Can celiac disease develop later in life?

By Liz Wood, Health Testing Specialist at at AlphaBiolabs
Last reviewed: 11/10/2023

In this article, we discuss celiac disease, what it is, and how the condition can develop in later life.

What is celiac disease?

Celiac disease is an autoimmune disease that affects around 1 in 133 Americans (about 1% of the population).

The condition develops over time because of a sensitivity to gluten, a protein found in certain cereal grains including wheat, rye, and barley, and commonly used in food products including bread, cereal, and pasta.

When a person with celiac disease eats gluten, this causes the body’s immune system to attack its own tissue, damaging the gut lining and preventing the body from adequately absorbing nutrients from food.

Symptoms of celiac disease can range from mild to severe depending on the person, and can include flatulence and bloating, constipation or hard stools, diarrhea or loose stools, indigestion, nausea and stomach cramps.

What are the symptoms of celiac disease?

The most common symptoms of celiac disease include:

• Flatulence
• Diarrhea
• Sudden, unexplained weight loss
• Bloating
• Abdominal cramps or pain
• Nausea
• Vomiting
• Constipation

Some people may also experience more general symptoms such as:

• Anemia
• Infertility or subfertility
• Malabsorption
• Malnutrition
• Dermatitis herpetiformis (a skin rash linked to celiac disease)
• Ataxia (problems with balance, co-ordination or speech)
• Nerve damage

Children with celiac disease may experience delayed puberty, stunted growth and problems with tooth enamel. You can learn more about the complications of celiac disease in children here.

If you are experiencing any of the symptoms associated with celiac disease, it is important to speak to your physician, who will be able to provide further guidance on testing and diagnosis.

Can celiac disease develop later in life?

The symptoms of celiac disease are most likely to develop when a person is 8-12 months old, or later in life when they are around 40-60 years old.

Some people with celiac disease can go undiagnosed for many years, and there are many reasons why a person with celiac disease may only start to experience symptoms in later life.

For example, they may only experience very mild symptoms or no symptoms at all, or their symptoms may be atypical, such as hair loss [AJ1] or dermatitis herpetiformis (a rash linked to celiac disease).

This means that they may go a long time before seeking advice from their physician, or they may be misdiagnosed as having a different illness.

There also appears to be a need for a ‘triggering event’ for the symptoms of celiac to occur.

Almost all people with celiac disease have the HLA-DQ2/HLA-DQ8 genes. However, scientists theorize that there needs to be another genetic or environmental factor involved to cause the onset of celiac disease, in addition to having the HLA-DQ2/HLA-DQ8 genes.

One theory is that an infection, such as a stomach bug, may trigger celiac disease. Therefore, it is possible for someone to have the HLA-DQ2/HLA-DQ8 genes for many years with no obvious signs of celiac disease, until a ‘triggering event’ causes the immune system to react to gluten.

Our Genetic Celiac Disease Test can tell you if you are genetically predisposed to having celiac disease, by looking for the HLA-DQ2/HLA-DQ8 genes that are associated with the illness, with only two simple cheek swabs required.

The results of the test can also help you seek a confirmatory diagnosis more quickly from your physician, if you are found to have these genes.

What causes celiac disease later in life?

A ‘triggering event’, such as another genetic disorder, or an environmental factor (e.g. infection, surgery, medication, changes to the gut bacteria), can cause the onset of celiac disease in a person who may not have experienced any symptoms previously.

They may have been able to eat gluten with no problems for many years until the ‘triggering event’ occurs, and they are no longer able to tolerate gluten.

Some people whose symptoms have been mild or non-existent, or who have been misdiagnosed as having another illness, may have lived with celiac disease for many years, even decades, without knowing that they have the condition.

However, it is important to remember that a person with celiac disease who does not experience symptoms, despite eating gluten, will still experience damage to the gut.

Over time, this damage will become so extensive, that symptoms may appear quickly and can be more severe, even if the person has felt ‘healthy’ for many years.

For this reason, it is extremely important to speak to your physician if you are experiencing symptoms that could indicate celiac disease, as they will be able to advise on next steps for testing and diagnosis.

How common is it to develop celiac disease later in life?

It is very common for people to develop celiac disease later in life.

Symptoms often begin between the ages of 40 and 60. However, an individual may have had celiac disease for many years before experiencing symptoms, without being aware of it.#

This can be a cause for concern because if a person with celiac disease continues to eat gluten, damage to the gut is still occurring even if they have no or few symptoms.
This long-term damage can lead to more severe symptoms in later life.

For this reason, it is extremely important to speak to your physician if you are experiencing symptoms that could indicate celiac disease, as they will be able to advise on next steps for testing and diagnosis.