When Celiac is Silent

in Celiac, Features
Published: November 29, 2011

This went against everything she had ever learned about diseases; it wasn’t like tonsillitis or the flu. Even though she didn’t feel sick, Marisa had to treat the disease by changing her diet, which meant changing her life.

Celiac disease specialists recommend going gluten-free as soon as you have the biopsy diagnosis rather than waiting until you start showing gastrointestinal symptoms. Better that, they say, than letting the damage progress. “If you follow people who test positive for the antibodies but have no manifestations of celiac disease, many of them will get symptoms sooner or later,” says Dr. Anthony DiMarino, chief of gastroenterology at Philadelphia’s Thomas Jefferson University Hospital.

And, as subjects in a study out of Tampere University in Finland recently discovered, going gluten-free just might improve your quality of life, even if you don’t realize it needs any improving. In a study presented at a medical conference in Chicago last spring, researchers used blood tests to screen 3,031 people over the age of 18 who had relatives with celiac disease. None had any serious health complaints. The result: 40 tested positive for the antibodies associated with celiac. Of those 40, half were randomly assigned to go on a gluten-free diet while the rest continued to eat whatever they wanted.

The results were stark. Dr. Katri Kaukinen, a gastroenterologist and one of the study’s authors, reported that after a year, the subjects who didn’t change their diets showed no change in their digestive system and vitamin levels, while the gluten-free group showed “significant improvement.” As she explained to Allergic Living, they also enjoyed a higher, more energetic quality of life.

“Before, many had minor abdominal symptoms like gas, bloating, indigestion, loose stools or joint pain. Only after they eliminated gluten did they realize their problems were linked to it,” Kaukinen says.

Even if silent celiac symptoms are minor or not the typical gastrointestinal signs, the loss of nutrients can still affect physical growth and learning skills in children. Undiagnosed adults risk anything from bone fractures due to osteoporosis and eroded teeth enamel to infertility, skin problems and being preternaturally short.


THE FIRST STEP in screening for silent celiac – a blood test by your doctor – is simple and cost-effective, not to mention 90 to 95 percent accurate, according to DiMarino. In Canada, there’s even a DIY finger-prick blood test that costs about $50 (not available yet in the United States), which will give an initial indication of whether it’s time to ask your physician about the disease. For those with a close family member with celiac disease, a blood test is certainly worth taking, since the chances of having the disease are up to 8 percent higher than in the general population.

However, a sticking point is wait times for an intestinal biopsy – the second step in screening for a definitive diagnosis. In North America, celiac specialists advise you not to go on a gluten-free diet until a biopsy confirms the disease, since being free of the protein can lead to a false-negative result.

But a tour of online celiac message boards in the U.S. and Canada shows that people whose blood has tested positive for the antibodies are often waiting several months for an appointment with a gastroenterologist. When you think you’re onto a serious health issue, it’s an anxiety-provoking period.

Next: Finding Relief