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Celiac Disease and Physical Activity 06/02/2009 - Celiac disease is an autoimmune disorder that is triggered by gluten, and it is being diagnosed more often than in the past. Previously considered quite rare, it is now estimated to occur in 1 in 100-150 people in all societies (with the possible exception of Japan). Physical activity counters some of the lasting symptoms of celiac disease, but some of the symptoms actually may inhibit physical activity. Older adults (+55) with celiac disease may have positive or negative attitudes toward physical activity. As it stands, we’re not sure whether celiac disease helps or hinders their will to exercise.

There are many symptoms associated with celiac disease. They may include neurological symptoms, physical symptoms and overall feelings of fatigue or depression. This makes celiac disease difficult to identify, but also forces individuals with celiac disease to find their own individualized balanced lifestyles. Balanced lifestyles are especially important for older adults with celiac disease because, as anyone diagnosed with a disease knows, they must maintain their physical wellbeing in order to heal. Older adults with celiac disease are also at risk of gaining weight after starting a gluten free diet because their bodies absorb nutrients so much more efficiently than before, and because many gluten-free breads and desert substitutes may be 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 living with the disease. Their will to excercise depends on how celiac disease has affected their appetite, energy level, mental health, nervous system 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 the Canadian Government can work with people with celiac disease to maintain or increase their levels of physical activity, and;
  • Provide literature on nutrient deficiency and physical activity to patients in need of information or reassurance about their attitudes toward physical activity.
Celiac disease may negatively affect the attitudes of people with celiac disease toward physical exercise and activity in two different ways. First, celiac disease symptoms inhibit exercise. Chronic and acute pain, fatigue, bruising and other symptoms associated with nutrient deficiency and celiac disease recovery could easily affect the motivation 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 induce food-dependent allergy symptoms (Sampson, 2003). If someone with celiac disease were to experience symptoms as if they were having an allergic reaction to gluten when they conducted certain exercises, they would either try to push through, stop, or change their exercise program or schedule. They could exercise only in the morning, before breakfast and after a long period of not eating, or they could choose activities with less physical impact,
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such as walking/hiking, or biking.

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

There is a long list of symptoms that are associated with celiac disease. Some of the symptoms of celiac disease that are documented in literature 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 small intestine, and people diagnosed with celiac disease should therefore be tested for vitamin deficiencies. Side effects of nutrient deficiency vary from person to person, but the level of nutrient deficiency may affect the amount that someone with celiac disease will exercise. For example, a person's calcium absorption rate may affect their bone density, and a person's iron absorption rate may affect their energy levels. In general, weight-bearing exercise is associated with stronger bone density. Anemia (lack of iron), though, decreases a person’s energy levels. Depending on the person, the two opposing influences of fatigue and bone density loss may sway the person’s attitude toward exercise in different ways.

This is the subject of a human geography honours project at the University of Victoria. If you have any comments on the subject, please contact 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 gluten withdrawal on bone mass, bone metabolism and nutritional status in newly diagnosed adult coeliac disease patients. Alimentary Pharmacology & Therapeutics. 14, 35-43.
  • Palosuo, K. (2003). Transglutaminase-mediated cross-linking of a peptic fraction of w-5 gliadin enhances lgE reactivity in wheat-dependent, exercise-induced anaphylaxis. Journal of Allergy and Clinical Immunocology: 111:6, 1386-1392. welcomes your comments below (registration is NOT required).

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23 Responses:

Kaz Powell
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said this on
02 Jun 2009 4:47:28 PM PST
Hi, I was confirmed via biopsy with celiac today in fact so I feel like sharing the story. whether its any use to you or not is another question! After years of symptoms but being ignored by my doctor and being called lazy by friends and family it was exercise which made me change doctors and get a diagnosis. As well as other symptoms my main is chronic fatigue. Sleeping for 37 hours straight is my record! 20 hours is normal. I also put on 4 stone in a year. Fair enough I suppose if all I do is sleep. So I decided to take up running *again*. I got to being able to run for 5 minutes without stopping over a period of weeks but then I got worse and worse very quickly. It wasn't that I was out of breath it was that my legs would give way benea6th me. Even after days off running to recover the pain did not go away and legs muscles did not recover, so I knew in my own head that it felt like vitamins weren't getting put back into the muscles. I guess the weeks building up to being able to run for 5 minutes or so used up anything that was left and then they were truly empty. So I changed doctors and four months later its been confirmed as coeliac (although I've been gluten free for 22 days - and counting!). Good luck with your work. Kaz .

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said this on
03 Jun 2009 10:00:15 AM PST
In my case the adoption of a gluten free diet allowed and encouraged me to increase my physical activity. I hike in the mountains every weekend, but prior to diagnosis my gluten induced anemia had me skipping the high peaks due to reduced power, cramps, restless body, etc. Now I do them all, do them fast, and feel great, like I did 20 years ago.

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said this on
04 Jun 2009 6:03:48 PM PST
I agree with John. My physical stamina is much better now that my anemia is resolved. I really hadn't noticed any specific problems before my doctor followed up on the anemia and diagnosed celiac disease this winter, but this spring I have the energy and stamina for longer hikes and recover faster.

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said this on
10 Jun 2009 6:59:23 AM PST
I was diagnosed in late Feb 2000 as I was finishing up my training for the Boston Marathon. At that time my long runs were planned so that there were plenty of wooded areas I could run off to. Since being on a gluten-free diet, I no longer need to worry about intestinal discomfort and my training and racing is better than ever. Last year I was ranked as an All American male triathlete in the 45-49 year old age group. I qualified and competed in the World's 70.3 Championship which completed my year of doing Boston Marathon, four half-ironman races and various other smaller triathlons and running races. Being diagnosed as Celiac Sprue to me has been a blessing in disguise as I need to always eat healthy to stay in shape and maintain my energy levels. The past few years I've noticed a lot more sports drink mixes that are now Gluten Free and are great for high caloric nutrition during the long workout sessions.

yvonne roush
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said this on
10 Jun 2009 3:35:34 PM PST
I was diagnosed with Celiac almost 3 years ago. I had started exercising at a 'ladies club' and even took up slow running. 6 months before my diagnosis, I started having such Strong intestinal problems (flatulence with bowel leakage) that I had to give up ALL physical exercise due to the imminent chance of an accident. I am happy to report with symptoms under control, I have re-started regular exercise. Fascinating study!

Jan Tacherra
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said this on
11 Jun 2009 5:20:51 AM PST
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?

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said this on
03 Aug 2009 9:37:44 PM PST
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.

Paul D
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said this on
11 Jun 2009 9:54:32 AM PST
Before I was diagnosed with Coeliac Disease, exercise was the only thing that made me feel better, since eating healthily at the time was still hurting me due to gluten.

Now, I am mid way in the healing process and on a strict gluten free diet, I find that exercise hinders me because it makes me too hungry (I am hungry enough since I don't absorb nutrients properly yet), so I avoid heavy exercise. When I heal more, I'll slowly increase the exercise, but for now, I just stretch or do some yoga (or veg on the couch instead!)

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said this on
11 Jun 2009 10:51:52 AM PST
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.

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said this on
19 Nov 2011 5:20:43 AM PST
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 GF diet! I really need some help! And I don't know who will have answers if my doctor doesn't!

Tina Hughes
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said this on
11 Jun 2009 1:19:23 PM PST
This article made very interesting reading, as do the comments of the other readers. I am now in my mid-forties and have not technically been diagnosed as a celiac, probably because I have been trying to avoid eating wheat for some years. I was originally diagnosed with IBS and left to figure out how to survive by a very disinterested physician. The result has been that I have tried to follow a 'healthy' diet which included barley, rye and oats. I have been very physically fit in the past, training in karate four times a week and more for four years as well as working as a full time gardener. Over the last four years, my symptoms gradually worsened and my new doctor suggested that I may be a celiac after an extreme reaction to a meal. For me the biggest deterrent to exercise related to the intense pains that I experienced in my joints, bones and muscles. These were so severe at times that I could hardly put one foot in front of the other! Even after following a strict gluten free diet for almost a year my stamina and energy levels fluctuate and there are times when I am totally exhausted. I walk regularly and am hoping to take up more intensive exercise in the coming months. From my point of view it is not the desire to exercise that is absent it is purely down to having the physical ability to do so, although now that the physical pain has gone it's much more appealing now.

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said this on
11 Jun 2009 2:26:16 PM PST
Posting this article and getting public comments is an interesting way to get data for your study. Like some others who've commented, I was anemic and had a lot of pain before diagnosis. Though I was always very active (running, hiking, dance), that was a real problem. Now, at 58, I have a lot more endurance and enjoy bicycle touring and other strenuous physical activity.

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said this on
11 Jun 2009 8:04:51 PM PST
Hi Claire,
I am curious if you know of anyone who is studying the attitudes of children with celiac disease toward physical activity?

We have a 12 year old daughter, with celiac disease, and Type 1 Diabetes. She is very athletic, training at a high performance level (provincial) in one of her many sports. She is a very picky eater, thus a concern on our behalf, for her ability to sustain a healthy body while being physically active.

Janne Ingram
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said this on
12 Jun 2009 7:14:43 PM PST
My husband, daughter and myself now all eat gluten-free, while we have not been diagnosed as celiac we are sure that we are all gluten intolerant and have other food allergies (dairy and egg) as well. We have been gluten-free for 5 weeks and I have had the best result of the three of us. My Arthritis has improved about 80%. The swelling and pain in my joints and entire body has decreased to the extent that I want to excercise, I haven't felt this good for 20 years! My stomach problems were always put down to IBS (as were my daughter's), but I think that is what the doctors say when they run out of ideas. No doctor and I've seen plenty... has ever said that our health problems could be diet/food allergy related and I wish they had because I've had to figure this all out all by myself. My husband was tested and confirmed as wheat allergic years ago, but wouldn't try going gluten-free, he was always very active and fit but for the last few years he becomes ill if he tries to exercise regularly which really makes him scared to exercise. He has not felt much better as yet but has agreed to keep up the gluten-free diet as its easier now the we are gluten-free as well. I hope to be able to start doing gentle exercise soon and regain some fitness, as in the five weeks I've been eating gluten-free I have lost about 3kg without even trying! And although eating gluten-free is a challenge I will never go back to gluten.

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said this on
15 Jun 2009 8:09:05 PM PST
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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said this on
22 Jun 2009 10:45:19 AM PST
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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said this on
09 Feb 2010 11:27:42 AM PST
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!

Bill Wells
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said this on
30 Jun 2009 5:07:11 PM PST
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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said this on
07 May 2012 3:58:48 PM PST
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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said this on
15 Jul 2012 8:15:22 AM PST
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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said this on
10 Sep 2012 12:17:29 PM PST
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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said this on
15 Oct 2012 8:12:55 PM PST
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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said this on
31 Aug 2016 10:41:05 AM PST
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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