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  3. Associated conditions and complications
associated conditions

Associated conditions and complications

Autoimmune disorders

Coeliac disease is an autoimmune disease and people with coeliac disease have genes that predispose them to the condition. Coeliac disease is more common in people with Type 1 diabetes and autoimmune thyroid disease.

If you have one autoimmune condition, there is an increased risk of having another autoimmune condition. It has been suggested that the chance of developing other autoimmune disorders is increased when diagnosis of coeliac disease is delayed. This may be because of the exposure to gluten before going onto a gluten-free diet.

Type 1 diabetes

Coeliac disease and Type 1 diabetes are both autoimmune conditions. People with Type 1 diabetes are at a higher risk than the general population of having coeliac disease, with between 4 and 9% of people with Type 1 diabetes also having a diagnosis of coeliac disease, compared with 1% in the general population. More information on coeliac disease and Type 1 diabetes.

Autoimmune thyroid disease

People with autoimmune thyroid disease are at a higher risk than the general population of having coeliac disease (1 - 4% compared with 1% in the general population). More information on autoimmune thyroid disease.

Other autoimmune disorders

The NICE (2015) guideline for the ‘Recognition, assessment and management of coeliac disease’ has reviewed the research evidence regarding coeliac disease and possible related conditions and has recommended who should be screened for coeliac disease. There are many other autoimmune conditions which have not been listed by NICE with which there may be a link and we are aware that research continues to explore coeliac disease and possible related conditions. However, more research is needed before recommendations can be made regarding people with other autoimmune conditions and whether they should be screened.


Undiagnosed and untreated coeliac disease may lead to developing osteoporosis, which is where the bones become thin and brittle. This is because you may not have been absorbing calcium properly for some time. 

Lactose intolerance

Lactose intolerance can be associated with coeliac disease as the disease damages the part of the gut where lactase, the enzyme that breaks down lactose, is produced. Symptoms of lactose intolerance are similar to that of coeliac disease.

Lymphoma and small bowel cancer

Lymphoma and small bowel cancer is a serious complication of coeliac disease. However, once someone with coeliac disease has been following the gluten-free diet for three to five years, their risk of developing these specific types of cancers is no greater than that of the general population.


There is no extra risk of infertility problems for most women with coeliac disease who are following a gluten-free diet. However, undiagnosed or untreated coeliac disease may be an underlying cause in cases of unexplained infertility so in these cases testing for coeliac disease should be considered.


Autism spectrum disorder (ASD) is a common developmental disability that affects the way a person communicates and relates to people around them.

Although there is currently not enough evidence to recommend the use of a gluten-free diet and casein free diet as a treatment for ASD. The most commonly requested dietary intervention in ASD is a gluten-free and casein free diet.

If you’re unsure about whether you should be tested for coeliac disease, you might find it useful to take the Coeliac UK online assessment for coeliac disease. This short questionnaire will take you through the symptoms of coeliac disease and other risk factors. Take the online assessment now.

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