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  • Claire Atkin
    Claire Atkin

    Celiac Disease and Physical Activity

    Reviewed and edited by a celiac disease expert.

    Celiac.com 06/02/2009 - Celiac disease is an autoimmune disorder thatis triggered by gluten, and it is being diagnosed more often than inthe past. Previously considered quite rare, it is now estimated tooccur in 1 in 100-150 people in all societies (with the possibleexception of Japan). Physical activity counters some of the lastingsymptoms of celiac disease, but some of the symptoms actually mayinhibit physical activity. Older adults (+55) with celiac disease mayhave positive or negative attitudes toward physical activity. As itstands, we’re not sure whether celiac disease helps or hinders theirwill to exercise.

    There are many symptoms associated with celiac disease. They mayinclude neurological symptoms, physical symptoms and overall feelingsof fatigue or depression. This makes celiac disease difficult toidentify, but also forces individuals with celiac disease to find theirown individualized balanced lifestyles. Balanced lifestyles areespecially important for older adults with celiac disease because, asanyone diagnosed with a disease knows, they must maintain theirphysical wellbeing in order to heal. Older adults with celiac diseaseare also at risk of gaining weight after starting a gluten free dietbecause their bodies absorb nutrients so much more efficiently thanbefore, and because many gluten-free breads and desert substitutes maybe higher in calories than their gluten-containing counterparts.

    Because each person with celiac disease exhibits different symptoms,each older adult with celiac disease must find their own way of livingwith the disease. Their will to excercise depends on how celiac diseasehas affected their appetite, energy level, mental health, nervoussystem and overall body functions.

    Research about the attitudes of older adults with celiac disease toward physical activity will help to understand:

    • The general attitudes of older adults with celiac disease toward physical activity;
    • The symptoms of celiac disease that directly or indirectly affect older adults’ attitudes toward physical activity;
    • How physicians, recreation centres, celiac associations and theCanadian Government can work with people with celiac disease tomaintain or increase their levels of physical activity, and;
    • Provide literature on nutrient deficiency and physical activityto patients in need of information or reassurance about their attitudestoward physical activity.
    Celiac disease may negatively affect the attitudes of people withceliac disease toward physical exercise and activity in two differentways. First, celiac disease symptoms inhibit exercise. Chronic andacute pain, fatigue, bruising and other symptoms associated withnutrient deficiency and celiac disease recovery could easily affect themotivation that people with celiac disease have to exercise. Second,the exercise may exacerbate symptoms of celiac disease. 

    Certain studies have shown that allergies can exacerbate or inducefood-dependent allergy symptoms (Sampson, 2003). If someone with celiacdisease were to experience symptoms as if they were having an allergicreaction to gluten when they conducted certain exercises, they wouldeither try to push through, stop, or change their exercise program orschedule. They could exercise only in the morning, before breakfast andafter a long period of not eating, or they could choose activities withless physical impact, such as walking/hiking, or biking.

    Symptoms of celiac disease may also encourage exercise. If an olderadult with celiac disease finds out that they have low bone density,they may choose to increase their weight bearing activity to encouragebone growth.

    There is a long list of symptoms that are associated with celiacdisease. Some of the symptoms of celiac disease that are documented inliterature about include:
    •  No obvious physical symptoms (just fatigue, overall not feeling well)
    • Gastrointestinal symptoms
    • Fatigue
    • Weight loss
    • Pallor (unhealthy pale appearance)
    • Flatulence
    • Borborygmi (stomach rumbling)
    • Nausea
    • Vomiting
    • Anorexia
    • Voracious appetite
    • Iron deficiency anemia
    • Failure to thrive
    • Lymphocytic gastritis
    • Vitamin B12 deficiency
    • Vitamin D deficiency
    • Hypocalcaemia/ hypomagnesaemia
    • Vitamin K deficiency
    • Coetaneous bleeding
    • Epitasis (nose bleeding)
    • Hematuria (red urine)
    • Gastrointestinal hemorrhage
    Celiac Disease affects the nutrient absorption level of the smallintestine, and people diagnosed with celiac disease should therefore betested for vitamin deficiencies. Side effects of nutrient deficiencyvary from person to person, but the level of nutrient deficiency mayaffect the amount that someone with celiac disease will exercise. Forexample, a person's calcium absorption rate may affect their bonedensity, and a person's iron absorption rate may affect their energylevels. In general, weight-bearing exercise is associated with strongerbone density. Anemia (lack of iron), though, decreases a person’senergy levels. Depending on the person, the two opposing influences offatigue and bone density loss may sway the person’s attitude towardexercise in different ways.

    This is the subject of a human geography honours project at theUniversity of Victoria. If you have any comments on the subject, pleasecontact me by using the comment form below this article.

    Related Articles:
    • Sampson, H.A. (2003). Food Allergy. Journal of Allergy Clinical Immunology. 111:2, S540-S547.
    • Sategna-Guidetti, C. et al. (2000). The effects of 1-year glutenwithdrawal on bone mass, bone metabolism and nutritional status innewly diagnosed adult coeliac disease patients. Alimentary Pharmacology& Therapeutics. 14, 35-43.
    • Palosuo, K. (2003). Transglutaminase-mediated cross-linking of apeptic fraction of w-5 gliadin enhances lgE reactivity inwheat-dependent, exercise-induced anaphylaxis. Journal of Allergy andClinical Immunocology: 111:6, 1386-1392.


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    I, too, am curious about the question Laurie previously posed: what are the attitudes of children with celiac toward physical activity? My 12-year-old daughter was diagnosed with celiac disease 5 years ago. She was always a sedentary child, and as a toddler was quick to tire when walking, and requested to be carried whenever we were hiking. She still has not learned to ride a bicycle, and refuses to even try. She is still slightly anemic despite 5 years of a gluten-free diet and iron supplementation. She is a bookish kid who'd much rather read or watch a movie or play a computer game than do anything physical. She doesn't have the stamina for even moderate activity.

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    I was just diagnosed with Celiac in Nov. 2008. Before I got sick, I was a sprint-triathlete. Since the onset of symptoms (late winter 2006), I gained 20 lbs and was very lethargic and had trouble getting motivated to exercise. Even with Celiac, I've still managed to run 2 half-marathons. All winter as I was managing my diet, my symptoms subsided considerably. But now that I am back training for sprint triathlons, even though I am watching my diet, some of my symptoms are returning. Can the physical stress of training cause symptoms in someone with Celiac? Since my Celiac was triggered by stress in my life, I am wondering if physical stress could have an influence on my level of symptoms. Also, I am really getting frustrated that I am not losing those 20 lbs that I put on when I developed Celiac.

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    I am now in the process of being tested for celiac disease by a gastroenterologist, as he thinks that my symptoms indicate that possibility. In reading your article, I find that I have several of the symptoms listed. Thanks for this very informative and helpful article.

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    I found this article very interesting but became confused at the paragraph which starts out:

     

    'Certain studies have shown that allergies can exacerbate or induce food-dependent allergy symptoms (Sampson, 2003).'

     

    My understanding is that celiac disease is an autoimmune response and not an allergy.

     

    Are you saying that someone with celiac disease can also experience an allergic reaction which is exercise related?

    Someone correct me if I am wrong, but I understand that stress can exacerbate or induce increased celiac or gluten intolerance responses. Many celiacs are unaware they have the intestinal damage. Few if any effects are apparent to them either because they are minor, they have always had them and that is their norm, or they have developed slowly or not at all. Exercise in itself is stressful as are allergies such as those to airborne agents like pollen, volatiles, and dust.

     

    Dairy products induce production of nasal mucous for me, as do dust and pollen. Grass and tree pollen without antihistamines have me all but incapacitated. Sneezing too hard and often and eyes watering too much to drive safely, for example. Symptoms this severe interfere with sleep (ya think?), adding more stress, and I got a flare-ups of what I now recognize as gluten-related intolerance symptoms, like nose bleeds, cluster headaches, angina (low calcium and magnesium and B vitamins), intestinal distress, arthritis, etc. Normally, the symptoms are in control. It is a threshold effect. When that level is exceeded, the digestive symptoms start. I did not know that was Gluten intolerance, until last fall.

     

    Treating sinusitis with antibiotics on a regular basis doesn't help the digestive issues of gluten either.

     

    I lost 35 lbs biking an one half to one hour a day for 6 months last year. The last 30 pounds pre-gluten-free did not begin to budge until going gluten free and addressing nutrient and vitamin deficiencies. Down another 15 with 10 to15 pounds to go. Sleeping better. Not starving for carbohydrates. Off of three hypertension-related medications, one reduced to 1/8 dose. Take heart. Have patience. I feel like I did over 20 years ago.

     

    IN 2000, I could hardly walk up or down stairs from a Lipitor side effect (celiac interaction?), three weeks ago I rode 520 miles in the Habitat 500! Not dead yet. Not sneezing, Exercising and sleeping well.

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    I was just diagnosed with Celiac in Nov. 2008. Before I got sick, I was a sprint-triathlete. Since the onset of symptoms (late winter 2006), I gained 20 lbs and was very lethargic and had trouble getting motivated to exercise. Even with Celiac, I've still managed to run 2 half-marathons. All winter as I was managing my diet, my symptoms subsided considerably. But now that I am back training for sprint triathlons, even though I am watching my diet, some of my symptoms are returning. Can the physical stress of training cause symptoms in someone with Celiac? Since my Celiac was triggered by stress in my life, I am wondering if physical stress could have an influence on my level of symptoms. Also, I am really getting frustrated that I am not losing those 20 lbs that I put on when I developed Celiac.

    Hi Melissa! Thank god we're not alone, so glad I discovered this site! I was diagnosed with celiac three years ago and have been greatly affected as a competitive mixed martial arts fighter.

     

    Have discovered that even for up to a couple months after accidentally eating gluten, training after consuming too much dietary fat (more than 50-100g/ day) will cause my symptoms to instantly return (fatigue being the most frustrating), removing me from competition until I can recover.

     

    Dairy products, excess dietary fat consumption, and exercise (especially anaerobic) are all 'kryptonites' to the celiac while the body is healing. If these are strictly avoided then a stress and symptom free lifestyle will be enjoyed!

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    I have a lot of various and complex symptoms. I was finally diagnosed last October after 30 years of trying to find answers. When I was a child I was a competitive swimmer, dancer and skier (snow and water) but staying physically active became increasing difficult for me as I got older. I often experienced increasing fatigue, headaches, nausea (with occasional vomiting), ear ringing and burning skin when I would exercise. Body pain did not affect my desire to exercise as much as fatigue because I was often in physical pain, whether or not I was exercising.

     

    I am 46 years old now. Up until last year, I walked about 1 hour/day and enjoyed hiking. During the past year, however, my fatigue and weakness has been extreme and I haven't been motivated to do any physical activity. I have gained weight and lost a lot of muscle tone. I also seem to have skin reactions to everything I touch now and I have reactions sometimes when I haven't eaten or touched anything. I believe I need to have extensive allergy testing done.

     

    I finally got tested for B6 and B12 deficiency and was told this morning that I am 'slightly' B12 deficient. I was previously told that I am not anemic and that my bone density was good. None of my doctors has tested me for other possible vitamin deficiencies. I am hoping that the B12 deficiency is responsible for the muscle twitches and weakness that I have been experiencing.

     

    Thank-you for this information. It helps me understand what has been happening to me since my doctors don't seem to know or understand the symptoms. Their management of Celiac Disease seems to be limited to telling me to go on a gluten free diet with the addendum, 'there are a lot of resources out there' (i.e 'your on your own!) They only seem do more testing when I tell them that I'm still in bad shape and I absolutely need something, so it is up to me to find out what I need.

    This is my EXACT experience. I was diagnosed 6 months ago and have been 100% faithful on my diet, yet I am still very very sick. I am 32 years old and have been working out since I was 16 years old. I worked out on average 4 - 5 days a week some weeks 7 days because I always felt SO good after working out. Now when I work out I am sick for 2 days, including bloating, moderate to severe abdominal pain, diarrhea and significant fatigue ! I do not have time to be in bed for 3 hours after working out so I have given up on it! The doctors all say well just stay on your gluten-free diet! I really need some help! And I don't know who will have answers if my doctor doesn't!

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    I was a keen runner before the symptoms of gluten and dairy intolerance appeared after my daughter was born. Even though I have been on a wheat and lactose-free diet for 4 years or so, I do have to take it easy, and only run maybe 3 times a week instead of every day like I used to, or it wipes me out for up to a week at a time. You can intersperse your cardio successfully with yoga-type exercises if you find this frustrating. Don't give up! It just takes a while for your body to recover and adjust.

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    I've found that I've never been able to get back to doing the vigourous exercise that I once did pre coeliac diagnosis. My first symptoms of coeliac appeared while exercising - extreme fatigue, fast heart rate and nausea. Even now after being on a strict gluten-free diet for a year and a half I can't exercise beyond walking as I start to feel unwell (although not quite as bad as I did before diagnosis). I'd like to hope that eventually I will be able to return to my previous exercise but so far, no luck.

    If I do accidentally get "glutenized", physical activity definitely increases the intensity of my symptoms, even days later.

    If anyone has had similar experiences I'd love to hear about it.

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    I have had constipation all of my life. I have also had ovation cysts since adolesence. After that, I just blamed all my stomach pain and gas on my cysts. A few years ago, my constipation started to swing wildly to diarrhea and back to constipation. My doctor told me to eat probiotic yogurt everyday and that seemed to help. In the last few years, I have had stretches of time (mostly in the winter) that I would have severe stomach pain and gas. Again, I blamed my ovarian cysts. Last October, I had what I thought was the flu except there was no fever. This went on for a month before I went to the doctor. I described my stomach pain and nausea as well as headaches and full body pain. He said that I had an intestinal infection and gave me a prescription. When that didn't work it was a bowel infection and then IBS. Finally he said try eating gluten-free and see what happens. I haven't eaten gluten since (except accidentally). There are other symptoms that have cleared up too, but that is the gist of my story. Each time I ingest gluten, the symptoms take about 6 weeks to taper off. Twice now I started to feel well enough that I thought I would start exercising again. A little pilates and elliptical. That was Saturday, that night I was awake with pain all over and Sunday it was too painful to move. I didn't get off the couch all day. I think that I will wait until it has been the full 6 weeks or a little more and try again. I am interested if anyone else has experienced this.

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    I have had constipation all of my life. I have also had ovation cysts since adolesence. After that, I just blamed all my stomach pain and gas on my cysts. A few years ago, my constipation started to swing wildly to diarrhea and back to constipation. My doctor told me to eat probiotic yogurt everyday and that seemed to help. In the last few years, I have had stretches of time (mostly in the winter) that I would have severe stomach pain and gas. Again, I blamed my ovarian cysts. Last October, I had what I thought was the flu except there was no fever. This went on for a month before I went to the doctor. I described my stomach pain and nausea as well as headaches and full body pain. He said that I had an intestinal infection and gave me a prescription. When that didn't work it was a bowel infection and then IBS. Finally he said try eating gluten-free and see what happens. I haven't eaten gluten since (except accidentally). There are other symptoms that have cleared up too, but that is the gist of my story. Each time I ingest gluten, the symptoms take about 6 weeks to taper off. Twice now I started to feel well enough that I thought I would start exercising again. A little pilates and elliptical. That was Saturday, that night I was awake with pain all over and Sunday it was too painful to move. I didn't get off the couch all day. I think that I will wait until it has been the full 6 weeks or a little more and try again. I am interested if anyone else has experienced this.

    I was diagnosed almost 6 months ago. I've always done a lot of running and usually work out 6 days a week. Prior to being diagnosed, I became extremely fatigued and weak. I also developed hypoglycemia. I was eating all day long while not gaining any weight. Since being gluten-free for nearly 6 months, most of my symptoms are greatly improved. But, if I push myself just a little too much while exercising, it can take me several days/weeks to recover. If I had to give out any advice from personal experience, I would recommend exercise. However, start out slow and don't stress your body while healing. Set-backs are really frustrating and can leave you feeling somewhat hopeless. Good luck everybody!

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    I am currently experiencing a myriad of mysterious health issues that is leaving the doctors scratching their head... including fainting, my legs just randomly giving out, itching, macrocytosis, gastro pain and rumbling, hair and eyelashes falling out and bruising. It has been an epiphany to read this in my research... my grandmother has coeliacs and I keep coming across a lot of the same things mentioned when discussing it. I hope there is more help available than just avoid gluten though, because I am desperate for my normal life back!

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  • About Me

    Claire is studying the attitudes of older adults diagnosed with celiac disease toward physical activity at the University of Victoria. She has been diagnosed with celiac disease since she was 20 years old, and writes an academic-oriented gluten-free blog at gfc.tumblr.com, where she posts academic article summaries, corporate correspondence, and a few extras on the side.

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