Should Those with Celiac Disease and Non Celiac Gluten Sensitivity Take Supplements?
Even though vitamin and mineral deficiencies are extremely common for those with celiac and non celiac gluten sensitivity (NCGS), the issue is largely ignored by doctors when a celiac diagnosis is made. Because nutrients are an essential part of the healing and recovery process, this article will discuss What supplements you should take if you have celiac or NCGS. In short, this article will help you understand:
- How common nutritional deficiencies are in those with gluten issues
- Why supplementation may be needed
- Gluten cross contamination in supplements
- How to identify hidden gluten fillers in supplements
- What supplements you should take if you have celiac disease or NCGS (The top 4)
The Nutritional Paradox for Celiacs
Multiple studies have shown the relationship between vitamin and mineral deficiencies, celiac disease, and gluten sensitivity. It is well established that gluten induced damage to the intestinal cells can lead to malabsorption and poor digestion. The inability to absorb nutrients from food sets up a viscous paradox. Gluten damages the gut. Gut damage leads to deficiency. Deficiency prevents the gut from healing. Nutritional deficiency continues to be a problem.
One study showed that celiac patients following the gluten free diet still had vitamin and mineral deficiencies after 10 years of compliance.(1) Add to this the fact that gluten has been linked to chronic autoimmune inflammatory damage beyond the gut. This chronic inflammation taxes the nutritional status of the body even further, creating a greater need for nutritional supplementation as part of the recovery process. (2-5)
How Common Are Nutritional Deficiencies in those With Gluten Sensitivity?
Extremely… Let’s take a look at what a recent research study published in the medical journal, Nutrients(7), found:
- 87.5% of patients diagnosed had at least 1 vitamin or mineral deficiency
- 53.8% were deficient in at least 2 nutrients
- 67% were deficient in the mineral zinc
- 46% were deficient in iron storage
- 20% were deficient in folate (vitamin B9)
- 32% were anemic
- 19% were deficient in vitamin B12
- 14.5% were deficient in vitamin B6
- 7.5% were deficient in vitamin A
- 4.5% were deficient in vitamin D
The most concerning part about the above study data is that it is incomplete. Not all nutrients were tested. For example, vitamins B1, B2, B3, B5, B8, vitamin C, magnesium, calcium, potassium, copper, selenium, chromium, iodine, vitamin K, vitamin E, and essential omega fats were evaluated. If they had been measured, the deficit issues would most likely be even worse. There are approximately 40 essential nutrients required by the body to maintain healthy function. Nutrients are vital to fight inflammation, repair damaged tissue, regulate immune function, produce thyroid hormones, produce digestive enzymes, replicate new cells, regulate the adrenal glands, produce energy, help with fat metabolism, and much, much more. Without them, how do you heal? How do you maintain health in a deficient state?
Almost 25% of Supplements Contain Gluten
Now imagine you are supplementing your diet in an attempt to support your recovery, and you are taking vitamins that contain hidden gluten. A recent study investigated over the counter vitamin and mineral supplements for the presence of gluten, and the results were alarming. Almost 24% of the products tested had enough gluten in them to create inflammatory damage. (6) Here is a quote directly from the study:
we investigated the presence of gluten in twenty one common dietary supplements from the national market using the immunochromatographic assay. This visual assay proved to be an efficient rapid tool for gluten screening as an alternative to the ELISA techniques. The results have shown the presence of gluten in 23.8% of the investigated samples (vitamins, minerals, plant extracts, probiotics supplements, lactoferrin, propolis supplements).
Why is Gluten Cross Contamination In Supplements Such a Problem?
Many supplement manufactures process multiple products in their facilities. Often times, grain is used as a filler or additive. Wheat germ is a common example of a gluten based ingredient being used in supplement processing. This same problem can be seen in a number of prescription and over the counter medications. Below is a list of commonly used terms that may be grain based fillers in vitamin supplement products:
- Wheat germ
- food glaze
- food starch
- Hydrolyzed vegetable protein
- Textured plant protein
- Artificial flavors and colors
Corn is a Very Commonly Added Component in Supplements
If you have stayed up to date with current information and research regarding corn gluten, then you are aware that corn is a major cause of inflammation in celiacs. If you are not aware, go here now for a summary on the research in this area. This is important to understand because corn based fillers are found in many supplement products. As a matter of fact, most brands of vitamin C are derived from corn. This is one of the many reasons why vitamin C formulations cause reactions in patients with celiac and NCGS. As corn is easily hidden and disguised in many ways, I have put together a list of terms you will want to be aware of to avoid this contaminant in your supplements.
4 Supplements That Everyone With Gluten Sensitivity and Celiac Disease Should Take
In an ideal world, doctors would perform comprehensive nutritional testing on all of their celiac and NCGS patients. Unfortunately, this is not the standard of care in medicine, as nutrition is not taught adequately in medical schools. This leaves millions of patients without any real nutritional guidance. So for those of you who turn to Gluten Free Society for knowledge, I have put together a list of the top 4 supplements that everyone with gluten issues should consider taking. In addition, I have added a short video (less than 10 minutes long) for you to gain a greater comprehension on this topic.
- A high quality multi-vitamin/mineral – A good multi contains a broad spectrum of vitamins and minerals that can help support your overall nutrition.
- Probiotics with Bifidobacterium and Lactobacillus – These strains of bacteria have been shown to be beneficial for those with gluten sensitivity.
- A clean, mercury free, concentrated Omega-3 fats with both EPA and DHA. Gluten is a common cause of fat mal-absorption, and omega 3 deficiency is more common in those with celiac disease.
- A full spectrum digestive enzyme that can also help support the break down of gluten
The following short video discusses each supplement on this top 4 list in more detail.
- C. Hallert, C. Grant, S. Grehne, et al. Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years. Aliment Pharmacol Ther 2002; 16: 1333–1339.
- Gonçalves C, Oliveira ME, Palha AM, Ferrão A, Morais A, Lopes AI. Autoimmune gastritis presenting as iron deficiency anemia in childhood. World J Gastroenterol. 2014 Nov 14;20(42):15780-6. doi: 10.3748/wjg.v20.i42.15780.
- Bizzaro G1, Shoenfeld Y. Vitamin D and autoimmune thyroid diseases: facts and unresolved questions. Immunol Res. 2014 Nov 19.
- McKeon A, Lennon VA, Pittock SJ, et al. The neurologic significance of celiac disease biomarkers. Neurology. 2014 Nov 11;83(20):1789-96.
- Ji Z, Fan Z, Zhang Y, Yu R, Yang H, Zhou C, Luo J, Ke ZJ. Thiamine deficiency promotes T cell infiltration in experimental autoimmune encephalomyelitis: the involvement of CCL2. J Immunol. 2014 Sep 1;193(5):2157-67.
- Oancea S, Wagner A, Cîrstea E, Sima M. Gluten screening of several dietary supplements by immunochromatographic assay. Roum Arch Microbiol Immunol. 2011 Oct-Dec;70(4):174-7.
- Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, et al. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients. 2013 Sep 30;5(10):3975-92. doi: 10.3390/nu5103975.