Celiacs who suffer unexplained symptoms for years often laud the health improvement they’ve seen on the gluten-free diet. But what about celiacs who suffer no signs or symptoms of the autoimmune disorder? According to new research, they may actually sense a decrease in well-being upon diagnosis and after making the switch to gluten-free.

Conducted by a team of Finnish researchers, including renowned celiac expert Dr. Markku Maki, the study surveyed 698 adults recently diagnosed with celiac disease about their sense of health and well-being. Respondents included both symptomatic and asymptomatic patients.

Among patients with symptoms of celiac disease, quality of life decreased at diagnosis, but then increased significantly with the transition to a gluten-free diet. Anxiety also decreased on the diet, the researchers reported. Among those who displayed no symptoms, however, the patient’s self-perception of health actually decreased with the transition to a gluten-free diet.

The researchers concluded:

Self-perceived health and well-being were low among patients at the time they are diagnosed with celiac disease. Most patients benefited from a gluten-free diet, so it is important to identify patients with celiac disease. Perception of health decreased among asymptomatic cases, which discourages population-based screening.