Can Celiac Disease Lead to Fatty Liver Disease?

Can Celiac Disease Lead to Fatty Liver Disease?
Can Celiac Disease Lead to Fatty Liver Disease?

A particular kind of fatty liver disease appears to strike people with celiac disease more frequently. The link might be caused, at least in part, by weight gain brought on by eating gluten-free foods that are high in sugar and bad fats.

Grain products including wheat, barley, and rye contain the protein gluten, which is what causes celiac disease, an autoimmune condition.

The accumulation of fat in the liver is known as fatty liver disease. Since 2023, the most prevalent type of the condition has been referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcohol-related fatty liver disease (NAFLD). Those who are overweight or obese are most likely to experience it.

A higher incidence of MASLD has been linked to celiac disease. Although the exact reason for this link is unknown, weight gain from consuming more fat and sugar from packaged gluten-free foods may be a contributing factor.

Continue reading to find out more about the relationship between celiac disease and fatty liver disease.

Does celiac disease cause fatty liver disease?

Compared to the general population, individuals with celiac disease seem to have a higher prevalence of MASLD.

In a 2022 study, researchers examined about 70 million people's medical records from commercial databases and discovered that 0.2% of them had been diagnosed with celiac disease.

0.7% of individuals with celiac disease also had MASLD. Individuals with celiac disease were 3.21 times more likely than non-celiac individuals to have MASLD.

In a similar vein, in a more limited investigation conducted in 2018, scientists looked at the frequency of MASLD in 202 individuals with celiac disease who were on a gluten-free diet, as well as an equivalent number in a control group.

The risk of MASLD was shown to be 2.9 times higher in individuals with celiac disease compared to those without the condition when age, sex, and MASLD risk variables were matched. 34.7% of individuals with celiac disease also had MASLD.

Those without obesity or overweight who had celiac disease had the highest relative chance of developing MASLD. Compared to those without celiac disease who were neither overweight nor obese, these individuals had a risk that was 5.71 times higher.

Why might celiac disease and MASLD be related?

A gluten-free diet is the mainstay of treatment for celiac disease. Starting a gluten-free diet often results in weight gain as a result of intestinal repair. However many people who begin a gluten-free diet end up gaining weight.

Diets free of gluten have been linked to higher intakes of fat and sugar, particularly when consuming packaged goods with the "gluten-free" label. According to several studies, obesity rates are higher because many packaged gluten-free meals have inadequate nutritional value.

The greatest risk factor for NAFLD is obesity. It is estimated that between 50% and 60% of overweight individuals and between 60% and 70% of obese individuals have dyslipidemia or abnormal blood fat levels. Dyslipidemia raises the possibility of MASLD because it might cause your liver to accumulate excess fat.

In what other ways does celiac disease affect the liver?

Individuals who already have one autoimmune illness are more likely to get another one.

Increased incidence of autoimmune hepatitis, or liver damage resulting from your immune system attacking healthy liver cells, has been linked to celiac disease. In patients with autoimmune hepatitis, the prevalence of celiac disease ranges from 4.4% to 6.4%.

Celiac disease and elevated liver enzymes

Liver enzymes are frequently mildly to moderately raised in people with celiac disease, but they frequently recover to normal levels after they begin eating a gluten-free diet.

Increased liver enzymes in celiac disease patients are not fully understood, however, autoimmune hepatitis may be a contributing factor. Increased intestinal permeability is another potential cause, as this can let toxins pass past your liver and into your circulation.

Symptoms of fatty liver caused by celiac disease

In most cases, MASLD remains asymptomatic even after progressing to cirrhosis. Certain individuals with advanced MASLD experience fatigue or soreness in the upper right side of their abdomen.

When to contact a doctor

If you have suspected symptoms of celiac disease but have not obtained a diagnosis, you must see a physician. Possible signs and symptoms consist of:
  • unexplained weight loss
  • nausea and vomiting
  • pale and foul-smelling stools
  • bloating
  • gas
  • abdominal pain
  • chronic diarrhoea

Treating fatty liver disease caused by celiac disease

It's critical to treat celiac disease first.

If you are overweight or obese and MASLD still occurs after celiac disease treatment, your doctor might advise you to lose weight. A physician might also suggest drugs to treat related disorders, such as glucagon-like peptide-1 receptor (GLP-1) agonists:
  • high triglyceride levels
  • high blood pressure
  • high cholesterol

Is a gluten-free diet bad for people with fatty liver?

After beginning a gluten-free diet, individuals with celiac disease frequently gain excessive amounts of weight. Gaining a little weight is normal and healthy, but becoming overweight or obese raises your chance of MASLD and other illnesses.

A lot of packaged gluten-free foods are high in sugar and bad fats. While occasionally consuming these items is acceptable, making whole, unprocessed meals the mainstay of your diet can lower your risk of developing MASLD. For example, consider:
  • lean fish, poultry, and meat
  • eggs
  • beans, seeds, and legumes
  • fruits and vegetables
  • low-fat dairy products
  • some grains or starches, such as quinoa, rice, and flax


Is fatty liver related to celiac disease?

According to the study, those with celiac disease had a nearly three-fold increased chance of getting fatty liver disease.

What is stage 4 celiac disease?

Naturally, stage four is the most developed and infrequent. Orlando Gastroenterology Consultants of Central Florida observes that the villi have fully atrophied, or flattened, at this point. The crypts, or hollows, that separate them have also reduced.

What triggers celiac disease later in life?

Someone can consume gluten for many years without experiencing any detrimental effects until developing celiac disease later in life. Research indicates that after consuming gluten for a lifetime, the body may reach a breaking point, leading to a change. Additional environmental factors and stress could also contribute to the shift.


It appears that MASLD develops more frequently in celiac disease patients than in non-celiac patients. People who eat a lot of highly processed, high-sugar, high-fat gluten-free meals may be at least somewhat to blame for the connection in terms of excess weight gain.

If you adopt a gluten-free diet, you may be able to lower your risk of developing MASLD by consuming fewer processed gluten-free goods such as cookies and biscuits. Consuming a diet high in whole, unprocessed foods, such as fruits, vegetables, lean meats and fish, is a better option.

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