It's all too common for many of us with celiac disease or non-celiac gluten sensitivity : we get that "uh-oh" feeling that we've been glutened , and then we get slammed with what feels like a brick wall of fatigue.

In fact, fatigue is one of the most frequent symptoms mentioned by those with celiac or gluten sensitivity, and it's a symptom that seems to stick around (or recur all too often) long after you adopt the gluten-free diet.  

And gluten-related fatigue can be debilitating—in some cases, even more debilitating than diarrhea and other digestive symptoms more commonly associated with celiac disease and gluten sensitivity. Therefore, figuring out how to cope with it is a high priority, especially if you experience symptoms frequently.

Malnutrition, Anemia May Cause Fatigue in Celiac Disease

It's not entirely clear what causes fatigue in celiac disease and non-celiac gluten sensitivity , but it's one of the top symptoms mentioned, both prior to initial diagnosis and when people are accidentally exposed to gluten following that diagnosis.

One study found that 82% of those newly diagnosed with celiac disease complained of fatigue.   Some researchers speculate that fatigue may be caused by malnutrition , at least in those with celiac disease—celiac-induced intestinal damage can mean your body doesn't absorb nutrients well.

Fatigue also can be caused by anemia , which frequently appears in people with celiac disease who haven't yet been diagnosed or who aren't following the gluten-free diet.   However, malnutrition and anemia probably don't explain the sudden fatigue people with celiac disease can experience if they've inadvertently ingested gluten, so there may be some other process at play.

Since people with gluten sensitivity don't have the same intestinal damage as those with celiac disease, malnutrition and anemia don't explain why non-celiac gluten-sensitive people experience fatigue, too—but they definitely do experience it.

In addition to fatigue, brain fog and sleep problems are common effects of accidental gluten ingestion. Both obviously have an impact on fatigue, as well—brain fog makes it even more difficult to function,   and insomnia makes you even more tired.

It's depressing to say that there's no magic bullet to relieve fatigue once you've been "glutened." Therefore, most recommendations involve common-sense measures you can take to ease your tiredness while your body is recovering:

• Slow down. Clear your schedule to the extent that you can and try to do as little as possible when you can afford it.
• Stay organized. Fatigue plus brain fog can make you careless and forgetful. When suffering from gluten-related tiredness, make lists of things you need to do and then follow those lists. A little structure can help.
• Get some exercise. It seems counterintuitive—exercising when you're already tired? But a short walk or some yoga can increase your energy level, not decrease it.   Don't overdo it (now is not the time to start marathon training), but even a few minutes of mild physical exertion can help with your fatigue and may help you sleep better.
• Get to bed early. If you also suffer from gluten-induced insomnia , you may feel as if you want to avoid bed, since hitting your pillow may wind up being an exercise in futility. But going to bed early, closing your eyes, and resting (even if you don't actually sleep) does help improve fatigue the next day.

Possible Help in Supplement Form?

There's some evidence that supplements of L-carnitine, an amino acid, can help with fatigue in people with celiac disease. L-carnitine helps your cells produce energy by breaking down fat, and may help your brain more efficiently utilize the neurotransmitters serotonin and glutamate. Studies have shown that L-carnitine reduces fatigue in people with chronic fatigue syndrome and fibromyalgia .

In a small study performed in Italy, 30 people with celiac disease took 2 grams of L-carnitine daily for six months while another 30 took a placebo, and researchers then compared the fatigue levels in the two groups. They found fatigue, as measured by a validated scientific scale, was significantly reduced in the L-carnitine group when compared with the placebo group.

Keep in mind that this study hasn't been duplicated—you definitely should talk about the benefits and risks with your healthcare provider before trying L-carnitine for gluten-related fatigue. Side effects can include a rapid heart rate, high blood pressure, nausea, headache and even difficulty sleeping (not what you want when you're suffering from fatigue!). People with thyroid disease or liver disease may need to steer clear of L-carnitine supplements altogether.

A Word From Verywell

There's no doubt that fatigue is a major problem for those with celiac and gluten sensitivity—and it's a problem that has no easy solution. There's no magic bullet or pill to make you instantly not tired. However, trying a few strategies for recovering from an accidental glutening may help you feel slightly better, or even possibly a little more energetic.

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