Common Nutrient Absorption Issues with Celiac and What to Do About It

As as we all are far to familiar with, celiac disease can present some challenges with absorbing nutrients from our foods.

Prior to being diagnosed, the inflammation and damage in the small intestine can cause food to “run right through us” so to speak, and even when that doesn’t happen those little villi aren’t up to par. (Which makes me think-those of use with intestinal issues are certainly a but more familiar with anatomy than the average person, aren’t we? Villi to anyone else may sound like a shape of pasta-but I digress.) And just in case you are not familiar with the word “villi”, it’s not a pasta or a grape varietal, they are the little finger-like projections that stick out from the walls of the small intestine, sucking up the good stuff-nutrients, vitamins, minerals, etc.

When the lovely little villi get mad at us if we eat what they consider to be the wrong thing, they don’t work so well.

They get riled up and inflamed, and then they don’t do a good job absorbing the good stuff anymore. Over time they can also get smaller (“villous atrophy”, anyone-prior to that are “flattened villi”) and then there’s even less surface area to absorb the good stuff. This continues on as long as the irritant is ingested-in this case, gluten. The good news is that the gut can heal to a large extent as long as gluten is not ingested-the irritant is removed and healing can begin. Some of us as are very fortunate and are diagnosed quickly, before too much permanent damage has been done. Others who have suffered through a lengthy diagnosing/mis diagnosing process have a bit more of an intestinal structural challenge when it comes to absorbing properly.

This impaired ability to absorb nutrients can create several issues, of which I’m going to touch on just a few, and lump some together as well. A good idea is to get tested for baseline levels of these items by your doctor (the ones that can be tested for,) generally a simple blood test will do the trick and give you a starting point.

1-Overall lack of nutrient absorption can cause weight loss while undiagnosed.

This is not a good thing. Conversely, after being diagnosed people may find they gain weight. Up to a normal weight this is a good thing, and necessary if an individual has been malnourished due to lack of nutrients. Weight gain after diagnosis is not uncommon, and something I will be touching on in greater depth in another article.

2-Essential fatty acids-Omega 3 and 6′s.

They are all over the media lately, so you’ve probably heard of them. In general, we get enough Omega 6′s from everyday stuff. However, unless you eat a lot of fish, you may want to actively get more Omega 3′s in your diet. Fatty fish like wild salmon are great sources. You can also get some vegetarian sources from walnuts, pumpkin seeds and flax. I also supplement with a fish oil. A TBSP a day of Carlson Fish Oil carlsonsfishoil
covers me, and really isn’t bad at all, I promise. Pour into a measuring spoon and just slam it.

3-Vitamin D, Calcium and Magnesium.

I lumped these together because they are all important for bone health. At age 30 I was diagnosed with osteopenia, and here I am an athlete who lifts weights! Bone health is a huge issue for celiacs in general, especially the females amongst us. Calcium is obviously in dairy, but that doesn’t help the casein intolerant, does it?
-Food sources of calcium: spinach, greens, (turnip, mustard, collard, kale) broccoli, molasses, squash, cabbage
-Food sources of magnesium: pumpkin seeds, brazil nuts, halibut, spinach (see a pattern…) beans, artichokes
-Food sources of Vitamin D: cod liver oil, salmon, milk. Other dairy products are generally NOT fortified with D.
Even with all this, in regards to Vitamin D that’s more than likely not going to get you enough. And I’m sure you’ve heard about how Vitamin D is the “sunshine vitamin” which we don’t produce enough due to our largely indoor-dwelling and sunscreen-wearing lives. I supplement with all 3-calcium, magnesium and Vitamin D in pill form. The The Food and Nutrition Board of the Institute of Medicine has established 2000 IU as generally safe for adults. There’s also a lot of talk about the RDA for Vitamin D being raised significantly. There are also many anecdotal reports of much larger doses being used without adverse affect. I say, do your research and read, then make an informed personal decision. My personal decision involves 2000 IU of Vitamin D, plus the amounts in my multivitamin, Cal/Mag supplement, and limited sunshine from walking the dog.

4-Iron.

There are 2 types of iron, heme and non heme. According to the McKinley Illinois website, “HEME iron is found only in meat, fish and poultry and is absorbed much more easily than NON-HEME iron, which is found primarily in fruits, vegetables, dried beans, and nuts.” The absorption of non heme foods can be enhanced by eating it with a Vitmain C source (such as citrus fruit, strawberries, red bell pepper) or by being cooked in a cast iron skillet.
-Heme iron sources: liver (you knew that was coming, didn’t you?), beef, chicken, pork, salmon, tuna, turkey
-Non-heme sources: almonds, apricots, beans, molasses, rice, broccoli

This just begins to scratch the surface. I always take a multivitamin/mineral to cover my nutritional bases. I think a digestive enzyme supplement and pro/prebiotics could also be helpful to assist in maximizing nutrient uptake.

Did you notice any patterns in the lists of recommended foods? Green leafy veggies, lean protein sources, healthy fats in the form of nuts and fatty fish, high fiber food like beans and the veggies again….sounds pretty good, doesn’t it?

Go forth and absorb!!

References:
www.mayoclinic.com
www.health.gov
www.mckinley.illinois.edu

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  1. Grace says:

    Great info. I have Celiac Disease and need to take extra Calcium as well. I don’t take extra fish oil (especially in liquid formula) but I will ask my doctor how much of it I need.

    One thing to mention also is that people with Celiac should ask their doctors, if not already prescribed, about probiotics. I take Florastor probiotic pills and ‘ve had less uncomfortable stomach aches.

  2. [...] explains this quite well in her blog (http://www.glutenfreefitness.com) per this link:  http://www.glutenfreefitness.com/common-nutrient-absorption-issues-with-celiac-and-what-to-do-about-….  Therefore, having good nutrition in a celiac’s diet is that much more [...]

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