If you’ve been diagnosed with coeliac disease, you’ve probably been told that it’s an auto-immune condition. But what does this mean? What exactly is an auto-immune condition, what causes them and how common are auto-immune conditions in the UK?

What is an auto-immune condition?

An auto-immune condition is one in which your body’s defences, or immune system, mistakes your own healthy cells for dangerous or foreign bodies and attacks them. 

If you have been diagnosed with coeliac disease, this means that your immune system mistakes gluten for a threat and attacks it. This response causes damage to the lining of the small intestine which prevents the gut from absorbing nutrients and causes a range of symptoms including constipation, diarrhoea, stomach pains and cramps.

Types of auto-immune condition

The term ‘auto-immune’ covers a wide range of conditions such as coeliac disease, type 1 diabetes, Crohn’s disease, ulcerative colitis, multiple sclerosis, psoriasis and rheumatoid arthritis. There are more than 80 different auto-immune conditions listed by the Auto-Immune Registry.

The symptoms of auto-immune conditions vary but often include fatigue, muscle and joint pain, abdominal issues and skin problems. These symptoms can range in severity and may come and go with flare ups and periods of apparent remission.

What causes auto-immune conditions?

While the triggers for many auto-immune conditions are well understood, the cause of these conditions and the mechanism by which they operate are less well known. If you have been diagnosed with coeliac disease, then the trigger for your symptoms is gluten, but exactly why this triggers the auto-immune response at a particular moment in time is not fully understood. 

It is thought that most auto-immune diseases are caused by a combination of genetic and environmental factors. If you have been diagnosed with coeliac disease, then the chances of a direct relative also having the disease rises from one in a hundred to one in ten.

How common are auto-immune conditions in the UK?

Studies have shown that as many as one in ten people in the UK have some form of auto-immune disease.  Around one in a hundred people in the UK have been diagnosed with coeliac disease or carry the disease undiagnosed. 

Women are more prone to auto-immune conditions than men, though the reasons for this are not fully understood.  According to Coeliac UK, research suggests that the later you are diagnosed with coeliac disease, the more likely it is that you will also be diagnosed with another auto-immune condition.

Does having one auto-immune condition make you more susceptible to others?

People who have been diagnosed with coeliac disease have been shown to be more likely to develop associated auto-immune conditions. As a result of this, NICE guidelines list a number of auto-immune conditions that should trigger a test for coeliac disease, including type 1 diabetes and auto-immune thyroid disease. 

A review by Denham and Hill found that people who have type 1 diabetes are 4.4% to 11% more likely to be diagnosed with coeliac disease. The same review found that people diagnosed with coeliac disease were 11.4 times more likely to develop Addison’s disease.

How are auto-immune conditions treated?

Currently, auto-immune diseases cannot be cured. Treatment usually consists of managing or reducing symptoms. If you have been diagnosed with coeliac disease, then the only treatment is to follow a strict gluten free diet. This removes the gluten that triggers the auto-immune response, but it does not cure the condition. That means that however strictly you have followed a gluten free diet, if you ingest gluten again, you will still experience the symptoms of coeliac disease.

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