Does Your Family Health History Determine Celiac Disease?

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How important is your family’s health history in diagnosing or ruling out celiac disease? Believe it or not, approximately 35% of the general population has the genes that predispose a person to celiac disease, but only 1% of the general population develop the autoimmune disorder.  

Celiac disease is considered a hereditary autoimmune disorder. However, experts say that while having a family history of celiac disease makes you more susceptible to developing it, family history alone doesn’t determine if you end up with it. 

Currently, there is no known genetic component to non-celiac gluten sensitivity (NCGS). NCGS is not yet fully understood. While genetic testing can be helpful to rule out celiac disease if you get a negative result, a positive result does not automatically mean you will develop celiac disease or that you have it. It is important to keep in mind that while a negative result rules out celiac disease, it does not rule out gluten sensitivity. 

Whether or not you end up with celiac disease involves several factors. In medical terms, celiac disease is a multifactorial disorder meaning that different genes interact with different conditions to potentially turn into a disease or disorder. The factors that interact and could increase your susceptibility to celiac disease are: 

  • HLA (human leukocyte antigen) genes known as HLA-DQ2 and DQ8. * 
  • Gluten intake  
  • Other environmental factors 

* Present in about 98% of individuals with celiac disease. 

The bottom line about hereditary aspects of celiac disease 

Being predisposed to celiac disease simply means you have a higher likelihood of developing it, but only if other factors are in place. These factors include eating gluten and experiencing a triggering event or environmental stressors like gastrointestinal infection, frequent use of antibiotics, or even surgery, among others. 

When looking to diagnose or rule out celiac disease, your doctor may check typical hereditary patterns, asking if any of your first-degree relatives — parents, siblings, or children – have the disorder. They may also ask if any second-degree relatives – aunts, uncles, and cousins – have it.  

If a first degree relative has celiac disease, your chances of developing the condition are about 5 to 15%. If a second degree relative has celiac disease, chances are lower but still greater than if no relatives have it. 

Family history alone is not a concrete determinator of whether you’ll get celiac disease because the disorder has no specific inheritance pattern. Having family members who have been diagnosed with celiac disease is a good reason to talk to your healthcare provider who can help you determine if testing is needed. Likewise, if you are diagnosed with celiac disease, letting your family members know and suggesting they get tested, too, can help them avoid or minimize related health complications.