I sat on the stairs again this morning, halfway through carrying a load of laundry, because my legs stopped cooperating. I am a mom who reads studies and labels, not a clinician. The word fatigue rarely appeared in celiac disease case reports until late in the twentieth century. I wanted to understand why.

Understanding that gap helped me stop blaming myself. It also changed how I talked to my doctor.

Samuel Gee described wasting, not weariness

Samuel Gee's 1888 lecture, On the Coeliac Affection, describes children with poor appetite, loose stools, and failure to grow. He cataloged weight and digestion. He did not isolate exhaustion as its own problem, because the picture in front of him was severe malnutrition.

Doctors at the time saw celiac disease through children who were failing to grow. Wasting was the metric that mattered. A child who was tired but still growing could be dismissed as having a passing phase. A child who was losing weight got the diagnostic workup. Doctors held that narrow frame for decades.

Patients described exhaustion in diaries and letters. Doctors rarely recorded it in case reports. Fatigue was too subjective to fit the chart.

Dicke removed wheat and changed the frame

Willem-Karel Dicke connected wheat protein to celiac disease during the 1940s. He observed children in the Netherlands improve when bread vanished from the wartime food supply. His 1950 publication helped establish gluten removal as the treatment. Doctors used that discovery to save lives.

It also created a new assumption. Once you removed gluten, many doctors considered the disease handled. They attributed lingering fatigue to anxiety, a thyroid problem, depression, or a too-full calendar.

Researchers described adult celiac disease more fully in the 1960s and 1970s, when biopsy studies showed the same intestinal damage in adults who had lived for decades with vague symptoms. Only then did researchers begin noting fatigue in case reports, still as a footnote to digestive complaints.

A 1997 lab finding gave fatigue a place on the chart

In 1997, Dieterich and colleagues identified tissue transglutaminase as the autoantigen in celiac disease, publishing the finding in Nature Medicine. That discovery led to blood tests that could screen for celiac disease without waiting for severe gut damage. A person with fatigue and only mild gut symptoms could finally test positive. She could get a diagnosis instead of being told to sleep more.

After serology spread, researchers could study groups of patients who didn't fit the old wasting-child profile. Researchers moved fatigue from a subjective complaint to a variable on symptom checklists. Quality-of-life studies kept reporting the same pattern. Patients named fatigue among their most disruptive symptoms, even when digestion had settled.

Three mechanisms that explain the exhaustion

Malabsorption

An inflamed small intestine absorbs iron, B12, folate, and vitamin D less well. Iron deficiency alone produces a fatigue that makes lifting a laundry basket feel like a workout. Ferritin can sit at the low end of normal and still leave you short of breath after one flight of stairs. I stopped assuming a normal lab meant nothing to address and started asking for the actual ferritin number.

Immune activation

Gluten triggers an inflammatory response, and inflammatory cytokines signal the brain to slow down. Researchers describe this pattern as sickness behavior. It is the same mechanism that makes you feel wiped out during a virus.

Sleep disruption

Reflux, pain, restless legs, and worry about accidental exposure show up more often in celiac disease. All of them steal rest.

What I stopped expecting and what helped

I asked my doctor to check ferritin, vitamin D, and B12. I stopped treating low energy as a moral failure. I told myself the intestinal lining rebuilds in stages. Nutrient stores refill slowly. Sleep stabilizes on its own timeline. Some adults report improved fatigue within months. Others take longer. A subset continues to manage fatigue even after repeat biopsies show a recovered intestinal lining.

Practical changes helped more than I expected. Batch-cooked meals, short ingredient lists, and a routine that didn't require me to stand in the kitchen for an hour. Clean Monday Meals ramen and seasonings became part of that routine. They are gluten-free, dairy-free, soy-free, and built around ingredients I can read in a single glance. The ramen noodles are organic brown rice flour, and the seasoning is clean but not certified organic. When my energy was low, that transparency mattered more than any wellness trend.

Fatigue didn't disappear all at once for me. It receded in layers. I wish someone had told me early on that the exhaustion wasn't a character flaw or a personal failure. It was a symptom with a long history that medicine had simply not named yet.

Small steps for low-energy days

• Ask your doctor or dietitian about checking ferritin, vitamin D, and B12.
• Give your body time. The intestinal lining rebuilds in stages.
• Find pantry staples that remove decision fatigue from dinner.

On low-energy nights, I reach for Clean Monday Meals ramen because the noodles are organic and the seasoning is clean. The free Clean Monday Meals Recipe App includes hundreds of gluten-free, dairy-free family recipes for days when cooking feels impossible.

Sources I kept returning to

• Samuel Gee, On the Coeliac Affection (1888)
• Willem-Karel Dicke's wheat-free diet research, published in 1950
• Dieterich et al., Nature Medicine (1997)

If a recipe helps on a low-energy day, tag @cleanmondaymeals. I see those posts and they help me too.