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Raising awareness about celiac disease is crucial for encouraging individuals to seek diagnosis and appropriate treatment. Education can help mitigate the risk of long-term health issues and improve the quality of life for those affected.

Celiac Awareness Month is a perfect time to highlight the importance of understanding this disease from a functional medicine perspective. It offers hope through its comprehensive, personalized approach to health and wellness.


By expanding our understanding and support for those with celiac disease, we can foster a more health-conscious society that prioritizes the well-being of every individual, particularly those affected by such challenging conditions.




What is Celiac Disease?

Celiac disease is an autoimmune condition triggered by gluten consumption, a protein found in wheat, barley, and rye. When individuals with celiac disease ingest gluten, their immune system mistakenly attacks the small intestine, leading to damage in the villi, small fingerlike projections that line the intestine and promote nutrient absorption. The damage prevents the body from absorbing nutrients properly, leading to malnutrition, and can cause a wide range of symptoms, including diarrhea, abdominal pain, bloating, and fatigue.

The Prevalence of Celiac Disease

Celiac disease affects about 1% of the global population, though the prevalence varies by country and population. In the United States, about 1 in 100 people are affected by celiac disease. However, many people with celiac disease are not diagnosed, which can lead to long-term health complications, including anemia, osteoporosis, and even neurological or reproductive issues.


Symptoms and Diagnosis

The symptoms of celiac disease can vary widely. They may include gastrointestinal problems and non-gastrointestinal symptoms such as anemia, skin rash, headaches, joint pain, and fatigue. Some individuals with celiac disease may have no symptoms at all, which makes the disease particularly challenging to diagnose.

Diagnosis typically involves a combination of blood tests to look for antibodies typical of celiac disease, followed by an endoscopic biopsy of the small intestine to look for damage to the villi. Genetic testing can also support diagnosis, as specific genes are associated with an increased risk of celiac disease.


Age of Diagnosis

Celiac disease can be diagnosed at any age, from infants to older age. However, it is most commonly diagnosed in two age peaks: the first occurs in children between 2 and 5 years old, as they are introduced to gluten-containing foods, and the second peak occurs in adults in their 30s and 40s. The symptoms can vary dramatically between these age groups, with children more likely to exhibit digestive symptoms and adults often presenting with systemic symptoms such as anemia, fatigue, or bone loss.



Understanding Borderline Celiac Disease

Borderline celiac disease, often referred to as “latent” or “potential” celiac disease, is a condition in which individuals have genetic markers or serological evidence of celiac disease but may have normal intestinal mucosa and no apparent symptoms when consuming gluten. These individuals are at a higher risk of developing full-blown celiac disease later in life, especially if they encounter an environmental trigger such as surgery, pregnancy, or severe stress.

The management and monitoring of borderline celiac disease involve regular check-ups and possibly maintaining a gluten-free diet, depending on the patient’s antibody levels and symptoms. A functional medicine approach is particularly beneficial here, emphasizing preventive care and personalized dietary strategies to help maintain gut health and prevent disease progression.


Gluten Sensitivity vs. Celiac Disease

Gluten sensitivity, or non-celiac gluten sensitivity (NCGS), presents symptoms similar to celiac disease, including abdominal pain, bloating, diarrhea, and fatigue. However, unlike celiac disease, NCGS does not involve an autoimmune attack on the intestines and does not cause the same kind of intestinal damage or risk of complications such as osteoporosis or anemia.

From a functional medicine perspective, differentiating between celiac disease and gluten sensitivity is crucial, as the treatment strategies differ significantly. While individuals with celiac disease must avoid gluten for life, those with gluten sensitivity may not need to be as strict, depending on their response to gluten. Diagnosis typically involves ruling out celiac disease through blood tests and intestinal biopsies before considering NCGS.

Functional medicine practitioners often employ an elimination diet to confirm whether symptoms improve upon removing gluten from the diet and worsen when it is reintroduced. This approach helps diagnose gluten sensitivity but also aids in identifying other potential dietary triggers that might contribute to the symptoms.





Functional Medicine Approach to Celiac Disease

Functional medicine approaches celiac disease by not only focusing on the avoidance of gluten but also addressing the broader aspects of health that can be affected by the disease. This approach is rooted in understanding each patient’s biochemical individuality and the intricate connections between lifestyle factors and immune function.


  1.  Comprehensive Diagnosis

Functional medicine emphasizes thorough testing to confirm the diagnosis of celiac disease and identify any other potential health issues that could be contributing to symptoms. This may include nutritional deficiency tests, gut microbiota analysis, and tests for other autoimmune conditions.

      2. Personalized Nutrition

A cornerstone of functional medicine is personalized nutrition. For someone with celiac disease, this involves crafting a gluten-free diet that addresses other individual dietary needs. Functional nutrition goes beyond simply avoiding gluten and considers the overall nutritional balance, other food sensitivities, and how diet influences the gut microbiome and inflammation.

      3. Gut Health Optimization

Improving gut health is crucial in managing celiac disease. Functional medicine focuses on strategies to heal and support the gut lining, balance gut bacteria, and reduce inflammation. This might include probiotics, prebiotics, glutamine, and other supplements that support mucosal health and immune function.

      4. Supporting Detoxification and Methylation

Detoxification and methylation are processes often overlooked in conventional treatment models but critical in functional medicine. People with celiac disease usually have compromised detoxification pathways due to nutrient deficiencies. Enhancing these pathways through diet, lifestyle changes, and supplementation can significantly improve health outcomes.

      5. Stress Management and Lifestyle Changes

Stress can negatively affect gut health and immune function. Functional medicine treatments often incorporate stress management techniques such as meditation, yoga, and biofeedback, recognizing the strong connection between stress and autoimmune flare-ups.

      6. Ongoing Monitoring and Support

Finally, functional medicine provides ongoing monitoring and support to adjust the treatment plan as needed, ensuring that it remains effective over the long term and adapts to changes in the patient’s condition and lifestyle.



The journey through understanding and managing celiac disease and related conditions is profoundly personal. It varies significantly from one individual to another. Functional medicine provides a comprehensive framework that addresses the dietary aspects and broader impacts on health and lifestyle. By fostering greater awareness and providing personalized care, we can support those affected by celiac disease and gluten-related disorders in leading healthier, more fulfilling lives.




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