Celiac disease is an immune-mediated disorder that occurs in genetically predisposed individuals who ingest gluten. Gluten is a dietary protein found in wheat, barley, and rye. In the susceptible person, this gluten-containing diet can lead to the development of an autoimmune enteropathy, causing malabsorption of carbohydrates, proteins, fats, and critical vitamins and minerals. Deficiencies of key nutrients in celiac disease occur due to poor dietary intake, and lack of fortification of gluten-free foodstuff.
For people with celiac disease, especially those recently diagnosed, eating gluten-free food and taking the right supplements is crucial. Absorption of food and nutrients occurs mostly in the small intestine; it is here that we have thousands of tiny protrusions that line the small intestines called villi, which play a significant role increasing the surface area available in the gut for maximum absorption. However, in celiacs, these villi are destroyed and the intestinal wall damaged causing serious implications.
An allergic reaction to gluten, celiac disease is a severe immune response which leads to inflammation of the small intestines and injury to the intestinal lining. Diarrhoea, abdominal bloating, vomiting and weight loss may be experienced from this reaction to gluten, and the consequential inability to properly digest food. As the villi are destroyed, the surface area is reduced and the intestinal lining is made smooth. Without the villi, absorption of dietary nutrients is made inefficient, leading to malnutrition. Many celiac sufferers are deficient in essential fatty acids, iron, zinc, vitamin D and K, calcium, magnesium and folic acid. If untreated, malnourishment and insufficient vitamins and minerals in the diet can cause osteoporosis (weakening of the bones).
Natural supplements for celiac disease patients
Reduced levels of iron, folate, vitamin B12, vitamin D, zinc, and magnesium are common in untreated celiac disease patients due to loss of proteins and enzymes needed for the absorption of these nutrients. In the majority of patients, removal of gluten from the diet leads to histological recovery and normalization of iron, vitamin, and mineral levels. Iron deficiency anemia is the most common sign of CD and usually resolves with adherence to a gluten-free diet. However, deficiencies of both folate and vitamin B12 may persist in some patients on a gluten-free diet, thus requiring vitamin supplementation to improve subjective health status. Also, exclusion of gluten from the diet does not always normalize bone mineral density. In these cases, supplementation of vitamin D and calcium is recommended. Resolution of mucosal inflammation may not be sufficient to abrogate magnesium deficiency. Since gluten-free cereal products have lower magnesium content, a magnesium-enriched diet should be encouraged in CD patients.
At present, strict and lifelong gluten-free diet is the only effective treatment for celiac disease. Even small amounts of gluten can be immunogenic; therefore all food and food items and drugs that contain gluten and its derivatives must be eliminated completely from the diet.
B vitamin supplements reduce the risk of developing very high levels of homocysteine in patients with celiac disease. Celiac disease raises the risk of folate and vitamin B12 deficiency, which can contribute to the development of excess levels of homocysteine, an amino acid, and its association with vascular disease. B-vitamin supplements can normalize B6, folate and B12 status, and total homocysteine levels.
Healing the damage from celiac disease and restoring the immune system back to a state of normalcy may improve many lingering symptoms in those with celiac disease. It is not a quick process, but with a truly healthy gluten-free diet, it is possible.