Research has shown that those with Celiac or who follow a gluten free diet may benefit from certain nutritional supplements to help guard against common deficiencies caused by malabsorption.
Celiac disease is an autoimmune condition that causes degradation of the finger-like projections, called villi atrophy, in the intestines which leads to painful inflammation after ingesting protein found in wheat, barley and rye - gluten. This makes it much more difficult to absorb certain nutrients from food and even most supplements.
Whether you are a newly diagnosed celiac disease patient or are following a gluten free lifestyle for other reasons, you may have a number of nutrient deficiencies including iron, zinc, vitamin D and several B vitamins. In addition, you may be falling short on fiber, calcium and magnesium; due to many gluten free products not being enriched or fortified with these nutrients.
Not everyone with celiac disease will have the same nutrient deficiencies due to several factors that affect the likelihood of nutrient deficiencies; including the length of time you have had celiac disease prior to being diagnosed, the extent and location of damage in the small intestines, the degree of malabsorption of nutrients, any medications you were or are taking that block nutrient absorption and other factors related to health.
Common Nutrient Deficiencies:
- Folic Acid - folate levels are lower in gluten-free products, works with B12 to make and maintain cells
- Vitamin B12 - B12 deficiency is common, increasing with age, but even more common in Celiac. Some studies show a direct correlation between Celiac and B12 deficiency.
- Vitamin B6 - Involved in over 100 enzyme reactions, mostly protein metabolism. Those with Celiac absorb less of the B6.
- Vitamin D - Very important for absorption of calcium. Decrease in the function of the upper intestines, common in Celiac, can compromise vitamin D activity and function and therefore absorption of adequate calcium. Vitamin D also supports the immune system and may also reduce inflammation in the intestinal tract.
- Calcium & Magnesium - Bone disorders are common in celiac disease with osteoporosis in over 25% of all patients at time of Celiac diagnosis and 40% with osteopenia. Risk of fracture is 30% higher. Many who follow a gluten free diet are also dairy free or lactose intolerant, making it even more difficult to get adequate calcium.
- Iron - Iron deficiency anemia is the most common extra-intestinal symptom of Celiac. May be corrected after following a gluten free diet. Always get tested before taking an iron supplement.
- Fiber - Often a gluten free diet is lacking in fiber as well, especially if completely grain free. A prebiotic fiber may be helpful for both providing added fiber and growth of good bacteria.
How will you know if you have a nutrient deficiency? Talk to your gastroenterologist about your concerns and get tested. Research shows that some nutrient deficiencies in celiac patients are evident even after years on a gluten free diet (which can reverse some of the villi atrophy, the cause of nutrient malabsorption). However, adherence to the gluten free diet and use of dietary supplements when indicated will improve health and may help reverse nutrient deficiencies.
Look for Certified Gluten Free Liquid Supplements
Many tablets and pill supplements contain a small amount of gluten as fillers and are also more difficult to absorb and digest for Celiac due to malabsorption. A certified gluten free liquid supplement is a great choice - they absorb quickly and are easier to digest because they do not have to be broken down first in the stomach.
Doherty C, Dennis M. Nutritional Supplements for Celiac Disease: What You Need to Know. New England Celiac Conference 2011.
Malterre, Tom, MS, CN. Digestive and Nutritional Considerations in Celiac Disease: Could Supplementation Help? Alternative Medicine Review Volume 14, Number 3, 2009.