Celiac disease arises from the body's inability to tolerate gluten, a protein contained in wheat and its cousins, rye and barley. It is condition in which the immune system begins to attack the tissue of the small intestine - which may sustain severe villi damage. Patients with celiac disease who continue to consume gluten may be at risk for malaise, weight loss, and have increased risks of developing anemia, osteomalacia, osteoporosis, osteomalacia, and some cancers. In some cases, other emotional disorders or neurological conditions may complicate the matter.
Healthcare professionals recognize that managing celiac disease requires three important steps.
- Gluten-free diet: Pay attention not only to foods that are gluten-free, but gluten-free supplements.
- Nutrients: Start with good quality, high-potency multivitamins and check with your doctor after several months to make sure that you are not still deficient in some nutrients. Supplements with digestive enzymes during the first month or so to make sure that you are getting the most from your supplementation while your body heals itself.
- Healing: During the first few months, help your intestinal tract heal with supplements to reduce inflammation and fight free-radicals.
Breast-feeding In one study, children who were breast-fed for less than 30 days, (formula-fed), were four times more likely to develop celiac disease, compared to those who were breast-fed for longer periods.15 This doesn't prove anything about preventing celiac disease, but it is indicative that such children have healthier digestive systems.16 Research has demonstrated that introducing very small amounts of gluten to babies at four months or more lessened the risk of celiac disease. This research also reported a relationship between infection in young children and the likelihood of developing celiac disease.31
Diet, lifestyle choices and supplementation with specific nutrients can make a significant difference in helping manage and control the effects of Celiac Disease.
For some people, celiac disease causes few obvious symptoms such as weight loss. For most there may more significant symptoms such as; frequent diarrhea or pale, foul-smelling, bulky stools; gas, bloating and abdominal pain; significant weight loss; tiredness, muscle cramps, short height or delayed growth; joint and bone; seizures; skin rashes, canker sores and infertility. Beyond physical symptoms the patient may experience depression and anxiety.
Villi are minute, hair-like tissues that line your small intestine for the purpose of absorbing minerals, vitamins and other nutrients from food. Celiac disease results in an overactive autoimmune system that attacks and damages these villi.
The result is that the lining of the small intestine loses its hair-like projections, becoming smooth and therefore unable to do their job of absorption. Many of the nutrients you would normally absorb through your intestines from food end up being eliminated through your stool.
While the causes of celiac disease are not known, it does run in families. Some gene mutations seem to increase the risk, but don't guarantee it. If someone in your family has celiac disease, there's a 10-20% chance that you also have it. Something happens in the body to cause the immune system to over react to gluten. It can arise at any age but symptoms don't appear unless there is gluten in the diet. Occasionally the condition develops after an infection, an injury, pregnancy, surgery or some stressful situation emotionally or physically.
- Multiple vitamin and mineral deficiencies
- Infertility Research reports that women and men who experience infertility find that the condition is resolved after they begin a gluten-free diet.10
- Depression One study also indicated that the side-effect of depression may continue even after several years but was eliminated after supplementation with vitamin B6 (80mg/daily) for six months.24
- Cancer Interestingly, for people with celiac disease, avoiding gluten in the diet might also reduce risk of cancer. Long term research over 11 years regarding 210 celiac patients found that they experienced a rate of cancer comparable to the population-at-large. However those people who were simply reducing gluten, or following a normal diet had a higher risk of (most) cancers of the mouth, esophagus and pharynx and lymphomas.6
- Bone density Both children and adults whose celiac condition is not treated have unusually low bone density. Putting children on a gluten-free diet for a year caused bone density to increase to normal levels rapidly.7 It is important that these children continue on a gluten-free diet as they grow up.8 After adults with low bone density have been on a gluten-free diet for a year, research demonstrates that their bone density of the spine and hip rises by more than 15% on average.9
- Night blindness Occasionally limitations in adapting to changing light environments has been reported, even though the celiac patient is taking vitamin A. Celiac disease can also cause nightblindness because the body cannot absorb enough essential vitamin A (a key component of beta-carotene and the reason your mom told you that carrots would help your eye sight).
- Anemia malabsorption of iron may give rise to iron deficiency anemia and malabsorption of vitamin B12 can give rise to pernicious anemia.
Three Pronged Healing Approach
1. Dietary changes that are essential
- Gluten-free diet: It is generally accepted that ingestion of gluten-containing grains (wheat, barley, and rye) is the primary cause of celiac disease. While oats contain a substance similar to gluten, modern research has found that eating moderate amounts of oats does not appear to cause problems for people with celiac disease.
- Sticking to the gluten-free diet helps with other conditions such as low bone density, decreased cancer risk, and reversal of infertility.
- Other dietary factors: Some individuals with celiac disease may be intolerant to other foods, in addition to gluten grains. If a gluten-free diet fails to relieve symptoms after three months, then other food intolerances should be ruled out with an elimination diet. Foods that have been reported to trigger symptoms include cows' milk11 and soy12-14.
2. Nutritional supplements that require attention
Beyond a high quality multi-vitamin / multi-mineral, you should be sure to work with your health care provider to determine whether any nutrients remain deficient even after you have been on your gluten-free diet.
- Multiple vitamin-minerals: A high potency multivitamin & mineral supplement is important. The malabsorption that occurs in celiac disease can lead to multiple nutritional deficiencies, some of which may be severe enough to cause illnesses such as anemia or bone disease. The most common nutritional deficiencies in people with celiac disease include essential fatty acids, iron, vitamin D, vitamin K, calcium, magnesium, and folic acid.
- Celiac disease is complex and multiple deficiencies may well exist of varying magnitudes. It is a good idea to work closely with your health care provider as to whether additional supplementation is needed.
- Magnesium is one of the nutrients that is sometimes found to continue to be deficient and is tied to bone demineralization.
- Enzymes: Digestive enzymes are often not adequately secreted from the pancreas. There are several strategies.
- Vitamin A deficiencies may contribute to poor night vision.
- Vitamin D might be needed for osteomalacia
- Zinc (for treatment of deficiency only): Zinc malabsorption occurs frequently in celiac disease, and may result in zinc deficiency, even in people who are otherwise in remission.
3. Healing the intestinal tract
As a result of the disease, your intestinal tract will be inflammed, and the villi will be destroyed. In order for healing and regrowth of villi it is important to reduce inflammation and support regrowth.
Some nutrients include: MSM, marshmallow, mucin, dandelion and you could also consider acupuncture for reducing inflammation.
See the following summary of research.
27. Picarelli, A., and associates, 2001. Immunologic evidence of no harmful effect of oats in coeliac disease. American Journal of Clinical Nutritrion 74:137-140.;
28. Kilmartin, C., and associates, 2003. Avenin fails to induce a Th1 response in celiac tissue following in vitro culture. Gut 52:47-52
29. Janatuinen, E. K., and associates, 2000. Lack of cellular and humoral responses to oats in adults with coeliac disease. Gut 46:327-331 30. Hoffenberg, E. J., and associates, 2000. A trial of oats in children with newly diagnosed celiac disease. J. Pediatr. 137:361-366. 31. Kagnoff, M. f., and associates,. 1984. Possible role for a human adenovirus in the pathogenesis of celiac disease. J. Exp. Med. 160:1544-1547.