Gluten is the generic name for a number of storage proteins in grains, including gliadin in wheat, hordein in barley and secalin in rye. If you have celiac disease, you know that ingesting these forms of gluten causes your immune system to identify the protein as a foreign body and try to destroy it. Although a gluten-free diet is the only treatment proven to be effective for celiac disease, it can cause some significant nutritional deficiencies.
Effects
If you continue to eat or drink gluten, you'll sustain damage to the villi, or little finger-like projections along the inside wall of your small intestines. As the villi become less effective at absorbing important nutrients from the food passing through your gut, you can develop a shortage of key vitamins, minerals and sometimes fluid and electrolytes. When you switch to a gluten-free diet, your villi start to repair themselves. However, the Celiac Sprue Association says, the repaired villi may not be able to absorb some nutrients as well as they did before they were attacked.
Contributing Factors
In the U.S., most commercial breads, cakes, pies, cookies, crackers and other baked goods are enriched with iron, calcium, thiamin, riboflavin, niacin, folate and other B vitamins. If you have celiac disease and avoid these gluten-laden products, you're eliminating a key source of vitamins and minerals.
Prevention/Solution
Nutritional deficiencies associated with CD are very individualized, so the Celiac Sprue Association recommends regular blood tests to see how well your villi are absorbing specific minerals and vitamins. When you review these lab results with your doctor, she may recommend that you take iron, folate and perhaps B vitamin supplements. You can boost your vitamin D levels with regular sun exposure, according to the Office of Dietary Supplements National Institute of Health. If your bone density is low, the physician may suggest taking oral vitamin D supplements as well.
Considerations
If you have celiac disease, you're more likely to develop other autoimmune disorders such as type 1 diabetes and thyroid problems that can complicate your nutritional picture. Ask your doctor for a referral to a dietitian familiar with these chronic conditions so you can anticipate and avoid nutritional deficiencies.
Tips
To make your meal planning a little easier, take advantage of the many brands, available from online markets and vendors offering gluten-free food products. You can read nutrition labels or contact the manufacturers directly to identify products fortified with various forms of vitamin B and D.
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