Celiac Disease and Its Impact on Muscle Function

By SWA

Celiac disease (CD) is a chronic autoimmune disorder triggered by gluten consumption, leading to damage in the small intestine. While it is primarily known for causing digestive issues, CD can also have significant effects on muscle function. This occurs due to chronic inflammation, malabsorption of key nutrients, and immune system dysfunction. Below, we explore the different ways in which celiac disease can contribute to muscle weakness, pain, and reduced physical performance.

The domestication of grains marked a turning point in human history, allowing early civilizations to settle, farm, and develop complex societies. Ancient grains like Einkorn were selectively bred for desirable traits such as larger seeds and easier harvesting, gradually transforming wild grasses into reliable food sources. However, as agriculture advanced, so did the complexity of wheat. Modern wheat varieties, particularly bread wheat, contain higher amounts of gluten—a mixture of proteins that gives dough its elasticity but also plays a central role in triggering celiac disease. In genetically predisposed individuals, the immune system mistakes fragments of gluten, especially gliadin, as a threat, leading to an autoimmune response that damages the small intestine. This contrast—between the external shaping of grain DNA through domestication and the internal response of the human immune system—highlights a mismatch that affects a subset of the population. While domestication aimed to feed more people, it inadvertently increased exposure to proteins that some immune systems cannot tolerate.

Reference: https://www.sciencedirect.com/science/article/pii/S1631069110003021


1. Malabsorption of Key Nutrients

Since celiac disease damages the small intestine, it impairs the absorption of essential nutrients crucial for muscle health. These deficiencies can significantly impact muscle function:

  • Protein – Needed for muscle repair and growth; inadequate intake can lead to muscle loss.
  • Iron – Low levels can cause anemia, leading to fatigue and muscle weakness.
  • Vitamin D & Calcium – Essential for muscle contraction and bone health; deficiencies can result in muscle pain, weakness, and an increased risk of fractures.
  • Magnesium & Potassium – Crucial for nerve function and muscle contraction; low levels may cause muscle cramps, weakness, and even irregular heart rhythms.

Without these nutrients, the body struggles to maintain muscle mass, leading to reduced strength and endurance.

2. Chronic Inflammation

Celiac disease is an autoimmune condition, meaning that consuming gluten triggers an inflammatory response that affects not just the intestines but the entire body. This inflammation can:

  • Lead to muscle wasting (sarcopenia) over time.
  • Cause myopathy (muscle weakness and pain) due to immune system overactivation.
  • Increase oxidative stress, which damages muscle cells and impairs recovery.

Chronic inflammation in CD can contribute to persistent fatigue, making it difficult for individuals to engage in physical activity and maintain muscle mass.

3. Neuromuscular Effects

Celiac disease can also impact the nervous system, leading to neuromuscular complications that affect muscle function.

  • Peripheral Neuropathy – Many individuals with CD experience nerve damage, leading to muscle weakness, tingling, numbness, and poor coordination.
  • Ataxia (Loss of Muscle Control) – In some cases, gluten ataxia can impair balance and coordination, making movement difficult.

These neurological symptoms further limit mobility and physical activity, contributing to muscle deterioration.

4. Loss of Muscle Mass (Sarcopenia)

Studies show that untreated celiac disease is linked to lower muscle mass and strength, particularly in older adults. This occurs due to:

  • Malnutrition, as nutrient deficiencies prevent muscle growth and repair.
  • Inflammation, which accelerates muscle breakdown.
  • Reduced physical activity, often due to fatigue and muscle weakness.

Without proper intervention, muscle loss can progress, leading to decreased mobility and increased risk of falls or injuries.

5. Fatigue and Reduced Exercise Performance

Chronic fatigue is a common symptom of celiac disease, and it can severely impact physical performance. Several factors contribute to this exhaustion:

  • Nutrient deficiencies reduce energy production, leading to persistent tiredness.
  • Immune system activation causes inflammation and muscle weakness.
  • Gastrointestinal distress can lead to poor sleep and reduced recovery from exercise.
  • Pain and weakness discourage individuals from engaging in regular physical activity, which further exacerbates muscle loss.

How Quickly Do Symptoms Appear After Eating Gluten?

The effects of gluten exposure vary depending on the individual, the severity of their condition, and the amount of gluten consumed. Here’s a general timeline of symptom onset:

Immediate to a Few Hours (0-6 Hours)

  • Some people react within minutes to a few hours after eating gluten.
  • Common early symptoms include:
    • Stomach pain or cramping
    • Bloating and gas
    • Nausea or vomiting
    • Diarrhea or constipation
    • Brain fog or fatigue

6-24 Hours

  • Symptoms often intensify within 6 to 12 hours, including:
    • Increased abdominal discomfort
    • Headaches
    • Joint or muscle pain
    • Skin reactions (rash or itching)
    • Mood changes (irritability, anxiety, or depression)

24-72 Hours

  • More severe reactions can appear or worsen over the next 1-3 days:
    • Ongoing digestive distress
    • Fatigue and exhaustion
    • Neurological symptoms (tingling, dizziness, balance issues)
    • Immune system activation leading to inflammation

Days to Weeks (Long-Term Effects)

  • If you have celiac disease, gut damage starts immediately and can take weeks to months to fully heal.
  • Continued exposure to gluten can lead to nutrient deficiencies, muscle weakness, and long-term health complications.

For many individuals with celiac disease, repeated gluten exposure can worsen symptoms over time and slow recovery, making strict gluten avoidance crucial.

Can a Gluten-Free Diet Help?

Yes! Following a strict gluten-free diet is the best way to allow the gut to heal, improving nutrient absorption and reducing inflammation. Over time, this can:

✔ Improve muscle strength and energy levels.
✔ Reverse some muscle loss, especially with proper nutrition and resistance training.
✔ Reduce neuropathy symptoms if caught early.

How to Recover After Accidental Gluten Exposure

If you’ve accidentally consumed gluten, here are some strategies to help your body recover faster:

  1. Hydrate – Drink water and herbal teas (like ginger or peppermint) to aid digestion and reduce bloating.
  2. Soothe Digestion – Probiotics, bone broth, and easy-to-digest foods (like bananas, rice, and steamed vegetables) can help.
  3. Reduce Inflammation – Anti-inflammatory supplements like turmeric, omega-3 fatty acids, and magnesium may help ease symptoms.
  4. Get Rest – Allow your body time to recover with extra sleep and stress reduction techniques.
  5. Support Your Immune System – Vitamin D, zinc, and glutamine can help repair the gut lining.

What's unique in Schuppan’s approach?

Other publications often lump non-celiac wheat sensitivity (NCWS) into a vague, undefined category, often attributing symptoms to "gluten sensitivity" without a clear mechanism.

Schuppan proposes that much of NCWS is not about gluten at all, but about ATIs, which:

  • Activate innate immunity

  • Exacerbate chronic inflammatory diseases (e.g. IBD, MS, NAFLD)

  • Do not involve autoantibodies or genetic predisposition

This idea reframes gluten-free diets as potentially helpful not because of gluten elimination, but because they reduce exposure to ATIs (which are mostly found in modern wheat and processed foods).

Schuppan’ Summary of the Difference:

 Conclusion

Celiac disease can have a profound impact on muscle function due to malabsorption, chronic inflammation, and neuromuscular complications. These factors contribute to muscle weakness, fatigue, and reduced exercise performance. However, by following a strict gluten-free diet, focusing on proper nutrition, and staying active, individuals with CD can improve muscle strength and overall health.

Video: Coeliac (Celiac) Disease - Overview (signs and symptoms, pathophysiology, diagnosis, treatment)
https://www.youtube.com/watch?v=Hxd0msD954I

© 2000-2025 Sieglinde W. Alexander. All writings by Sieglinde W. Alexander have a fife year copy right. Library of Congress Card Number: LCN 00-192742 ISBN: 0-9703195-0-9

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