Does Stress Affect Celiac Disease? What I Told Dr. Jaclyn Smeaton on the Podcast

Erin Kenny
Jul 31
4 min read

If you've been gluten-free for a while and you're still not feeling like yourself, stress might be a bigger piece of the puzzle than you think. I sat down with Dr. Jaclyn Smeaton for episode 162, and we spent almost an hour on something I don't think gets talked about enough: what celiac disease does to your body beyond your gut, and how stress and HPA axis dysregulation keep so many of my clients stuck even after they've cleaned up their diet.

You can listen to the full conversation right here on the page, but I wanted to pull the most important parts into a post, because a podcast is easy to nod along to and then forget by dinner.

https://youtu.be/mxQwzODjAy0

Celiac Disease vs. Gluten Sensitivity: Why the Distinction Matters

We started with the basics - Celiac disease is an autoimmune condition. Your immune system attacks your small intestine when you eat gluten, and that damage happens whether or not you feel anything. Gluten sensitivity doesn't carry that same autoimmune mechanism or intestinal damage, even though some of the symptoms overlap.

That distinction changes how seriously you have to take exposure. With celiac, cross-contact from a shared toaster or a scooper in the bulk bin isn't a preference issue. It's a trigger for the same immune response as eating a full slice of bread (though cross-contact would be a much smaller exposure, a very important distinction too!)

Less Symptoms Doesn't Mean Less Damage

Here's the part that surprises people most, and it's one of the biggest myths I correct on repeat. Some of my clients with the worst intestinal damage on biopsy report barely noticing anything day to day. Meanwhile some of my clients with mild damage feel wiped out for a week after a trace exposure.

Symptom severity and intestinal damage don't always correlate. That mismatch is why so many people either get diagnosed late or stay convinced they're fine to cheat occasionally, because they can't feel the damage happening.

The Gut-Brain Connection Nobody Warns You About

You probably know that anxiety can upset your stomach (or give you butterflies). What surprises people is how much gut health can also impact the brain too! Celiac disease physically damages the gut lining and disrupts the microbiome, and both of those changes send signals straight up to your brain through the vagus nerve and through inflammatory markers in your bloodstream.

That's why so many newly diagnosed people describe brain fog, anxiety, or a low mood they can't explain. The biology, gut chemistry, your neurotransmitter production, and your inflammation levels all shifting at once while your intestine heals. These are all factors that arn’t talked about or considered often enough with individuals with celiac.

Why Stress Alone Can Keep You Sick

This is the part of the episode I most want most people to hear loud and clear too! Going gluten-free stops new intestinal damage. It doesn't automatically undo chronic stress, and chronic stress on its own drives inflammation, disrupts digestion, and can dysregulate your HPA axis, the communication loop between your brain and your adrenal glands that controls your cortisol response.

When that loop gets dysregulated, you can end up with high cortisol, low cortisol, or a flattened rhythm that never spikes or dips the way it should. Any of those patterns can leave you feeling exhausted, wired at night, or stuck with digestive symptoms even on a completely clean gluten-free diet. This is one of the biggest reasons people tell me "I've done everything right and I still feel awful." On top of that, celiac disease is stressful when every meal you have to consider ingredients. This is a feedback loop that also needs to be addressed when it comes to celiac-focused care.

What DUTCH Testing Actually Shows You

We talked through DUTCH testing (Dried Urine Test for Comprehensive Hormones) as one of the tools I use to see what's actually happening with cortisol and the HPA axis, rather than guessing based on symptoms alone. It maps your cortisol pattern across the day, along with markers tied to your sex hormones and how your body is metabolizing them.

For a lot of my clients, that test is the first time anyone has shown them proof that their exhaustion has a physiological driver. It's not a personality flaw. It's not laziness. It's a hormone pattern with a name and a treatment path.

The Other Hidden Drivers We Covered

Stress and cortisol weren't the only pieces. We also went through:

Dysbiosis — an imbalance of bacteria in your gut, which is one of the most common findings I see even years into someone's gluten-free diet
Thyroid dysfunction — more common in people with celiac because autoimmune conditions tend to travel in clusters
Nutritional deficiencies — iron, B12, vitamin D, and zinc are the ones I check first, since intestinal damage blocks absorption long before you'd notice symptoms
Nervous system dysregulation — a body stuck in fight-or-flight struggles to digest well no matter how clean your diet is

Listen to the Full Episode

The full conversation is embedded above on this page. We go deeper into each of these topics, including specific nervous system rehabilitation strategies and what mindful eating actually looks like when your gut is still healing.

If any of this sounds like where you're at right now, book a free consultation and let's figure out what's actually driving your symptoms. You can also join the email list for more content like this.