Coeliac disease presents a multifaceted challenge that extends beyond its gastrointestinal symptoms, involving immune dysregulation, intestinal damage, and intricate nutritional implications. Looking deeper into the nutritional landscape of coeliac disease reveals a complex interplay of absorption challenges and potential deficiencies, highlighting the importance of comprehensive management strategies.
Essential Nutrients and How Nutrients are Absorbed in Coeliac Disease
The small intestine serves as the primary site for nutrient absorption, housing specialised structures known as villi and microvilli. These microscopic finger-like protrusions significantly increase the surface area available for nutrient uptake. In individuals with coeliac disease, the immune system mistakenly identifies gluten, a protein found in wheat, barley, and rye, as a threat, triggering an inflammatory response. This immune reaction damages the delicate villi and microvilli, leading to villous atrophy and impaired absorption of essential nutrients such as:
Iron: a vital component of haemoglobin responsible for oxygen transport in the blood, is particularly vulnerable to impaired absorption in coeliac disease. Reduced iron uptake can result in iron deficiency anaemia, characterised by symptoms such as fatigue, weakness, pallor, and shortness of breath.
Folic Acid (Vitamin B9): plays a pivotal role in DNA synthesis, red blood cell formation, and neural tube development. Impaired absorption of folic acid in coeliac disease may lead to megaloblastic anaemia, presenting with symptoms such as fatigue, weakness, cognitive impairment, and mood disturbances.
Vitamins B6 and B12: essential for neurological function, DNA synthesis, and red blood cell production. Deficiencies in these vitamins can manifest as peripheral neuropathy, tingling sensations, muscle weakness, cognitive impairment, and mood disturbances.
Vitamin D: Often referred to as the " sunshine vitamin ," vitamin D plays a critical role in calcium absorption, bone health, immune function, and overall well-being. Impaired absorption of vitamin D in coeliac disease may predispose individuals to osteoporosis, fractures, muscle weakness, and increased susceptibility to infections.
Calcium: indispensable for bone health, muscle function, and nerve transmission. Reduced calcium absorption in coeliac disease may contribute to osteoporosis, bone fractures, and dental abnormalities.
Other Micronutrients: Trace minerals such as zinc, copper, and magnesium are integral to numerous physiological processes, including immune function, wound healing, and antioxidant defence. Deficiencies in these micronutrients may manifest as impaired immune function, delayed wound healing, skin abnormalities, and oxidative stress.
Managing Nutritional Challenges in Coeliac Disease
To address these issues, proactive management is essential:
Diverse Diet: Eat a variety of nutrient-rich foods including fruits, vegetables, quality proteins, legumes, nuts, seeds, and whole grains such as brown rice, buckwheat, millet, quinoa, and certified gluten free oats if tolerated.
Supplementation: Consider a broad-spectrum supplement that contains essentials vitamins and minerals to aid in correcting underlying deficiencies.
Supplements such as Revive Active contain the active form of Folic Acid (Methylfolate), Vitamin B12 (Methylcobalamin) meaning that the conversion has already been done for you. We need adequate B vitamins for energy which is particularly helpful in coeliac disease where fatigue is common. Revive Active also contains all the nutrients required to support your immune health, heart, and thyroid health too.
In addition, Revive Active contains a little something special: L-glutamine. Some research shows that L-glutamine, an amino acid, may help preserve the mucosal structure of the gut wall lining which is damaged in coeliac disease.
For those living in the northern hemisphere it is also very important to supplement with Vitamin D3 during the winter months and get as much sunshine exposure as possible during the summer.
Regular Monitoring: Keep track of nutrient levels with blood tests and work closely with healthcare providers to ensure optimal nutrition.
Education and Support: Learn how to make informed dietary choices, read food labels, and advocate for your nutritional needs. Seek support from healthcare professionals and support networks.
Some great resources:
As more people become aware of coeliac disease then more resources pop up. We especially love following coeliac friendly baker Becky Excell on her website www.glutenfreecuppatea.co.uk. Becky’s Instagram page has us drooling @beckyexcell
Navigating Nutritional Health with Coeliac Disease
Managing your nutrition with coeliac disease can be challenging but it is achievable. By understanding absorption challenges, addressing underlying deficiencies, and taking a holistic approach to nutrition, individuals can improve their health and well-being.
