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Is Celiac Disease Worse in People with Anemia?

Celiac.com 09/05/2013 - Current medical science describes diarrhea as a classical symptom of celiac disease, while anemia is described as an atypical or silent manifestation.

Photo: CC--CommonsHowever, there was actually very little information that accurately compares the severity of celiac disease between patients who present with anemia against those who present with diarrhea.

A team of researchers recently set out to determine whether people with anemia have more severe celiac disease than people with diarrhea.

The research team included H.A. Daya, B. Lebwohl, S.K. Lewis, and P.H. Green. They are affiliated with the Celiac Disease Center, Department of Internal Medicine at the Columbia University College of Physicians and Surgeons in New York.

For their study, the researchers selected a study group of 727 patients from a database of celiac disease patients evaluated at a tertiary referral center between 1990 and 2011. They used the degree of villous atrophy and clinical and serologic parameters to determine the severity of the celiac disease for each patient.

The team compared patients according to mode of presentation and sex. They also conducted age and sex-adjusted multivariable analyses to assess the association between the mode of celiac disease presentation and cholesterol level, bone density, severity of villous atrophy, erythrocyte sedimentation rate (ESR), and level of anti-tissue transglutaminase (anti-tTG).

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They found that just over three-quarters of the patients presented with diarrhea, while just under one-quarter presented with anemia; 92% of which was iron deficient anemia.

Multiple regression analysis showed that celiac disease with anemia was associated with lower levels of total cholesterol (P=.02) and high-density lipoprotein (P=.002), and a higher ESR (P=.001) and level of anti-tTG (P=.01).

In women only, celiac disease with anemia was associated with a lower level of cholesterol.

Anemic patients were more than twice as likely to have severe villous atrophy and a low bone mass density at time they were diagnosed with celiac disease than were patients who presented with diarrhea.

So, the results show that celiac disease patients who present with anemia have more severe disease than those who present with diarrhea. There also seem to be sex-specific differences with respect to the connection between anemia and the various features of celiac disease, such as cholesterol.

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6 Responses:

 
Matt
Rating: ratingfullratingfullratingemptyratingemptyratingempty Unrated
said this on
05 Sep 2013 9:23:47 AM PDT
Anemia comes from having celiac disease...of course they were twice as likely the anemia is caused from not absorbing nutrients because you have CELIAC disease! Come on folks...


 
Desoperate Lady Saved
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said this on
06 Sep 2013 5:01:56 PM PDT
This article compared those who have been diagnosed because they have diarrhea to those that were diagnosed because they have anemia. I had the anemia and think that if one had diarrhea, they couldn't ignore it. I wonder if those with anemia are generally sick longer and that could be the reason they have more malabsorption problems.

 
Penelope
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said this on
11 Sep 2013 10:34:29 AM PDT
My celiac presented with anemia. I tried to address it myself, with diet, until I was passing out. Then doctors misdiagnosed it for years until the intestinal issues presented. So I think you are correct, plus doctors don't think of celiac when they see anemia.

 
Donnie
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said this on
08 Sep 2013 5:25:40 PM PDT
I had anemia and really bad diarrhea for many years, before my celiac diagnosis. My parents had the same, but were never tested for celiac. We all had low iron and other nutrients on our blood tests.

 
rastas
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said this on
11 Sep 2013 2:18:18 PM PDT
I had anemia and bowel issues when I was diagnosed as well. Although my bone desnisty is good. I was 29 when I was diagnosed, I'm 31 now and my Ttg is still above normal (although it's now in the readable test range, so that's good). And no, after diagnosis I haven't 'cheated'.

 
Cindy

said this on
11 Sep 2013 5:31:50 PM PDT
My GI and hematologist said that since I was diagnosed with celiac at age 51 and most likely had the disease most of my life with no symptoms until severe anemia a few years ago, my iron deficiencies may continue because my small intestine is very damaged and not absorbing well...I have been gluten free 14 months. I have had a series of iron infusions in the past year.....




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We have gone gluten free, our whole house, as of a month ago. It was pretty seamless since I had been gluten-free for 5 months last year. I have found many good recipes, and my picky husband and one of my boys who is also a picky eater, even prefer many gluten-free recipes to the regular ones. My husband did see my point about the size of the gluten protein means nothing. Its a gluten protein period, that's what you are avoiding. It doesn't matter if its hiding in the scratch of your baking sheet and you can't see it. You can't see the wind, but it's still there. I hear you on the anemia. I've been anemic for several years, I just thought it as because I was getting a little older. Has your anemia gone away or do you still have problems with it?

Ennis, it is made out of metal, coated with plastic I think. You have such a hard time, my heart really hurts for you. But you are such a support to those on this board, and a great teacher for those of us who are new.

Thanks everyone! I think its hard for people to fully accept because they cant see the damage it does every time you get glutened. It's invisible. Im glad to know I wasnt being paranoid. I sure was when I was first diagnosed. I laugh at myself now, but its a pretty steep learning curve.

FYI......anxiety is a common symptom with celiac disease and NCGI. It seems to resolve on a gluten-free diet. ?

Yes, I will definitely update you and would love to hear what your experience is. I'm glad I found this forum because you're right--it's nice to not feel so alone. I'm also prone to anxiety--so waiting and worrying is not fun! Cyclinglady, thanks for sharing your experience as well. I do plan to maintain a gluten-free diet for a while at least if the biopsy is negative just to see how I feel.