With celiac disease when the gut is damaged it's common to get nutritional deficiencies and for those nutritional deficiencies to continue after a gluten free diet is implemented because of a lack of nutrients in the diet. Like i've mentioned in the past, gluten free flours and foods aren't enriched like regular gluten containing foods. Meaning they don't have vitamins added in like B vitamins, magnesium, vitamin D and zinc. It's important to start getting these nutrients back up to a healthy range, so today I'm going to share which vitamins and minerals are commonly deficient in those with celiac disease and what foods can reverse these deficiencies.
Celiac symptoms overlap with those of other gastrointestinal conditions, such as leaky gut syndrome, foods that show promise for alleviating these disorders also may help those with celiac disease. Some of the nutrients and benefits being studied include probiotics and omega-3 fattyacids for reducing inflammation, alkaline fruits and vegetables for reducing gastrointestinal acidity, and glutamine and zinc for strengthening the gut lining.
Calcium is one of the most common deficiencies in those with celiac disease. When someone with celiac disease has damage to their the villi in their gut they are unable to digest lactose, because lactase (the enzyme the digests lactose in milk products) is produced in the tip of the villi, if you have damaged villi they will also have less lactase and may be restricting calcium intake due to lactose intolerance.
It's common for those with celiac disease and the general population to be lactose intolerant (70% of adults are). So it's important to get some non dairy sources of calcium to make sure you're bones are getting enough. Eating a diet low in sugar and excess salt can help prevent calcium deficiency because salt and sugar cause calcium to be excreted through urine.
- Leafy greens, sea vegetables
- Fortified orange juice, dried fruit
- Milk, yogurt, cheese, fortified nut, coconut and soy milk
- Quinoa, brown rice
The fatigue celiac disease patients experience may be due in part to a magnesium deficiency since it aids in the body’s energy production and transport. For someone with malabsorption, such as in celiac disease, there is a risk of deficiency (1).
- Leafy greens, peas
- Bananas, dried apricots, avocados
- Brown rice, millet
You need vitamin B6 to help you fight off infections, maintain normal nerve function, and carry oxygen throughout your body. You also need it to keep your blood sugar within normal limits. Unfortunately, studies have shown that many people with celiac disease and those following the gluten-free diet are low in vitamin B6.
- Sunflower Seeds
- Fish (Tuna, Cooked), Turkey & Chicken
- Dried Fruit
- Avocados, Spinach
Folate deficiency is common as well since damage often occurs in the jejunum, the center section of the small intestine, where folate is absorbed. Folate, also known as folic acid, is another B vitamin. You may be familiar with folate's role in preventing birth defects (it prevents malformations in your unborn baby's brain and spine), but everyone needs sufficient amounts of it to help their bodies make new cells. Lots of conventional gluten-containing foods are fortified with extra folate, so if you're eating gluten-free, you'll need to take special care to get enough.
- Leafy greens
- Beans, lentils
- Enriched rice
Vitamin B 12
Vitamin B12 helps maintain your nerve and blood cells, and those who are particularly deficient in B12 can find themselves fighting constant fatigue. Research has shown that people with celiac disease don't tend to get enough of vitamin B12 in their diets, although their bodies may not be low in the nutrient. Part of the reason for that low intake may be that most conventional breakfast cereals are fortified with 100% of your daily vitamin B12 requirements, and of course people who avoid gluten will need to avoid many of those cereals, as well.
- Heme iron sources, eggs
- Fortified gluten-free grains
- Milk, yogurt, cheese
It's common for those with celiac disease to have a vitamin D deficiency but it's important to get you levels checked. Over supplementing vitamin D might lead to a magnesium deficiency. In order for supplemental or stored vitamin D to be converted to the active form, it requires magnesium. Vitamin D is known as "the sunshine vitamin" because your skin produces it in response to sunlight, vitamin D also can be found in fortified dairy and conventional cereal products and if you're eating gluten-free (and especially dairy-free, too), you may not get enough.
- Plant oils (eg, olive)
- Salmon, nuts, enriched eggs
- Fortified milk
Blood that iron-deficiency anemia can be detected in 46% of celiac disease cases. Anemia with its link to iron deficiency is a common symptom of celiac disease, and in fact a study shows people who are anemic at diagnosis may have worse damage to their small intestine than people whose primary celiac symptom was diarrhea. Therefore, people with celiac disease need to be more careful than average to get enough iron, either through their diets or through supplements. People who don't have celiac but who are following the gluten-free diet also need to be careful, since many people following a conventional gluten-filled diet get enough iron through fortified cereals and other products.
Foods with Iron
- Spinach and other leafy greens
- Beef, poultry, fish, seafood (heme)
- Beans, tofu (nonheme)
- Amaranth, teff, buckwheat, quinoa