Throughout the months of May and June, we are focusing on GUT health. Today, let’s talk about CELIAC DISEASE.
Celiac disease is an autoimmune condition of the gut where the immune system recognizes gluten as a threat. This causes the body to mount an immune response, leading to damage of the lining of the small intestine. Gluten is a protein naturally found in wheat, barley, rye, and their derivatives. Gluten can be found in bread, pasta, cereal, baked goods, sauces, soups, salads dressings, personal care products, etc.
Keep reading to learn everything you need to know about celiac disease.
How does Celiac Disease impact gut health?
The small intestine is where the majority of digestion and absorption of food takes place. The small intestine is lined with fingerlike projections called villi. The intestinal villi are responsible for digesting and absorbing the nutrients from our food. Due to the immune response mounted against gluten in the gut, the villi become damaged and shrinks. This leads to digestive issues such as bloating, abdominal pain, constipation, diarrhea, and more. Severe nutrient deficiencies are commonly seen due to the small intestine’s impaired ability to properly digest and absorb food.
Who is at risk for Celiac Disease?
Genetic Predisposition
At least 95% of people with celiac disease have 2 specific genes: HLA class II haplotypes DQ2 and/or DQ8. Just because someone has the genes for celiac disease doesn’t mean they are actively being expressed. Plenty of people have these genes and do NOT have celiac disease. If you’re interested in having your genes tested and learning how to interpret those results, we encourage you to join our waitlist for our online nutrigenomics course offered twice a year.
Family History
People with a first degree relative with celiac disease have a 10 – 15% chance of getting celiac disease themselves.
Autoimmune Overlap
There is an increased risk for celiac disease of other autoimmune conditions are present. This includes type 1 diabetes, psoriasis, Hashimoto’s thyroiditis, etc.
What are the signs & symptoms of Celiac Disease?
Gastrointestinal Symptoms:
- Abdominal pain
- Bloating
- Constipation
- Diarrhea
- Loss of appetite
- Nausea & vomiting
- Indigestion
- Lactose intolerance
- Reduced pancreatic enzyme production
- Pancreatitis
Other Signs & Symptoms:
- Weight loss
- Fatigue
- Dermatitis herpetiformis (itchy, blistering skin)
- Nutrient deficiencies
- Osteopenia or osteoporosis
- Late or missing periods
- Early menopause
- Impaired coordination
- Failure to thrive, short stature (in children)
- Elevated liver enzymes
- Headaches
- Low albumin
- Macrocytic anemia
- Iron deficiency anemia
- Tooth decay or enamel defects
- Infertility
- Recurrent miscarriages
- Reduced sperm count or motility
- Arthritis
- Depression
- Dementia
- Abnormal red blood cells
- High platelet count
What is the treatment for Celiac Disease?
1. Gluten-Free Diet
- The primary treatment for Celiac Disease is following a strict gluten-free diet.
- Gluten is a protein naturally found in wheat, barely, rye, & their derivatives.
- Following a gluten-free diet neutralizes the immune system & regenerates the damaged intestinal villi.
- With 100% compliance…
- Diarrhea should resolve within days
- Most symptoms will disappear in ~4 weeks
- Antibodies should return to normal within 12 months
- All hidden sources of gluten must be eliminated as well:
- Medications & supplements
- Personal care products
2. Lactose-Free Diet (as needed)
- A lactose-free diet may be recommended during the first 3-6 months of following a gluten-free diet.
- Lactose is a sugar naturally found in milk & milk products.
- Lactase, the enzyme to breakdown lactose, is produced in the brush border of the intestines.
- Lactose intolerance often develops in individuals with celiac disease due to damage of the brush border.
- A lactose-free is often temporary, as the ability to digest lactose usually returns once the intestinal villi heal.
3. Correct Nutrient Deficiencies
- Damage to the intestinal villi often leads to malabsorption of nutrients, resulting in deficiencies.
- Most common vitamin & mineral deficiencies:
- Vitamin A, B6, D, K, B12
- Copper, Calcium, Iron, Magnesium, Phosphorus, Selenium, Zinc
- Micronutrient testing should be done to determine individualized supplement needs.
4. Address Food Intolerances & Sensitivities
- If an individual is still experiencing gastrointestinal symptoms after being on a gluten-free diet for at least a month, food sensitivities and/or intolerances may need to be explored.
- MRT testing for food sensitivities & a customized elimination diet protocol (LEAP) may be helpful.
- MRT tests 176 different foods/food chemicals
- A low-FODMAP diet trial may be helpful.
- FODMAPs = fermentable oligosaccharides, disaccharides, monosaccharides and polyols.
- FODMAPs are short-chain carbohydrates (sugars) that the small intestine absorbs poorly. Some people experience digestive distress after eating them.
5. Gut Healing Supplements (as needed)
- The small intestine usually requires a lot of healing after diagnosis.
- Gut healing supplements to restore the intestinal villi & reducing inflammation may be beneficial to include.
- Dietary interventions:
- Bone broth
- Omega-3’s (salmon, tuna, mackerel, anchovies, sardines, herring, chia seeds, flaxseeds, etc.)
- Antioxidants (berries, cruciferous veggies, turmeric, green tea, etc.)
- Supplements to consider*:
- L-Glutamine
- NAC (N-acetylcysteine)
- Zinc carnosine
- *Always consult your dietitian or healthcare provider prior to adding supplements!
We hope you enjoyed this blog post “Everything You Need to Know About Celiac Disease.” Let us know what you found helpful in the comments below.
Are you interested in booking an appointment at Clem&Thyme Nutrition? We have three convenient locations in the state of Ohio – our flagship office in Yellow Springs and extension offices in Upper Arlington and Westerville in the Columbus area. We also offer virtual sessions and online programs. You can learn more about our registered dietitians to find the right fit for you. Click here to get started.
