Understanding the Link Between Rheumatoid Arthritis and Celiac Disease (+Video)

Celiac.com 06/23/2025 - Doctors and researchers have long suspected that people with one autoimmune disease may be at higher risk for developing others. This study focused on two such conditions: rheumatoid arthritis and celiac disease. The main goal was to find out how common celiac disease is among people who have rheumatoid arthritis, compared to people who do not have it. The researchers also wanted to track how often new cases of celiac disease appeared in both groups over time.

How Was the Study Done?

The study used healthcare records from a large database in the Lombardy region of Italy, which covers over 10 million people. The researchers looked at data from 2004 to 2013.

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They identified over 70,000 adults diagnosed with rheumatoid arthritis and compared them to over 270,000 people without rheumatoid arthritis, carefully matching them by age and sex. These records included diagnosis codes from doctors, prescriptions, and certifications for chronic illnesses.

Importantly, the researchers used official diagnostic codes to confirm both rheumatoid arthritis and celiac disease diagnoses, meaning the results are based on medically verified cases—not just suspected or mild cases.

What Did the Researchers Find?

Celiac Disease Was More Common in People With Rheumatoid Arthritis

One of the clearest findings was that people with rheumatoid arthritis were more likely to also have celiac disease. Specifically:

• 0.24% of those with rheumatoid arthritis had celiac disease
• 0.14% of the people without rheumatoid arthritis had celiac disease

While these percentages may seem small, this actually means that celiac disease was nearly twice as common among those with rheumatoid arthritis.

Women With Rheumatoid Arthritis Were at Higher Risk

The connection between the two diseases was especially strong in women. Women with rheumatoid arthritis were much more likely to have celiac disease than women without it. However, this pattern was not seen in men, whose rates of celiac disease were about the same regardless of whether they had rheumatoid arthritis.

The study also found that younger women with rheumatoid arthritis—especially those under age 60—had the highest rates of celiac disease, suggesting that this might be a key group to monitor closely.

The Rate of New Celiac Diagnoses Stayed Stable

Another question the researchers asked was whether new cases of celiac disease were becoming more common over time in people with rheumatoid arthritis. Interestingly, they found that the incidence, or rate of new cases, remained stable during the 9-year follow-up period. This is in contrast to some other studies that have shown rising rates of celiac disease in the general population, especially among young people.

How Reliable Are the Results?

The study's large size and long follow-up period add weight to its conclusions. Additionally, because the researchers only included medically confirmed diagnoses, the findings are likely to reflect true disease patterns.

However, there are some limitations to keep in mind. Since the study relied on administrative data, it lacked detailed clinical information like symptoms, test results, or dietary habits. Also, because both conditions are relatively rare in the general population, the total number of people with both diseases was still fairly small, which can limit deeper analysis.

Moreover, since the non-arthritis control group was matched by age and gender to people with rheumatoid arthritis, it may not represent the broader population perfectly. This could slightly affect how the results compare to other studies.

Why Does This Matter for People With Celiac Disease?

This study highlights an important connection between two autoimmune conditions. If you or someone you know has rheumatoid arthritis—especially if you are a woman under 60—it may be worthwhile to talk to your doctor about the possibility of celiac disease, especially if you experience symptoms like unexplained digestive problems, fatigue, or nutrient deficiencies.

Currently, routine celiac screening is recommended for people with certain other autoimmune diseases, like type 1 diabetes or autoimmune thyroid disease. Rheumatoid arthritis has not traditionally been part of that list, but this study suggests it may deserve more attention—at least for certain patients.

By identifying celiac disease earlier in people with rheumatoid arthritis, doctors might be able to reduce complications, improve quality of life, and ensure proper nutrition through a gluten-free diet.

Read more at: frontiersin.org

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