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Signs and Symptoms of Celiac Disease Gastrointestinal: Pain, bloating, gas Constipation and/or diarrhea Loss of appetite Nausea, vomiting Brain and nervous system: Recurring headaches Decreased sensation in peripheral nerves Anxiety, panic attacks Depression Other systems of the body: Fatigue Itchy skin rash (dermatitis herpetiformis) Unexplained infertility and miscarriage Iron-deficiency anemia and other nutritional deficiencies Arthritis Diagnosis of Celiac Disease Gold standard for diagnosis is a biopsy of the small intestine A more simple four-out-of-five guideline has been proposed: Typical symptoms of celiac disease (see Signs and Symptoms of Celiac Disease) Celiac disease immunoglobulin A antibodies are strongly positive in the serum HLA DQ2 and/or HLA DQ8 genes are present Characteristic changes are evident on small intestine biopsy Positive clinical response to a gluten-free diet Dietary and Lifestyle Changes Maintaining a gluten-free diet for life is essential for those with celiac disease

Volek, JS, et al, Effects of carnitine supplementation on flow-mediated dilation and vascular inflammatory responses to a high-fat meal in healthy young adults. in The American Journal of Cardiology , Volume 102, Issue 10, November 2008, pp 1413 - 1417

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24 In one double-blind, randomized, placebo-controlled study of IBS sufferers who specifically did not have celiac disease, addition of gluten worsened abdominal pain, bloating, fatigue, stool consistency, and overall symptoms of IBS

Vegetarians may have lower levels of l-carnitine, which is due to the fact that fruits and vegetables (the main components of their diet) are very low in l-carnitine