Gluten intolerance is associated with severe vitamin and mineral deficiencies
People with celiac disease are hyper-sensitive towards gluten, which we get from wheat and other grains. Gluten triggers inflammatory processes in the mucosa of the small intestine, impairing the uptake of nutrients. At the time of being diagnosed with the condition, people are often severely deficient in vitamin B12, vitamin D, folic acid, zinc, and copper. That problem should be addressed, according to a large study from the Mayo Clinic, a large, non-profit medical center based in Minnesota, USA. A growing number of people are affected by celiac disease that is linked to digestive problems plus other symptoms that are often misdiagnosed because the patient lacks vital nutrients. In this article, you can read about the difference between celiac disease and other types of gluten intolerance and find out how to deal with the problem.
Celiac disease is a chronic, autoimmune disease that is caused by gluten intolerance. Gluten is primarily found in wheat but also in rye and barley. Gluten is made of two different proteins called gliadin and glutenin. If a person with celiac disease eats gluten, it triggers the immune system to react, primarily against gliadin, by treating it as a microbe and attacking it. This sets off chronic inflammation in the mucosa of the small intestine. At the same time, the intestinal villi in the small intestine are destroyed. Normally, their job is to increase the surface area (and potential for nutrient absorption) of the intestine, so when the villi are destroyed, it impairs the small intestine’s uptake of vitamins, minerals, carbohydrate, and fat. The increased risk of diarrhea may also result in the loss of nutrients. In toddlers, the risk of getting celiac disease increases if they begin eating bread and porridge before the age of six months. Some people may even be genetically predisposed. Also, the risk of celiac disease goes up with age.
A new view on celiac disease and severe lack of nutrients
The new study was carried out on 308 adults, all of whom had been diagnosed with celiac disease in the period between 2000-2014. Contrary to what the scientists had expected, weight loss was only observed in 25.5 percent of the participants, which is not all that much. What surprised the researchers, however, was that nutrient deficiencies were far more widespread than they had imagined. They found that a whopping 59.4 percent of the patients lacked zinc, and that can affect health in a number of ways, as this mineral is involved in around 1,000 different enzyme processes, which are relevant for growth, fertility, vision, skin, hair, appetite, smell sense, and mental balance.
Lack of vitamin B12, vitamin D, folic acid, and copper was also quite widespread. This may affect physical and mental health in a number of ways. The study also showed that an increasing number of patients with celiac disease appears to suffer from other symptoms than the classic ones like diarrhea, weight loss, and anemia. Nutrient deficiencies may impair quality of life and damage your health in the short and the long run, but the Mayo Clinic scientists state that more research is needed to fully understand these mechanisms.
In any case, patients with celiac disease should be checked for any vitamin or mineral deficiencies as soon as they are diagnosed with the disease so they can take the necessary supplements as compensation. It is worth noting that some deficiencies are insidious, especially when it comes to vitamin B12 that may not show until months or years later, when the liver’s stores of the nutrient have been depleted. With regard to vitamin B12 supplements, it is best to use lozenges that ensure better absorption through the oral mucosa.
It is also known that lack of vitamin A and calcium may occur at later stage, and it is also important to consider that magnesium is necessary for the activation of vitamin D and also for the proper calcium distribution, which makes sure that most of the ingested calcium ends up in the bones and teeth. However, it is difficult to measure magnesium levels because we nearly all of our magnesium inside our cells.
Symptoms of celiac disease:
Symptoms vary and most people only experience minor symptoms, which makes it difficult to diagnose the condition. In fact, there is a term called subclinical celiac disease or silent celiac disease with somewhat unspecific symptoms. Still, the disease may be linked to serious and potentially life-threatening symptoms if it is not treated in time.
Treating celiac disease
In order to treat celiac disease, it is necessary to stick with a lifelong gluten-free diet with guidance of a trained dietician or nutritionist. As a general rule, the following principles should be followed:
- Read the declarations and avoid gluten in any form (food or beverage) from all sorts of wheat, rye and barley. Oats do not contain gluten but may contain traces of it after being processed industrially
- Instead, you can use rice, millet, corn, quinoa, sweet potatoes, gluten-free oats etc.
- Avoid beer based on grain
- To begin with, you should avoid dairy products due to transient lactose intolerance
- There are various recipe books with gluten-free and nondairy recipes
- Take a bioavailable multivitamin supplement and extra supplements of the nutrients that you may be lacking
What gluten sources are there?
The difference between celiac disease and gluten intolerance
Celiac disease is an autoimmune disorder that should not be mistaken for gluten allergy, although both conditions are associated with similar symptoms. Also, with both these conditions it is vital to avoid the gluten-containing foods that trigger the symptoms. The whole difference lies in the way the immune defense is activated to handle the protein compounds in gluten. In the case of celiac disease, the immune defense produces various antibodies (IgA, IgE, and anti-TTG) that cause diarrhea and inflammation, which attacks the cells in the intestinal mucosa. These reactions normally show rather soon.
With gluten allergy, it is normally only IgG antibodies that trigger inflammation without initiating a targeted attack against the intestinal mucosa. However, many people experience digestive discomfort and different physical and/or mental symptoms. It may take up to several days before the symptoms show.
People with celiac disease should avoid any form of gluten for the rest of their lives in order to allow the intestinal mucosa to heal properly. With gluten allergy, it is often a matter of how much gluten they ingest or a matter of avoiding certain gluten sources such as wheat or rye. Grain quality and industrial processing may also make a difference. For instance, many people are better able to tolerate retarded bread based on sourdough.
How to diagnose celiac disease
The different symptoms may give rise for concern and a blood test that screens for e.g. gluten antibodies such as TG (transglutaminase) or auto-gliadin antibodies (IgA) can be used as confirmation. Nonetheless, such blood samples can also be misguiding and should therefore be accompanied by screening procedures or a colonoscopy that can determine if the small intestine is chronically inflamed.
Adam C Bledsoe et al. Micronutrient Deficiencies Are Common in Contemporary Celiac Disease Despite Lack of Overt Malabsorption Symptoms. Mayo Clinic Proceedings, 2019
Mayo Clinic. Micronutrient deficiencies common at time of celiac disease diagnosis. ScienceDaily 2019
Gerry K. Schwalfenberg and Stephen J. Genuis. The Importance of Magnesium in Clinical Healthcare. Scientifica (Carro) 2017
Krysiak R. The Effect of Gluten-free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto’s Thyroiditis: A pilot Study. Exp. Clin Endocrinol Diabetes 2019
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