Gluten and Chronic Fatigue: Tired on a Gluten-Free Diet

If you have celiac disease or gluten intolerance, often gluten causes chronic fatigue. The good news is, going gluten-free can reduce fatigue.

But what happens if you are still tired on a gluten-free diet for celiac or gluten intolerance? In this post, we will discuss some potential causes for fatigue with celiac, despite following a gluten-free diet.

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Gluten and Chronic Fatigue Tired on a Gluten-Free Diet - Tayler Silfverduk, celiac dietitian

Why Follow a Gluten-Free Diet?

For people with gluten intolerance or celiac disease, they can get a lot of symptoms from eating gluten, and chronic fatigue is one of them. While celiac disease and gluten intolerance are different, both require a gluten-free diet to prevent symptoms.

A gluten-free diet for celiac disease works to prevent small intestinal damage, prevent an autoimmune reaction, and allow the small intestine to heal. This, in turn, can help address nutrient deficiencies that make you tired, nutritional anemias occurring with celiac, and overall inflammation that can cause celiac disease fatigue.

A gluten-free diet for gluten intolerance works to prevent inflammation and indigestion from occurring. This in turn can help address any chronic fatigue caused by gluten; in other words, prevent gluten intolerance fatigue

Why You Still Have Chronic Fatigue on a Gluten-Free Diet

But what happens when you’ve been diagnosed with celiac disease or gluten intolerance and you’ve gone gluten-free but you’re still feeling tired all the time? What happens when you’re avoiding gluten and still have chronic fatigue?

To get to the bottom of why you’re still tired on a gluten-free diet, you need to figure out what’s causing the fatigue. Sometimes it’s gluten causing fatigue, other times there other factors at play.

Below we will cover how accidental gluten exposure, imbalanced gluten-free diet, unaddressed food intolerances, lack of sleep, exercise, anemia, gut health, blood sugars, burnout, and other conditions can cause you to be tired despite eating gluten-free.

Accidental Gluten Exposure is Causing Fatigue

You might still be fatigued despite going gluten-free because you’re still being exposed to gluten. Despite trying your hardest, accidental exposures can happen.

The best way to know if this is happening to you with celiac is through follow-up celiac testing. If your results are not improving and still coming back positive, it can indicate continued gluten exposure.

If you have gluten intolerance, knowing if you’re still getting exposed to gluten can be a lot more complex. Depending on your level of strictness with living gluten-free, you may want to try being stricter.

Regardless of if you have gluten intolerance or celiac, working with a gluten-free specialized dietitian can help you determine if gluten exposure is at play with your chronic fatigue.

An Imbalanced Gluten-Free Diet is Causing Chronic Fatigue

An unbalanced gluten-free diet can cause you to still be tired after going gluten-free. For example, if you’re not balancing your macros appropriately you could be setting yourself up for blood sugar imbalances and energy crashes.

And if you’re not balancing your gluten-free diet appropriately for micronutrients, you could be setting yourself up for gluten-free diet nutrient deficiencies. That’s because a gluten-free diet eliminates common sources of fortified foods and nutrient-dense foods. Losing access to these foods can cause you to not get enough iron on a gluten-free diet, or cause vitamin D deficiency with celiac.

Again, getting help from a gluten-free specialized dietitian can help you make sure your diet is balanced appropriately to prevent tiredness.

Food Intolerances Beyond Gluten Are Causing Chronic Fatigue

Another potential cause for fatigue with gluten intolerance or celiac disease could be that you have other unaddressed food intolerances. I say this with a lot of caution because I think it’s easy to point the finger at other foods when gluten was the answer before.

But with gluten intolerance, often there can be co-occurring intolerances that may be at play too. Especially if your intolerances are related to your gut health.

And with celiac disease, the small intestinal damage can impair the release of digestive enzymes essential to proper digestion. This, in turn, can cause food intolerances like lactose intolerance with celiac, which if unaddressed can make you tired from the inflammation and indigestion.

When assessing if other food intolerances are at play with celiac chronic fatigue or gluten intolerance fatigue, it’s important you are making sure you’ve ruled out the other potential causes. In general, the goal is to make sure you have the least restrictive lifestyle safely possible and while it’s easy to suspect other food intolerances, it’s important to consider other causes as well.

Gluten and Chronic Factigue: Why Sleep is Important for Gluten-Free Living - Not geting enough sleep can leave you tired on a gluten-free diet - Tayler Silfverduk, Celiac Dietitian

You’re Fatigued Because You're Not Sleeping Enough

While maybe a no-brainer: you might be experiencing chronic fatigue while avoiding gluten because you’re not getting enough sleep. The average adult needs anywhere from 7-9 hours of sleep, but up to 40% of Americans are getting less than that.

Add on the fact that if you have gluten intolerance or celiac, you may experience GI distress which can impact sleep, well sleep may be at play here.

Some tips for better sleep include:

  • Discuss your sleep habits with a doctor to make sure you don’t have a sleep disorder at play. And maybe even bring up taking melatonin, I like melatonin gummies!
  • Brain dump your worries in a journal before bed to try to stop them from running through your mind as you try to fall asleep
  • Pay attention to how hunger, fullness, meal, and snack timing impacts your sleep
  • Pay attention to exercise timing and how it impacts your sleep
  • Try waking up and laying down around the same time every day (yes, even on the weekend).
  • Spend time making your bedroom into a calming relaxing space, our environment can be very influential in our behaviors
  • Try to keep it cool, 68-70 degrees is typically the optimal sleeping temperature
  • Take a shower before bed, studies show that it can help you fall asleep faster and improve sleep quality.
  • Limit fluids before bed to prevent having to wake up to use the restroom

You’re Fatigued Because Your Exercise Habits are Imbalanced

Gluten can cause chronic fatigue in people with celiac and gluten intolerance, but so can not getting enough or getting too much exercise.

In fact, in a 2018 systematic review of how exercise impacts sleep quality, they found that exercise could improve sleep quality. And as we know, sleep is essential to making sure you’re energized.

On the flip side, overexercising or overtraining can cause you to be fatigued by the overuse of your body. Overtraining might include frequent injuries, overuse injuries, performance plateau or decline, and more.

Using exercise to boost your energy involves a careful balance. Looking at how your moving and if you’re moving your body too often can give insight on if exercise may be playing into chronic fatigue.

Anemia From Gluten may be Causing Fatigue

Both gluten intolerance and celiac disease have been linked to iron deficiency anemia. And with celiac disease, there are risks of other dietary anemias as well.

One of the key symptoms of anemia is often fatigue. So you may still be feeling fatigued on a gluten-free diet because you’re still recovering from nutritional anemias.

Getting a blood test to assess for anemia can help you determine if this may be at play. If it is, addressing the anemias may help improve any excessive tiredness you’ve had while eating gluten-free.

A Damaged Gut From Gluten can Lead to Chronic Fatigue

Diet culture likes to blame gut health a lot and I think often gut health is blamed without looking at other causes. Regardless, gut health can play a role in continued tiredness on a gluten-free diet.

Specifically, if you have celiac disease or if gluten intolerance has been triggered related to gut imbalances, then repairing your gut can help with fatigue.

Because if your gut is not working right then your gut-brain axis isn’t working right. And if your gut-brain axis is working right, then all kinds of things can go off-balance. Things that can leave you feeling exhausted, tired, and fatigued while gluten-free.

To support your gut, meet with a gluten-free specialized dietitian to figure out what lifestyle changes will be the most impactful for you and your situation.

You’ve got Celiac Burnout Causing Celiac Fatigue

You might be fatigued despite being gluten-free because you’re experiencing celiac burnout. Celiac burnout is when you are exhausted from managing a strict gluten-free diet safe for celiac.

You are exhausted from managing a budget, grocery shopping, reading food labels all the time, spending more time planning for travel, figuring out where your next safe meal is coming from, and navigating a gluten-centric culture and social scene.

This burnout can ultimately lead to fatigue because you have to spend energy on so many other things than the average person.

And combatting celiac burnout and the fatigue it can lead to requires an individualized approach. One a celiac dietitian can help with.

You Have Another Condition That Causes Fatigue

Lastly, you may be experiencing chronic or lingering fatigue with celiac disease or gluten intolerance due to an undiagnosed condition. Things like hormone imbalance, hypothyroidism, hyperthyroidism, depression, anxiety, and more can play a role in chronic fatigue.

You also might just have chronic fatigue syndrome.

Regardless, if you are worried about the fatigue you are experiencing, it is essential to make sure you inform your doctor to make sure you don’t have an undiagnosed condition at play.

What to do About Gluten and Chronic Fatigue - What to Do if You're Tired on a Gluten-Free Diet - Tayler Silfverduk, celiac dietitian

What to do if You’re Still Tired on a Gluten-Free Diet

We’ve identified that eating gluten causes chronic fatigue in some celiac disease and gluten intolerant people. And we’ve also talked about how things other than gluten can cause chronic fatigue. So if you have lingering tiredness on a gluten-free diet, what should you do?

Here are my top 10 tips to addressing continued chronic fatigue on a gluten-free diet:

  1. If you have celiac, get follow-up testing to rule accidental exposure in or out.
  2. Talk to your doctor to rule out other fatigue-causing conditions.
  3. Get a blood test to assess for nutrient deficiencies and anemia caused by celiac, gluten intolerance, or an imbalanced diet
  4. Make sure you’re eating a balanced gluten-free diet to prevent diet-related nutrient deficiencies and anemias 
  5. Ensure you’re getting enough sleep
  6. Exercise: make sure you’re getting enough but not too much movement to support sleep and overall energy levels
  7. Assess and address your burnout level. Whether it be from managing celiac, gluten intolerance, or other life stressors, burnout can lead to or worsen fatigue. If you are burned out, the book “Burnout” by Emily Nagoski is incredibly helpful.
  8. Live to support gut health. Your gut health can play an active role in your energy and overall well-being, making sure you’re supporting it is essential to feeling energized. 
  9. Assess for and address additional food intolerance as indigestion and inflammation caused by food sensitivities can lead to tiredness and fatigue.
  10. Meet with a gluten-free specialized dietitian to connect the dots: as mentioned previously, a specialized dietitian can assess for diet balance, nutrient deficiencies, nutrient gaps, food intolerance, food anxiety, and more to help you get to the bottom of lingering fatigue.

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