Celiac diseasedoes not treat all people the same. This includes variations in the symptoms and characteristics of the disease in males and females.
Celiac disease (CD) is an immune-related disorder that causes symptoms when a person ingestsglutenin food and other products.In males, celiac disease can run the gamut fromclassic symptomsof diarrhea, weight loss, and fatigue to more subtle signs, such as liver dysfunction and skin rash.
This article takes a look at some of the ways that celiac disease differs in males compared to females. It also explores why diagnoses are often delayed in males as well as some of the conditions that affect men with CD more than those of the general population.
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Celiac Disease and Delayed Diagnoses in Men
Celiac disease (CD) is just as impactful in males as it is in females. With that said, celiac disease affects females two to three times more often than males. As a result, diagnoses in males are often delayed because healthcare providers may not readily associate CD with men.
Studies suggest that it takes an average of nine years from the appearance of symptoms for CD to be diagnosed.In males, particularly younger males, this can take longer due to the ongoing misdiagnosis of symptoms.
According to a 2014 study males between the ages of 16 and 34 are far less likely to be diagnosed with CD than any other group.
Other studies suggest that males are as likely as females to be diagnosed if they have classic CD symptoms (like chronic diarrhea, bloating, gas, fatigue, abdominal pain, and weight loss) but less likely if they have atypical CD symptoms (such as anemia, liver dysfunction, CD-related skin rash, short stature, or dental/bone problems).
How Celiac Disease Is Treated
Celiac Disease Symptoms in Men
Generally speaking, CD symptoms in females and males are the same. There are some conditions likeosteoporosis(porous bones) that are more common in females, in part because females are already at an increased risk of this bone disorder.
Among males, several conditions are more commonly seen. Some of these conditions cause overt symptoms. Others cause subclinical symptoms (without overt symptoms) or are asymptomatic (without symptoms).
Dermatitis Herpetiformis
Dermatitis herpetiformis, also known as a celiac disease rash, is an intensely itchy, blistering rash that commonly affects the elbows, knees, buttocks, and back.
Most population-based studies have that found males are up to two times more likely to be affected than females. Males are also more like to have dermatitis herpetiformis on the genitals and in the mouth.
Liver Disease
If symptoms are present, they may include:
It is not entirely clear why males with CD are more likely to experience liver dysfunction than females with CD.It could simply be that men are at generally higher risk offatty liver diseaseor alcohol-related liver disease than women.
Weight Loss
Studies also suggest that males with CD are slightly more likely to experience weight loss than females with CD. Even so, it is unclear how significant the difference is.
Weight loss with CD is primarily due to themalabsorption(lack of absorption) of nutrients from food due to chronic diarrhea and co-occurring liver dysfunction (which can interfere with digestion and contribute to diarrhea).
Older studies have suggested that men with CD are more likely to experience malabsorption than women with CD.
Autoimmune Diseases
Generally speaking,autoimmune diseasesare more common in females than males.Studies suggest that this is not so with celiac disease. Several have shown that the rate of autoimmune diseases is more or less equal among females and males with CD.
A 2018 study from the Mayo Clinic reported thathypothyroidism(low thyroid function), a disease that is five times more common in females than males of the general population, occurs more frequently in males with CD. When CD is involved, females are only twice as likely to have hypothyroidism as their male counterparts.
Hypothyroidism and Celiac DiseaseHypothyroidism is the most common autoimmune disorder seen in people with celiac disease,the symptoms of which include:FatigueSensitivity to coldConstipationDry skinWeight gainPuffy faceHoarsenessMuscle weaknessJoint painImpaired memoryGoiter(enlarged thyroid gland)
Hypothyroidism and Celiac Disease
Hypothyroidism is the most common autoimmune disorder seen in people with celiac disease,the symptoms of which include:FatigueSensitivity to coldConstipationDry skinWeight gainPuffy faceHoarsenessMuscle weaknessJoint painImpaired memoryGoiter(enlarged thyroid gland)
Hypothyroidism is the most common autoimmune disorder seen in people with celiac disease,the symptoms of which include:
Celiac Disease Symptoms in Women
Summary
Celiac disease (CD) generally causes the same and symptoms in males and females. Even so, it is more likely to be misdiagnosed in males, particularly younger males, in part because CD is often regarded as a “female” disease.
Where CD differs in males is that is more likely to cause weight loss, liver dysfunction, and a celiac-related skin rash called dermatitis herpetiformis. In addition, men with CD are far more likely to have a co-occurring autoimmune disorder than men in the general population.
A Word From Verywell
Even in the best of situations, celiac disease can be difficult to diagnose. It often takes years and numerous healthcare visits before the disease is finally diagnosed. This may be especially true for men who access healthcare 30% less often than women.
To this end, it is important to recognize the signs and symptoms of celiac disease, especially if treatments for chronic diarrhea, bloating, and abdominal pain are not working. If needed, ask your primary care provider for a referral to an internal specialist known as agastroenterologist. A simple blood test may offer the first clue that celiac disease is involved.
How Celiac Disease Is Diagnosed
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus Genetics.Celiac disease.Norström F, Lindholm L, Sandström O, et al.Delay to celiac disease diagnosis and its implications for health-related quality of life.BMC Gastroenterol.2011;11:118. doi:10.1186/1471-230X-11-118Dixit R, Lebwohl B, Ludvigsson JF, Lewis SK, Rizhalla-Reilly N, Green PHR.Celiac disease is diagnosed less frequently in young adult males.Dig Dis Sci. 2014 Jul;59(7):1509-12. doi:10.1007/s10620-014-3025-6. doi:10.1007/s10620-014-3025-6Jansson-Knodell CL, King KS, Larson JL, Van Dyke CT, Murray JA, Rubio-Tapia A.Gender-based differences in a population-based cohort with celiac disease: more alike than unalike.Dig Dis Sci.2018;63(1):184–92. doi:10.1007/s10620-017-4835-0Reunala T, Salmi TT, Hervonen K, Kaukinen K, Collin P.Dermatitis herpetiformis: a common extraintestinal manifestation of coeliac disease.Nutrients. 2018;10(5) doi:10.3390/nu10050602Caproni M, Boncdiolini V, D’Errico A, Antiga E, Fabbri P.Celiac disease and dermatologic manifestations: many skin clue to unfold gluten-sensitive enteropathy.Gastroenterol Res Pract.2012;2012:952753. doi:10.1155/2012/952753Kim JV, Wu GY.Celiac disease and elevated liver enzymes: a review.J Clin Transl Hepatol.2021;9(1):116–24. doi:10.14218/JCTH.2020.00089Lonardo A, Nascimbeni F, Ballestri S, et al.Sex differences in nonalcoholic fatty liver disease: state of the art and identification of research gaps.Hepatology. 2019;70(4):1457-69. doi:10.1002/hep.30626Bai D, Brar P, Holleran S, Ramakrishnan R, Green PHR.Effect of gender on the manifestations of celiac disease: evidence for greater malabsorption in men.Scand J Gastroenterol.2005 Feb;40(2):183-7. doi:10.1080/00365520510011498Ngo ST, Steyn FJ, McCombe PA.Gender differences in autoimmune disease.Front Neuroendocrinol. 2014 Aug;35(3):347-69. doi:10.1016/j.yfrne.2014.04.004American Thyroid Association.Hypothyroidism.Wang Y, Hunt K, Nazareth I, et al.Do men consult less than women? An analysis of routinely collected UK general practice data.BMJ Open.2013;3:e003320. doi:10.1136/bmjopen-2013-003320
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus Genetics.Celiac disease.Norström F, Lindholm L, Sandström O, et al.Delay to celiac disease diagnosis and its implications for health-related quality of life.BMC Gastroenterol.2011;11:118. doi:10.1186/1471-230X-11-118Dixit R, Lebwohl B, Ludvigsson JF, Lewis SK, Rizhalla-Reilly N, Green PHR.Celiac disease is diagnosed less frequently in young adult males.Dig Dis Sci. 2014 Jul;59(7):1509-12. doi:10.1007/s10620-014-3025-6. doi:10.1007/s10620-014-3025-6Jansson-Knodell CL, King KS, Larson JL, Van Dyke CT, Murray JA, Rubio-Tapia A.Gender-based differences in a population-based cohort with celiac disease: more alike than unalike.Dig Dis Sci.2018;63(1):184–92. doi:10.1007/s10620-017-4835-0Reunala T, Salmi TT, Hervonen K, Kaukinen K, Collin P.Dermatitis herpetiformis: a common extraintestinal manifestation of coeliac disease.Nutrients. 2018;10(5) doi:10.3390/nu10050602Caproni M, Boncdiolini V, D’Errico A, Antiga E, Fabbri P.Celiac disease and dermatologic manifestations: many skin clue to unfold gluten-sensitive enteropathy.Gastroenterol Res Pract.2012;2012:952753. doi:10.1155/2012/952753Kim JV, Wu GY.Celiac disease and elevated liver enzymes: a review.J Clin Transl Hepatol.2021;9(1):116–24. doi:10.14218/JCTH.2020.00089Lonardo A, Nascimbeni F, Ballestri S, et al.Sex differences in nonalcoholic fatty liver disease: state of the art and identification of research gaps.Hepatology. 2019;70(4):1457-69. doi:10.1002/hep.30626Bai D, Brar P, Holleran S, Ramakrishnan R, Green PHR.Effect of gender on the manifestations of celiac disease: evidence for greater malabsorption in men.Scand J Gastroenterol.2005 Feb;40(2):183-7. doi:10.1080/00365520510011498Ngo ST, Steyn FJ, McCombe PA.Gender differences in autoimmune disease.Front Neuroendocrinol. 2014 Aug;35(3):347-69. doi:10.1016/j.yfrne.2014.04.004American Thyroid Association.Hypothyroidism.Wang Y, Hunt K, Nazareth I, et al.Do men consult less than women? An analysis of routinely collected UK general practice data.BMJ Open.2013;3:e003320. doi:10.1136/bmjopen-2013-003320
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus Genetics.Celiac disease.Norström F, Lindholm L, Sandström O, et al.Delay to celiac disease diagnosis and its implications for health-related quality of life.BMC Gastroenterol.2011;11:118. doi:10.1186/1471-230X-11-118Dixit R, Lebwohl B, Ludvigsson JF, Lewis SK, Rizhalla-Reilly N, Green PHR.Celiac disease is diagnosed less frequently in young adult males.Dig Dis Sci. 2014 Jul;59(7):1509-12. doi:10.1007/s10620-014-3025-6. doi:10.1007/s10620-014-3025-6Jansson-Knodell CL, King KS, Larson JL, Van Dyke CT, Murray JA, Rubio-Tapia A.Gender-based differences in a population-based cohort with celiac disease: more alike than unalike.Dig Dis Sci.2018;63(1):184–92. doi:10.1007/s10620-017-4835-0Reunala T, Salmi TT, Hervonen K, Kaukinen K, Collin P.Dermatitis herpetiformis: a common extraintestinal manifestation of coeliac disease.Nutrients. 2018;10(5) doi:10.3390/nu10050602Caproni M, Boncdiolini V, D’Errico A, Antiga E, Fabbri P.Celiac disease and dermatologic manifestations: many skin clue to unfold gluten-sensitive enteropathy.Gastroenterol Res Pract.2012;2012:952753. doi:10.1155/2012/952753Kim JV, Wu GY.Celiac disease and elevated liver enzymes: a review.J Clin Transl Hepatol.2021;9(1):116–24. doi:10.14218/JCTH.2020.00089Lonardo A, Nascimbeni F, Ballestri S, et al.Sex differences in nonalcoholic fatty liver disease: state of the art and identification of research gaps.Hepatology. 2019;70(4):1457-69. doi:10.1002/hep.30626Bai D, Brar P, Holleran S, Ramakrishnan R, Green PHR.Effect of gender on the manifestations of celiac disease: evidence for greater malabsorption in men.Scand J Gastroenterol.2005 Feb;40(2):183-7. doi:10.1080/00365520510011498Ngo ST, Steyn FJ, McCombe PA.Gender differences in autoimmune disease.Front Neuroendocrinol. 2014 Aug;35(3):347-69. doi:10.1016/j.yfrne.2014.04.004American Thyroid Association.Hypothyroidism.Wang Y, Hunt K, Nazareth I, et al.Do men consult less than women? An analysis of routinely collected UK general practice data.BMJ Open.2013;3:e003320. doi:10.1136/bmjopen-2013-003320
MedlinePlus Genetics.Celiac disease.
Norström F, Lindholm L, Sandström O, et al.Delay to celiac disease diagnosis and its implications for health-related quality of life.BMC Gastroenterol.2011;11:118. doi:10.1186/1471-230X-11-118
Dixit R, Lebwohl B, Ludvigsson JF, Lewis SK, Rizhalla-Reilly N, Green PHR.Celiac disease is diagnosed less frequently in young adult males.Dig Dis Sci. 2014 Jul;59(7):1509-12. doi:10.1007/s10620-014-3025-6. doi:10.1007/s10620-014-3025-6
Jansson-Knodell CL, King KS, Larson JL, Van Dyke CT, Murray JA, Rubio-Tapia A.Gender-based differences in a population-based cohort with celiac disease: more alike than unalike.Dig Dis Sci.2018;63(1):184–92. doi:10.1007/s10620-017-4835-0
Reunala T, Salmi TT, Hervonen K, Kaukinen K, Collin P.Dermatitis herpetiformis: a common extraintestinal manifestation of coeliac disease.Nutrients. 2018;10(5) doi:10.3390/nu10050602
Caproni M, Boncdiolini V, D’Errico A, Antiga E, Fabbri P.Celiac disease and dermatologic manifestations: many skin clue to unfold gluten-sensitive enteropathy.Gastroenterol Res Pract.2012;2012:952753. doi:10.1155/2012/952753
Kim JV, Wu GY.Celiac disease and elevated liver enzymes: a review.J Clin Transl Hepatol.2021;9(1):116–24. doi:10.14218/JCTH.2020.00089
Lonardo A, Nascimbeni F, Ballestri S, et al.Sex differences in nonalcoholic fatty liver disease: state of the art and identification of research gaps.Hepatology. 2019;70(4):1457-69. doi:10.1002/hep.30626
Bai D, Brar P, Holleran S, Ramakrishnan R, Green PHR.Effect of gender on the manifestations of celiac disease: evidence for greater malabsorption in men.Scand J Gastroenterol.2005 Feb;40(2):183-7. doi:10.1080/00365520510011498
Ngo ST, Steyn FJ, McCombe PA.Gender differences in autoimmune disease.Front Neuroendocrinol. 2014 Aug;35(3):347-69. doi:10.1016/j.yfrne.2014.04.004
American Thyroid Association.Hypothyroidism.
Wang Y, Hunt K, Nazareth I, et al.Do men consult less than women? An analysis of routinely collected UK general practice data.BMJ Open.2013;3:e003320. doi:10.1136/bmjopen-2013-003320
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