Gluten & Fatigue – Could you have coeliac disease?

27 November 2020

Gluten & Fatigue - Could you have coeliac disease?

Food and Fatigue

Symptoms of fatigue and tiredness are all too common in the modern world. The demands of a busy work and home environment, coupled with every day stresses and a poor work-life balance are frequently to blame. However, our food choices and meal patterns also have a big role to play. After all, food equals fuel and, just like any engine, when the tank is low or filled with the wrong stuff, it’s like to work less effectively! 

The truth is that there are a variety of factors that are likely to contribute towards fatigue, and therefore a variety of things that could be tried to help relieve the problem. Getting sufficient sleep, drinking plenty of fluids throughout the day, eating regular, healthy meals and snacks based on higher fibre starchy carbs and including exercise in your daily routine are simple ways to boost your energy levels. However, despite best efforts and intentions, some people continue to suffer from persistent tiredness. If this is you, then it could be worth considering other potential causes related to your overall health, diet or lifestyle. 

Gluten and tiredness – is there a link?

Many people believe that specific foods contribute to their poor energy levels. One such commonly identified culprit is bread, and other foods rich in simple carbohydrates. Others go further and believe that the gluten contained within bread is the real cause of their fatigue. 

But could this association be unfair? Gluten is a protein found in wheat, rye and barley, and all food products made from these grains, including bread, pasta, cakes, biscuits and pastries. As such, gluten is ubiquitous amongst the starchy carbohydrate food group that most of our meals and snacks derive from. Eating a meal rich in simple, or lower fibre starchy carbohydrates (e.g white bread) can cause a rapid and substantial rise in blood sugar, followed by an equally impressive dip – resulting in your classic post-lunch lull! Many scientists believe that the dip in energy experienced after eating is also due to an increase in the body’s production of the sleep hormone serotonin. Carbohydrates and protein-rich foods are particularly encouraging of this response – further cementing the perceived association between gluten-containing foods and fatigue. 

Fatigue – the under-recognised symptom of coeliac disease

There are some groups of people in whom gluten really can cause a particularly devastating effect on energy levels. Extreme tiredness is a common symptom of undiagnosed coeliac disease, and for some, it may be the only symptom. The gut damage caused by coeliac disease results in poorer absorption of essential food nutrients involved in energy metabolism, including iron, folic acid and vitamin B12. As the gut starts to heal on a gluten free diet, fatigue can quickly resolve for coeliac sufferers. Unfortunately, in the absence of other symptoms, persistent tiredness is often not a reason to motivate people to ask their doctor to investigate further. It’s important to note that only one in three people who have coeliac disease know that they have the condition, hence seemingly benign symptoms such as persistent tiredness are always worth investigating further.

A further group of people who may experience symptoms of tiredness after eating gluten are those suffering from non-coeliac gluten sensitivity. The symptoms of non coeliac gluten sensitivity often appear to mimic those of coeliac disease, however, unlike coeliac disease, there is currently no medical test available to help diagnose the condition and the diagnosis must be made on the basis of an improvement in symptoms whilst following a gluten-free diet and the return of symptoms when gluten is reintroduced. 

If you’re experiencing fatigue, or any other symptoms that you feel may be related to gluten, it’s vital that you don’t remove gluten from your diet until you have been tested for coeliac disease, otherwise your test results may not be accurate.

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