August 5, 2013

Gluten Sensitivity and Iron Deficiency Anemia – Are They Related?


Iron RBC GlutenIron deficiency is one of the most common nutritional deficits found in patients with celiac disease and non celiac gluten sensitivity.  The most common symptom linked to iron deficiency is unwavering fatigue.  Patients will often report severe loss of energy even when sleep has been adequate.  This energy deprivation can also contribute to severe brain fog and mental clarity issues.  Iron deficiency can often times be confused with low thyroid or hypothyroidism.

Iron loss can contribute to a multitude of health problems – not just fatigue.  Some of the most common side effects of iron deficiency include:

  • shortness of breath (people often report that they cannot get enough air into their lungs)
  • irritability
  • extreme fatigue (people commonly report sleeping for 8 + hours and still waking up exhausted)
  • chronic recurrent infections (cold and flu)
  • craving ice
  • hair loss
  • headaches
  • weakened nails
  • restless legs syndrome
  • angular stomatitis (cracking in the corner of the lips)
  • chapped lips
  • easy bruising

Research Shows Iron Deficiency Linked to Gluten Exposure

The following research study published in the Turkish Journal of Gastroenterology discusses how iron deficiency can be the first symptom associated with celiac disease.  The results of the research led to the recommendation of ruling out gluten sensitivity in all patients with iron deficiency anemia.  The study additionally recommends this screening in patients who supplement with iron, but still have persistently low levels (refractory iron deficiency).

Bottom line: if you suffer with any of the symptoms listed below for unknown reasons.  You should have your doctor do two things -

  1. Order an iron panel with ferritin
  2. Rule out gluten sensitivity

What You Should Know About Gluten and Iron

Gluten can contribute to iron deficiency in several ways.  Malabsorption of iron is often a consequence of villous atrophy.  Additionally, gluten can damage the acid producing cells of the stomach.  Since acid is a necessary component for iron absorption, this commonly leads to anemia even in the absence of villous atrophy identification.

Anemia leads to oxygen deficiency which in turn can reduce the body’s ability to generate energy, which in turn can cause a cyclic state of healing inhibition.

Aside from gluten induced damage, iron deficiency can occur in menstruating women with heavier periods.  Iron deficiency can also occur when there is slow steady blood loss.  This can occur in a hidden manor (occult blood loss) or it can be more obvious as in the case of hemorrhoids.

Iron deficiency and gluten sensitivityLack Of Iron Causes Immune Problems

Iron is an essential element in the formation of lactoferrin, a protein used by the immune system to help fight gastrointestinal infections.  This includes viral, bacterial, fungal, and parasitic infections.  This is critical because in the presence of persistent GI infection, leaky gut syndrome is allowed to perpetuate regardless of a gluten free diet change.  Additionally, the protein lactoferrin aids in both growth and in some studies has shown cancer protective qualities.

Children with iron deficiency often exhibit lethargic behavior, and suffer with unexplainable fever spikes as well as chronic recurrent infections.
Dr. Osborne – The Gluten Free Warrior

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5 Responses to “Gluten Sensitivity and Iron Deficiency Anemia – Are They Related?”

  • Melissa Shackford says:

    Be sure to ask to have your ferritin level checked. My hemoglobin has always been OK but low ferritin levels. Ferritin is your storage of iron.

  • Antoinette says:

    My son suffers low iron and many symptoms you mention. But what’s the best way to increase iron levels and absorption for a 5 year old? Docs just say he’s on the very low side of normal and not to worry about it.

  • Find a functional medicine doctor who understands nutrition. don’t wait for the problem to become a disease.

  • Good point Melissa!
    The standard blood work up to evaluate iron properly should include a CBC (paying attention to RBC count, hemoglobin, hematocrit, and RDW), a chemistry panel to ensure adequate liver function (liver helps recycle components important for RBC production), ferritin levels, iron, iron binding capacity, and % iron saturation.

  • Keli davis says:

    I have had a ferritin level below 5 for five years. Hgb and Hct just below normal. My doctor monitors it a few times a year and treats it with bid ferrous gluc. I do not have heavy periods of any signs of bleeding. I have had a long history of bowel problems and I tried a glutin free diet for a year but no improvement in the ferritin. A sleep study specialist that I was referred to for restless leg syndrome told me I need iron infusions but my doctor does not agree and refuses to order them, After a long debate with my doctor and then finally a friendly agreement to disagree he is sending me to see a haematologist to decide on tests and treatment, I am now worried that I have harmed my organs as I have always had symptoms and have developed multiple health problems. I am wondering if I should not have accepted my dr lack of concern over the anemia for this many years! I guess I will see what the haematologist says.

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