Celiac Disease
(gluten intolerance) |
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information on diet, nutrition, & self-help
Celiac disease (also called gluten-induced enteropathy) is an intestinal disorder that results from intolerance to gluten, a protein found in wheat, oats, barley, and rye. Microscopic examination of the small intestine lining often reveals severe damage. Individuals with untreated celiac disease may eventually experience malaise and weight loss and have an increased risk of developing anemia, osteoporosis, osteomalacia, and certain types of cancer. Neurological disorders and emotional problems may also complicate celiac disease in some cases.
Diet, lifestyle choices and supplementation with specific nutrients can make a significant difference in helping control the effects of this condition.
Nutritional Supplements for Celiac Disease
These are the most important supplements and recommendations.
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Causes
Normally, your small intestine is lined with tiny, hair-like projections called villi. Resembling the deep pile of a plush carpet on
a microscopic scale, villi work to absorb vitamins, minerals and other nutrients from the food you eat. Celiac disease damages the villi.
Without villi, the inner surface of your small intestine becomes less like a plush carpet and more like a tile floor, and your body is
unable to digest and absorb nutrients necessary for health and growth. Instead, nutrients such as fat, protein, vitamins and minerals are
eliminated with your stool.
The exact cause of celiac disease is unknown. What is known is that the disease is often inherited. If someone in your immediate
family has it, chances are 10 percent to 20 percent that you may have it too. It can occur at any age, although symptoms don't
appear until gluten is introduced into the diet.
Many times, for unclear reasons, the disease emerges following some form of trauma: an infection, a physical injury, pregnancy,
severe stress or surgery.
Conventional Treatment
The conventional treatment is strict adherence to a gluten-free diet. People with severe damage to the absorptive surface of their intestines may also be prescribed intravenous nutritional supplements. Immunosuppressive and anti-inflammatory medications, such as glucocorticoids (e.g., prednisone) and 6-mercaptopurine, are sometimes used as components of conventional treatment.
Self Help
Nutritional supplements that may be useful
- Multiple vitamin-minerals: (high potency multivitamin/mineral supplement [i.e., one of the 3- to 6-per-day formulas]) 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.
- Because of the complexity of this condition and the multiple nutritional factors involved, people with celiac disease should be under the care of a doctor. Some doctors may recommend the use of nutritional supplements, including a high potency multiple vitamin/mineral formula to reduce the risk of future deficiencies. Doctors may recommend additional amounts of various nutrients, above the levels that may be found in a multiple vitamin/mineral formula, for some individuals with more severe nutritional deficiencies.
- Magnesium: After commencement of a gluten-free diet, overall nutritional status gradually improves. However, deficiencies of some nutrients may persist, even in people who are strictly avoiding gluten. For example, magnesium deficiency was found in eight of 23 adults with celiac disease who had been following a gluten-free diet and were symptom-free. When these individuals were supplemented with magnesium (250-500 mg per day) for two years, their bone mineral density increased significantly.
- Enzymes: People with celiac disease often do not produce adequate digestive secretions from the pancreas, including lipase enzymes. In a double-blind trial, children with celiac disease who received a pancreatic enzyme supplement along with a gluten-free diet gained significantly more weight in the first month than those treated with only a gluten-free diet. However, this benefit disappeared in the second month, suggesting enzyme supplements may only be useful at the beginning of dietary treatment.
- Vitamin A: In one study, six people with diet-treated celiac disease had abnormal dark-adaptation tests (indicative of "night blindness"), even though some were taking a multivitamin that contained vitamin A. Some of these people showed an improvement in dark adaptation after receiving larger amounts of vitamin A (10,000-25,000 IU per day), either orally or by injection.
- 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.
Lifestyle changes that may be helpful
- Breast- vs. formula-feeding: In one study, children who were breast fed for less than 30 days were four times more likely to develop celiac disease, compared with children who were breast fed for more than 30 days.
Dietary changes that may be helpful
- 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.
- Strict avoidance of wheat, barley, and rye usually results in an improvement in gastrointestinal symptoms within a few weeks, although in some cases the improvement may take many months. Adherence to a gluten-free diet has been shown to help reverse many conditions associated with celiac disease, including low bone mineral density, increased cancer risk, and 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' milk and soy.
Studies
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