Celiac disease is an autoimmune disease that leads to damage of villi in the small intestine, fingerlike projections that help our body absorb nutrients from food. The culprit? Gluten, a protein found in wheat, rye and barley.  Often, those who are diagnosed with celiac are also anemic.

If you have had undiagnosed celiac disease for a long period of time or if you have been newly diagnosed with celiac disease, your villi may not be completely healed (a normal, healthy small intestine is possible over time when a celiac disease patient adopts a gluten free lifestyle). If they aren’t healed, you probably are not absorbing several nutrients, which could set the stage for a deficiency. And, one of the nutrients you could be deficient in is iron. In fact, when iron deficiency anemia is difficult to treat through iron supplementation, physicians should screen for celiac disease.

Get Tested!

How will you know if your iron levels are low? First consider the signs and symptoms of iron deficiency anemia (listed below) and if you have celiac disease, get tested regularly for nutrient deficiencies. The only treatment for people living with celiac disease is a strict gluten-free lifestyle. In addition to avoiding all gluten in foods (including foods that are cross contaminated) there are many sources of gluten that may not be so obvious including fillers in toothpaste, medications (over the counter and prescription), deodorants, cosmetics, seasonings, some sources of alcohol.

Signs and Symptoms of Anemia:

• Weakness and fatigue
• Decreased performance at work or school
• Feeling cold, difficulty maintaining adequate body temperature
• Impaired immune functioning
• Shortness of breath
• Chest pain
• Brittle nails
• Cracks on the side of the mouth

If you take an iron supplement, make sure it is gluten-free too.  Many pills and tablets use gluten as a filler to bind them together.  Try a liquid iron supplement that is easy to digest and absorbs quickly into the body and says gluten-free on the label.  Be sure to take iron and calcium at least 2 hours apart as calcium does interfere with the absorption.

References:

Am J Gastroenterol. 2001;96:132–137.

Proc (Bayl Univ Med Cent). 2002 January; 15(1): 16–17.