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Anxiety and celiac disease are a lot more common than many might think. Anxiety can be felt throughout the celiac process from pre-, mid-, and even post-diagnosis.
Other psychological issues may present themselves throughout the celiac disease process, but anxiety is one of the more common symptoms. To get a better understanding of where the anxiety stems from, it’s equally important to understand what it is.
Celiac is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. When people with celiac disease eat gluten (a protein found in wheat, rye, barley, and contaminated foods like oats), their body mounts an immune response that attacks the small intestine.
These attacks lead to damage to the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.
This inflammatory response to gluten and related nutrient deficiencies can cause a wide variety of symptoms in people with celiac. From bloating, headaches, constipation, joint pain, bone health complications, infertility, weight gain, weight loss, and more.
This can start at any age, and occur in any body, as long as someone is eating gluten and has the celiac genes. If left untreated, celiac disease can lead to additional serious health problems.
It’s common to experience anxiety and celiac simultaneously, but what is it? Where does it come from? According to the National Library of Medicine, anxiety is a reaction to stress and can involve feelings of uneasiness, excessive worry, and fear.
Per the National Library of Medicine, symptoms may include uncontrollable thoughts, rapid heartbeat, shortness of breath, and behavior changes. It can be felt temporarily, like studying for a big exam, or long-term.
Anxiety that is prolonged and worsens over time may be classified as an anxiety disorder. Anxiety disorder has different subgroups, all of which can impact quality of life and activities of daily living if not managed properly.
Currently, there is no clear answer for the cause of anxiety, although factors like genetics, stress and the environment could play a role.
Every individual has a risk of experiencing anxiety, but for some, the risk is increased based on certain factors. These may include family medical history, health conditions, traumatic events, and/or personality.
Celiac and anxiety together increase the chances of experiencing a panic attack, and one might ask what exactly is this. Per the Mayo Clinic, a panic attack is defined as a sudden feeling of intense fear. They can happen at random and occur a few times or frequently.
Symptoms of a panic attack may include the feeling of impending doom, rapid heart rate, nausea, chest pain, hot flashes, and more.
Panic attacks are also a subjective experience and triggers may vary depending on the individual. For me, panic attacks feel like I’m going to die and I can’t breathe.
Again, if you or someone you know may be experiencing this, please reach out to your primary healthcare team.
Experiencing anxiety and celiac disease together is completely normal, but what does this mean for those who are undiagnosed? Repeated visits to the doctor while waiting for a definitive medical diagnosis is mentally taxing alone.
Feelings of anxiety, uncertainty, and more are completely valid when all you want is answers. You just want to figure out what’s going on so you can tackle the problem and continue with your life.
The reality of it is this: having any kind of undiagnosed medical condition can cause anxiety. And the same thing applies to those with undiagnosed celiac disease. Before being officially diagnosed, doctors may run you through a series of tests to rule out other medical conditions. This can take months and make the diagnosis process more difficult.
This is because celiac disease has over 300+ presenting symptoms when exposed to gluten. They are similar to other medical conditions, and this can even lead to multiple misdiagnoses before getting the correct diagnosis.
Moreover, going undiagnosed is actually dangerous. And knowing just this small bit of information may cause or increase anxiety even more. This is why if you suspect anything is wrong or have any medical concerns, I highly encourage you to reach out to your primary healthcare provider.
Lastly, undiagnosed celiac means you’re likely still eating gluten and your small intestine is damaged. The damage to the small intestine can impact what’s known as the vagus nerve. This can have an impact on mood and anxiety symptoms.
Anxiety and celiac disease together have the potential to cause damage. As previously mentioned, anxiety is a subjective experience and its severity can vary depending on the individual. One thing to take into consideration when it comes to anxiety is how well it is managed.
Medical management is a factor to consider for celiac disease because of the gut-brain axis, or the connection between the GI system and brain. When a person experiences anxiety, they often feel a sense of fear.
When the brain feels fear, it perceives something as a danger or threat, in turn activating the sympathetic nervous system to enter fight-or-flight mode. During this response, a number of physical or psychological responses may occur.
One common response is that energy used in the gut will now be directed to other areas of the body more immediately used in the fight-or-flight response. This redirection of energy can result in decreased GI activity, nausea, or constipation.
For an individual with anxiety, this could potentially worsen symptoms of celiac. Especially in someone who was recently exposed to gluten. When a celiac is glutened, the body triggers an autoimmune response that attacks the small intestine.
If the person glutened also had unmanaged anxiety and was in a fight-or-flight response when glutened, energy would be drawn away from the gut and redirected to extremities for “fighting” or “flighting”. In turn, this takes energy away from healing the gut after gluten exposure and might worsen symptoms experienced from it.
The challenge here is often when someone with celiac is glutened, they are in a stressful situation. Speaking for myself, I’ve been accidentally glutened most often at parties or restaurants. The key during these events is to try to stay as calm as possible so that if we do get glutened, we minimize the impact our stress response has on the reaction.
There are different approaches to alleviating symptoms of anxiety and celiac. When it comes to celiac disease, going gluten-free is a medical necessity to alleviate celiac symptoms. In turn, this could potentially relieve anxiety symptoms related to gut damage impacting the vagus nerve.
However, anxiety can stem from other causes of celiac as well. Anxiety can be felt at any stage of the celiac process. For example, a person pending a celiac diagnosis may feel anxiety before and/or after their diagnosis.
Some research has even shown that anxiety felt pre-diagnosis may reduce after switching to a gluten-free diet. On the other hand, a newly diagnosed celiac may also feel more anxiety having to adopt a gluten-free diet.
This can be a stressful situation in itself due to the new challenges of managing celiac disease. Nonetheless, going gluten-free is necessary for those with celiac and after getting a better understanding, one might not feel as anxious as they first were.
For me, I felt anxious trying to get answers before my diagnosis, and after I was met with overwhelming relief. Only to feel anxious again after realizing what managing celiac entailed. This anxiety from managing celiac has gotten better over time as I’ve learned to trust my knowledge and ability to keep myself safe no matter where I am.
If you’re recently diagnosed with celiac disease and need extra help, check out my Celiac Crash Course where I give you clear-cut information and simple strategies on how to stay celiac-safe.
But if you don’t have celiac and you just have anxiety, going gluten-free is not guaranteed to alleviate it. There’s no data to suggest that those without a gluten-related disorder benefit from avoiding gluten to manage their anxiety.
That said, anxiety is a subjective experience and is influenced by multiple factors. Because of this, there are various therapeutic means of relieving or reducing anxiety. Per the Mayo Clinic Health System, anxiety can be reduced with therapy, breathing exercises, physical activity, journaling, meditation, and more. It’s important to note that if you have any concerns regarding anxiety, I highly suggest you contact your healthcare provider.
While going gluten-free can help with celiac-related anxiety, it can also worsen it. Being diagnosed with celiac means changing your entire way of life overnight.
And while I already talked about the impacts of a new celiac diagnosis, sometimes the anxiety can be long-lasting. After all, most people live in a gluten-centered culture and we all live in a gluten-centered global food system…
Meaning gluten is everywhere and it can be anxiety-inducing having to face that every single day. If you can relate to this, I’m holding so much space for you. I felt this same way for the first few years of my diagnosis and it was absolutely terrible.
The biggest thing that helped me with my anxiety over this was studying to become a registered dietitian. Now I’m not saying you have to do this too, but learning about food service, food science, and nutrition gave me the tools to simplify my approach to celiac safety.
And if you want my help doing the same for you, this is exactly why I created the Celiac Crash Course. Because having this knowledge and skill has changed my life after years of trying to get by on my doctor’s oversimplified advice of “just avoid gluten”.
So no pressure, but if you want to learn the simple strategies I use as a dietitian who specializes in celiac disease and who has lived with celiac for over 10 years, I’ll teach you the basics of avoiding gluten and cross-contact in this self-paced course! Learn more here.
When talking about celiac and anxiety it’s important to know what gluten is so we know if it can cause anxiety. Gluten is a protein found in barley, rye, contaminated oats, and wheat. It may be helpful to remember the acronym “BROW” when trying to remember what foods have gluten.
In baked goods, gluten holds things together working as a binding agent. It gives texture and chew to foods. Most people can safely eat gluten. However, some people have gluten sensitivity or celiac disease which means they need to avoid gluten. It can cause digestive issues such as diarrhea and nausea as well as nonintestinal symptoms such as anxiety, headaches, or joint pain.
For someone with celiac disease or other gluten-related disorders, gluten can impact their mental health. While we don’t fully understand why this happens, it’s largely theorized to be due to the inflammatory response in the gut impacting the vagus nerve.
Currently, research on the effect of gluten on the brain is limited and mixed. It’s also important to note that some symptoms of anxiety overlap with celiac symptoms (nausea, dizziness, fatigue). This can make living with celiac scary if you feel like you can’t tell if you’re anxious or if you’ve been glutened.
I’ve worked with many clients to overcome disordered eating behaviors that stem from this. If you feel like it’s hard for you to tell the difference between getting glutened and feeling anxious, If this, I’m holding space for you and want to encourage you to get support. A dietitian specializing in celiac and/or a GI psychologist can be very helpful with this.
But for someone with anxiety who does not have a gluten-related disorder, gluten has not been conclusively proven to affect mental health.
TLDR: If you don’t have a gluten-related disorder, there’s no evidence to suggest gluten is impacting mental health. If you do have a gluten-related disorder like celiac, there’s evidence to suggest it might cause or worsen mental health.
Anxiety and celiac disease are one of many mood combinations felt when it comes to gluten exposure. In fact, it can be normal for those with celiac disease to experience mood swings.
First, mood swings can be a normal part of grieving your life before celiac. You might be fine one moment, and be hit with a new way celiac has changed your life and feel grief the next.
Alternatively, it might be related to feeling fine one moment and then being hit with symptoms the next. As previously mentioned, gluten exposure has over 300+ presenting symptoms in those with celiac including pain, bloating, constipation, and more.
Any form of pain or discomfort can affect emotional well-being, and for those with celiac, this change is sometimes believed to be due to the gut-brain connection. These feelings can manifest in the form of anxiety, depression, happiness, fear, sadness, and others.
Having mood swings can be a frustrating experience, and I want to remind you that it can be normal as you heal. However, if you’re concerned, please contact your healthcare provider ASAP.
That said, if you don’t have celiac disease or another gluten-related disorder, there’s not much evidence to support that mood swings are caused by gluten.
Having anxiety and celiac may increase the chances of experiencing a panic attack, but if you don’t have a gluten-related disorder, there’s no evidence to suggest gluten would cause one.
Panic attacks are the sudden feeling of intense fear, and like anxiety, they are a subjective experience. This means the trigger of a panic attack may vary depending on the individual.
For someone with celiac, the thought of being exposed to gluten could trigger this. Certain stressful food situations might also play a role if the fear of gluten is that intense for someone. In this way, it’s not gluten that’s causing the panic attack but the fear of gluten.
That said, research on the effect of gluten on the brain is very limited and mixed. Currently, there is no clear indicator or answer that gluten directly causes panic attacks. It may be possible, however, that someone with celiac may experience a panic attack due to gluten exposure.
Personally, I don’t get panic attacks because I was exposed to gluten or in fear of being glutened. However, I do notice that I am more prone to panic attacks when I’ve been exposed to gluten. But this is a purely anecdotal observation and likely does not represent everyone’s experience.
Should you have any medical concerns regarding this, I strongly suggest reaching out to your primary care provider.
Celiac and anxiety have associations based on the limited research available, however, there is not enough research to indicate gluten and anxiety is directly correlated. Remember, celiac is a gluten-related disorder. Gluten is just a protein found in barley, wheat, and rye.
Some research shows that gluten may contribute to symptoms of anxiety, however, these symptoms are prevalent in those with celiac or gluten-related disorders. Currently, more research needs to be done to verify any form of connection between gluten and anxiety for those without gluten-related disorders.
Assuming the bread contains gluten, eating bread with celiac disease might cause anxiety likely because the person knows the bread will harm them or because of the damage that happens in the gut that impacts the vagus nerve.
If you don’t have celiac (or another gluten-related disorder) and you eat bread, it likely won’t cause anxiety unless you have food fears related to the bread.
There is no research available to support that eating bread causes anxiety in those without celiac or other gluten-related disorders unless food fears and other challenges are present. That said, if you’re feeling anxious after eating bread but don’t have a gluten-related disorder, you might consider talking to your healthcare team about why this might be happening.
There are different ways to help with symptoms of anxiety and celiac. If the anxiety is stemming from gluten with celiac, removing (not reducing) gluten from the diet may help.
However, if the anxiety is not caused or influenced by celiac, then despite removing gluten, you still might feel anxiety. For me, getting glutened worsens my anxiety but I still have it when I’m avoiding gluten in my everyday life.
It’s also important to note that if you’re starting out on managing celiac, it might take a minute to heal and notice an improvement in anxiety after avoiding gluten. Additionally, the process of trying to manage celiac can be anxiety-inducing too – especially if no one is helping you and your doctor told you to “just go gluten-free”.
So if you’re hoping for relief from anxiety after going gluten-free for celiac, know that it might take time to decipher where the anxiety is building up from.
However, if you remove gluten from the diet without a gluten-related disorder, there’s no guarantee that it will help beyond a placebo effect.
Anxiety and celiac disease are commonly experienced together, but what about gluten intolerance? It’s important to know that celiac disease and gluten intolerance are not exactly the same.
Celiac disease is an autoimmune disorder characterized by over 300 symptoms that mostly overlap with gluten intolerance. The exception is people with celiac have characteristic damage to the small intestine which is thought to influence a big part of the symptoms experienced.
Unfortunately, celiac is better understood and researched when compared to gluten intolerance. Because of this, there’s not much verifying the impacts of gluten intolerance on mental health but know that lived experience is absolutely valid.
I do, however, think it’s important to note that you identify whether or not it’s truly gluten, the fear of gluten, or food anxiety that’s causing the mental health impacts. I say this because food intolerances are real and so is the big overlap between food intolerances and eating disorders and given how deadly eating disorders can be, It’d be prudent not to make the clarification.
One might ask “celiac and anxiety are common to experience together, but what about gluten intolerance?”. The gist of it is: you can experience depression and anxiety with gluten intolerance as well.
This may in part, be because many of the symptoms of gluten exposure overlap with celiac disease. Therefore, any pain or discomfort felt can affect emotional well-being, therefore, manifesting in the form of anxiety or depression. All of which, might I remind you, are completely normal.
It’s important to remember that depression and anxiety are subjective experiences and may vary from person to person. So one person with gluten intolerance may exhibit different symptoms than someone else with the same intolerance.
Anxiety and celiac disease are very common to experience together. Anxiety is a subjective experience and there is no clear cause for it, however, there are factors that could influence it.
And one of those factors could be celiac disease. From the damage to the gut impacting the vagus nerve to anxiety over getting a celiac diagnosis or managing a gluten-free diet – I want to remind you that it’s completely normal to experience anxiety throughout the celiac process.
And if you don’t have a gluten-related disorder, there’s no evidence currently, that avoiding gluten will help your anxiety beyond a placebo effect.
That said if you have any concerns regarding your physical or mental health, if your anxiety feels like it’s unbearable or taking over your life, please reach out to your primary healthcare team.