disease as subclinical or asymptomatic celiac disease. [1] Below, we’ll touch on why certain people may not know they have celiac disease, as well as options for asymptomatic celiac disease diagnosis and treatment.

Why Are Some People Who Have Celiac Disease Asymptomatic?

When a person with symptomatic celiac disease eats gluten, they typically notice digestive symptoms like [1]:

  • Abdominal pain
  • Bloating, gas, and flatulence
  • Nausea and vomiting
  • Diarrhea or constipation
  • Fatigue

Undiagnosed and untreated celiac disease can impact other areas of the body if a person continues to consume gluten, triggering weight loss, persistent headaches, brain fog, skin rashes, and even more severe symptoms like nerve damage. [3]

Despite the severity of celiac disease, some people who have it experience no symptoms at all.1 Or, their symptoms are so heterogeneous that their healthcare provider may not recognize them as markers of celiac disease.

Several theories have been posed as to why some people experience hidden symptoms of celiac disease including:

  • Symptoms go unnoticed – It’s thought that people with asymptomatic celiac disease possess symptoms of the disease without being aware. Often, they only realize they experienced symptoms once they begin a gluten-free diet.
  • Many symptoms of celiac disease remain unknown – Current research suggests that more people have celiac disease than originally thought.1 Moreover, the number of people with celiac disease in the US has increased five-fold between 1975 and 2000. [1]
  • As clinical research into symptomatic celiac disease develops, researchers and healthcare providers are learning more about the diverse ways the condition can manifest. It’s likely that many more people have celiac disease, but the medical world isn’t yet familiar with all of the symptoms associated with the disease. [1]

See related: Refractory Celiac Disease

How to Know If You Have Silent Celiac Disease

People living with asymptomatic celiac disease neither exhibit nor self-report symptoms typical of the condition. However, when tested for certain clinical markers, they often exhibit indicators like [2]:

  • Iron deficiency anemia
  • Impaired liver function
  • Osteoporosis

Though other markers of celiac disease may be absent, people with silent celiac disease also frequently show subtle signs of intestinal damage during an endoscopy.2 Often, they report no pain or digestive disturbances even if they have sustained damage to their small intestine. [2]

For this reason, testing for the disease may be a critical way to protect yourself.

Understanding Celiac Disease: Diagnosis and Treatment

Diagnosing subclinical celiac disease often depends on two key understandings of the disease:

  • Celiac disease is an autoimmune disorder – “Autoimmune” means the immune system attacks itself to guard against a perceived pathogen. [1] In this case, gluten, a protein found in wheat products and other grains, is perceived as a pathogen. Learn more about a wheat allergy vs. celiac disease.
  • Celiac disease is heritable – As a genetic condition, you may be more likely to develop it if someone in your family has it. However, relatives may experience their celiac disease differently. Even if one person discovers their illness because of symptoms like abdominal pain, another relative may notice no symptoms at all.

If someone in your family has celiac disease, it may be worth speaking to your healthcare provider to find out how you can screen for it. Genetic testing can help determine whether your DNA has human leukocyte antigens. [4] These immune markers may make a person more likely to develop celiac disease and other autoimmune disorders. [4]

Other commonly used methods for diagnosing celiac disease include [5]:

  • Endoscopy, whereby a camera is passed through your small intestine to examine it for structural damage. Often, a healthcare provider retrieves a tissue sample to examine it for damage in a lab.
  • Serology testing, whereby a healthcare provider runs bloodwork to test for certain antibodies dispatched by the immune system in people with celiac disease. Alternatively, at-home blood tests can be an excellent preliminary option if you’re not ready to visit a healthcare provider.

And, if you’re not ready to undergo rigorous clinical testing, other options are available.

For instance, you can try a celiac diet plan, essentially eliminating gluten from your diet under the supervision of a healthcare provider. If you experience an improvement in your physical functioning or quality of life with a gluten-free diet it could indicate that you’re gluten-intolerant or be at an increased likelihood for developing celiac disease.

Screen for Celiac Disease with Everlywell

Given the estimated prevalence of celiac disease, it could be important to test for the condition, especially if a family member has it. Silent celiac disease can still compromise your health in the long-term, even if you don’t experience trademark symptoms of the disease.

With Everlywell, you can take a closer look at your immune health with the Celiac Disease Screening Test. All Everlywell tests are reviewed by CLIA-certified labs so that you receive results you can trust. If your results indicate you need further treatment, our patient care team will reach out to you to help you navigate the path to recovery.

To get started, visit Everlywell today.

Celiac Diet Plan: Benefits and How To Create One

Can Celiac Disease Go Away?

Hidden Symptoms of Celiac Disease

Understanding Refractory Celiac Disease

Wheat Allergy vs. Celiac Disease: How Are They Different?


References

  1. Caio G, Volta U, Sapone A, et al. Celiac disease: a comprehensive current review. BMC Medicine. 2019;17(1). doi:https://doi.org/10.1186/s12916-019-1380-z URL. Accessed September 29, 2023.
  2. Silent celiac disease. National Celiac Association. URL. Accessed September 29, 2023.
  3. Mayo Clinic. Celiac Disease - Symptoms and Causes. Mayo Clinic. Published August 10, 2021. URL. Accessed September 29, 2023.
  4. Celiac genes. National Celiac Association. URL. Accessed September 29, 2023.
  5. Mayo Clinic. Celiac disease - Diagnosis and treatment - Mayo Clinic. Mayoclinic.org. Published 2018. URL. Accessed September 29, 2023.
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