Hormonal disorders and celiac disease – An interaction with Dr. Anju Virmani Diabetologist and Endocrinologist

1. Are there any ‘hormone’ problems associated with celiac disease?

Celiac disease is an autoimmune disorder. Other auto-immune diseases like hypothyroidism (autoimmune destruction of the thyroid gland) and Type 1 diabetes (autoimmune destruction of the insulin producing cells within the pancreas) can be associated with it.

Also, there may be many hormonal consequences of uncontrolled celiac disease, like slow growth, delayed puberty, irregular periods, infertility, poor bone health, etc. These are most seen if the disease remains either undetected for a long period of time or untreated.

 2. What can I do to diagnose these conditions early?

 3. What is puberty and why is it so important?

The 4 years of puberty are a time not just of sexual maturation, but also of rapid height gain, rapid bone density gain, rapid muscle growth (especially in boys), change of body image, and psychological maturation.

Poor control of celiac disease (i.e. by consuming gluten) causing delayed puberty would also result in the child being short, thin, easily tired, with muscle pains and even bone pains. This affects not only the body, but also self-esteem and studies. Hypothyroidism also causes similar symptoms (poor height gain, delayed puberty, poor bone health). Corrective measures must be taken in time.

 4. How should puberty be checked for?

The first sign of puberty in a girl is budding of breasts. This normally starts by age 9-11 years, but should definitely start by age 13 years. Girls usually start menstruating 2 years later, by age 11-13 years, but should definitely start within 3 years of starting breast budding or by age 16 years.

The first sign of puberty in boys is increase in the size of the testes. This normally starts by age 11-13 years, but should definitely start by age 14 years.

5. During the growing years and puberty, what nutrition should I focus on?

The growing child needs enough protein (lentils, milk, and for non-vegetarians eggs, fish, chicken and meat), in balance with carbohydrates, fats, fiber, vitamins and minerals. Milk is especially important because it provides good quality protein as well as calcium: milk and milk products (paneer, desserts, etc.) should be low fat (1-2% milk fat). Fruits and vegetables should be plentiful; avoid juices.

Children with celiac disease are often able to escape the pressure to eat junk food and absolutely must comply with it!

 Ensuring strict compliance with gluten free diet, providing a balanced healthy diet, and making sure the child does plenty of games and sports, just like all other children, are very important for normal growth and development.

6. Should all children with autoimmune hypothyroidism or Type 1 diabetes be tested for celiac disease?

Yes, it is important for children with either of these conditions to be screened for celiac disease at the time of diagnosis and then periodically.

For any more questions, please contact us at glutenfree@celiacindia.org.in