Men's celiac disease symptoms run the gamut from "classic" symptoms of diarrhea, weight loss and fatigue to more subtle signs of the condition, such as anemia and elevated liver enzymes.
It is more common for men who have celiac disease to have classic symptoms when they're diagnosed ... but that may be because doctors don't tend to suspect celiac in men with atypical symptoms and, instead, mainly diagnose it in men who have those classic symptoms. In addition, men are less likely than women to seek medical advice for health problems.
There's no question that men are diagnosed with celiac at about half the rate of women. Studies show the condition does seem to occur somewhat less frequently in men than in women, but it's also more underdiagnosed in men than it is in women.
Men's Celiac Disease Signs Include Low Weight, Reflux
Celiac disease symptoms in both men and women can include a variety of digestive, neurological and skin conditions. Here's a comprehensive overview: Signs of Celiac Disease Vary, and Sometimes There Are None At All.
Only a handful of studies have looked specifically at what symptoms of celiac disease are more common to men than to women, but there are several differences between the genders.
For example, celiac men are more likely to be underweight (a symptom often seen in concert with "classic" celiac diarrhea) and to have significant intestinal malabsorption (meaning they're not absorbing nutrients from the foods they eat).
In addition, men seem to suffer from more celiac-related reflux, and they also exhibit more liver abnormalities than women. Finally, men seem to have higher rates of the itchy skin rash dermatitis herpetiformis than women.
Autoimmune Conditions, Infertility Common in Celiac Men
Celiac disease is an autoimmune condition, and men are less likely to be diagnosed with any autoimmune condition (not just celiac disease) when compared to women.
However, one study showed that about 30% of men with celiac disease also had another autoimmune condition (the same percentage as women). The findings indicate that, unlike men in the general population, men who have celiac are just as susceptible as celiac women to autoimmune diseases, such as thyroid disease and Sjögren's syndrome.
There also seems to be a link between celiac disease and male infertility — men with undiagnosed celiac disease have higher rates of abnormal sperm and abnormal hormones. Both sperm characteristics and hormone levels seem to improve and even normalize on the gluten-free diet.
Why Are Men Underdiagnosed with Celiac Disease?
Various researchers have speculated that fewer men are diagnosed with celiac disease because they're less likely than women to seek help for nagging health issues. Therefore, many men are diagnosed only when they become seriously ill — when they're losing weight and can't function due to the fatigue and diarrhea.
Meanwhile, silent celiac disease (i.e., celiac disease without symptoms) is likely to go undiagnosed in men unless they're screened for the condition for some reason. In fact, celiac disease screening in close relatives picks up many men who would otherwise not be diagnosed, since they might not have sought testing without the additional impetus of a relative's diagnosis, regardless of what symptoms they had.
Bai D. et al. Effect of gender on the manifestations of celiac disease: evidence for greater malabsorption in men. Scandinavian Journal of Gastroenterology. 2005 February;40(2):183-7.
Bardella M. et al. Gluten intolerance: gender- and age-related differences in symptoms. Scandinavian Journal of Gastroenterology. 2005 January;40(1):15-9.
Llorente-Alonso M. et al. Gluten intolerance: Sex-and age-related features. Canadian Journal of Gastroenterology. 2006 November; 20(11): 719–722.