The development of coeliac disease is due (in part) to particular genes that are inherited from your parents. These genes (HLA DQ2 and HLA DQ8) that make you susceptible to coeliac disease also predispose you to a number of other autoimmune conditions (an autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue). This genetic link means that autoimmune diseases often appear in clusters (either multiple disorders within one person or a history of autoimmune disease within the immediate or extended family).
The presence of an autoimmune disease in an individual or their family members should prompt screening for coeliac disease. There is some evidence that early diagnosis and treatment of coeliac disease reduces the risk of other autoimmune disease developing, so early detection and adherence to the gluten free diet is very important.
Likewise, if someone has been diagnosed with coeliac disease, routine screening for other commonly associated autoimmune conditions should occur.
The most common autoimmune conditions associated with coeliac disease are autoimmune thyroid disease and type 1 diabetes (although there are more than 80 different types of autoimmune disease – see our conditions associated with coeliac disease brochure for a comprehensive list).
Autoimmune thyroid disease
Autoimmune thyroid disease occurs when the immune system attacks the body’s own thyroid gland. The thyroid gland, which is a small gland at the front of the neck, becomes inflamed and production of thyroid hormones is either abnormally increased or decreased. Often the gland becomes enlarged which is called a “goitre”.
Thyroid hormones are important for many bodily functions and metabolism. An underactive thyroid can lead to weight gain, constipation, cold intolerance and general sluggishness. An overactive thyroid can cause a racing heart, anxiety, heat intolerance, poor sleep and weight loss.
Up to 10% of people diagnosed with coeliac disease also suffer from autoimmune thyroid disease. It is therefore recommended that if you are diagnosed with either of these conditions, you should be tested for the other.
Type 1 diabetes
Diabetes is a condition where the body is unable to regulate the amount of glucose in the blood. Insulin, produced in the pancreas, is responsible for transporting glucose from the blood to the body’s cells to be used as energy. In those with diabetes, either insufficient insulin is produced by the pancreas (type 1 and LADA (Latent Autoimmune Diabetes in the Adult)), or the insulin produced does not work properly (type 2).
Type 1 diabetes and LADA are autoimmune diseases associated with coeliac disease. Type 1 diabetes is usually diagnosed in children and young adults, while LADA usually appears in adult life. Up to 10% of children and adolescents with type 1 diabetes also have coeliac disease, most often diagnosed during routine screening.
There is no link between coeliac disease and type 2 diabetes. However, it is possible for both of these conditions to occur in the same person, independent of each other.
A booklet called living with diabetes and coeliac disease, has been prepared by Coeliac Australia and Diabetes Australia, and is available from your state Coeliac organisation.
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