Nutrition Deficiencies in Celiac Patients

Rachel Brandeis, MS, RD
www.rachelrd.com

"If you are a newly diagnosed person with Celiac disease, it is imperative that you are screened by a dietitian or your doctor for nutritional deficiencies. Significant vitamin and mineral deficiencies can occur depending on how long a person has gone with active, but undiagnosed disease, the damage to the GI tract, where the damage is done in the GI tract and the degree of malabsorption. Also, secondary lactose intolerance can present as well.

The most common nutrient deficiencies that occur are iron, folate and calcium. These vitamins and minerals are absorbed in the proximal small intestine which is the most predominant site of inflammation in newly diagnosed patients.

As the disease progresses along the parts of the intestine, other deficiencies can occur. Malabsorption of carbohydrates and fat can cause deficiencies in the fat soluble vitamins A, D, E and K as well as magnesium and vitamin B12.

The frequency of iron deficiency anemia in newly diagnosed patients ranges from 12-69% and incidence of vitamin B12 deficiency ranges from 8-41%. Studies have shown that 78-94% of adults recovered from iron deficiency anemia by dietary compliance to gluten free diet alone.

Most of these deficiencies mentioned above are due to damaged villi and the consequential inability to facilitate absorption from the intestinal tract. In order for the intestinal villi to regenerate and reverse nutritional deficiencies, it is important to follow these guidelines:

Strict adherence to a gluten free diet for LIFE.
Increase foods that are high in iron. Rich sources of iron are found in lean red meats. Chicken and fish provide lesser amounts, but can still contribute to daily intake.
Consider a gluten free multi-vitamin; look for those that have 100% of the daily value for iron and other vitamin and minerals.
Increase dietary sources of calcium (if lactose intolerance is an issue, choose lactose free alternatives) such as milk, yogurt, cheese.
Consider gluten free calcium supplement with vitamin D. Remember to spread out calcium supplementation throughout the day since only 500 mg of calcium can be absorbed at one time. Also, do not take calcium supplements and multi-vitamins together, because calcium can bind the iron, making it unavailable for absorption.
Choose whole grain and enriched gluten free products that have B vitamins and iron added back. Check the nutrition facts label on the package to see if the product is enriched."

-GFree Connect, March Newsletter