Malabsorption of Vitamins from Gluten Damage.
Malabsorption of vitamins and minerals is one of the major
effects of gluten intolerance or sensitivity. This is
especially true in celiac disease, where the reaction to gluten
in the diet causes an autoimmune response in the body. This
response erodes away the villi in the small intestine, reducing
the absorption of nutrients from food.
When damage is present, the lack of nutrition can reach
critical levels. The malabsorption of vitamins and also
minerals means that they are not able to be absorbed into the
body. Many of these nutrients are essential for the proper
function of the heart, brain, muscles, bones and immune system.
Anyone who has been diagnosed with celiac disease, osteoporosis,
or anemia needs to be evaluated for these forms of malnutrition.
The effects on the body may not be fully repaired by the gluten
free diet, as levels of some elements are needed in larger doses
than can be achieved through diet alone, especially in the
early stages of healing.
Your doctor can screen you for the levels of Vitamin D, Iron,
Vitamin K, Vitamin B12 and folate. Calcium and magnesium as
well. The interaction between these vitamins and minerals will
not be effective unless they are in adequate supply for the
body.
In the case of osteoporosis, vitamin D status(25-hydroxy
Vitamin D blood test) and parathyroid hormone levels need to
be evaluated and monitored. A bone density scan also needs to
be done. The malabsorption of vitamins like vitmain D can
cause many problems. Vitamin D behaves like a hormone, and
is used by the body for many functions.
Mineral Malnutrition
Magnesium is essential for proper cell function and the
production of ATP for energy. Lack of magnesium in the body
will lead to fatigue. It is also necessary for magnesium to
be present to aid in the absorption of calcium, and for proper
muscle function. If magnesium is in short supply, muscle
cramps are likely.
Without adequate potassium levels, the heart cannot beat
regularly. Calcium and magnesium are also necessary for
proper heart function. If the level of calcium in the blood
falls below normal levels, the body will pull the calcium from
the bones to keep the heart functioning. (This is regulated by
the parathyroid gland.) If this goes on for very long, bone
mass will decrease, and this process will eventually result
in osteoporosis.
Iron is often below normal levels in people with gluten
intolerance. Lack of iron can be due to poor digestion or
absorption, heavy menstrual periods, heavy coffee drinking, or
intestinal bleeding. Without enough iron, the body cannot
produce hemoglobin, which is essential for the body to
oxygenate red blood cells. It is also involved in energy
production.
Iron should only be taken if there is a deficiency, as it
is stored by the body and excessive iron can lead to heart
disease. Lack of iron leads to anemia and exhaustion.
Fat Malabsorption
A common problem with malabsorption is the inability to absorb
or digest fat. Although that may sound like a good thing if
you want to lose weight, it creates it's own problems. One
indicator of fat malabsorption is steahtorrhea, or floating
stools. In this scenario stools will be off color, hard to
flush, and smell very bad.
Fat soluble vitamins like vitamin K help your blood to clot. A
deficiency can make you vulnerable to excessive blood loss
with a minor cut. It also plays a role in bone formation and
repair.
Vitamin A, another fat soluble vitamin, is important for
eyesight, and for the skin and immune system. Night blindness
can be a sign of vitamin A deficiency.
Vitamin D, the sunshine vitamin, is often very low in people
with gluten sensitivity. Vitamin D is necessary for the
absorption of calcium. A vitamin D deficiency can often be the
underlying cause of osteoporosis. Of course the malabsorption
is most likely the underlying cause of low vitamin D.
Vitamin D deficiency can also cause depression. In the northern
climates, winter sun is not strong enough in the proper
wavelengths to promote skin production of vitamin D, sometimes
leading to seasonal affective disorder, or SAD. This can also
happen year round with a vitamin D deficiency caused by
malabsorption.
The lack of these nutrients causes so many dysfunctions in the
body that it is not surprising that gluten sensitivity can
affect so many areas of life. From brain fog to bloating, and
from diarrhea to depression, from anemia to osteoporosis, and
from skin rashes to immune problems. All areas of the body
can be affected.
Fat malabsorption can cause low cholesterol levels. It is a
cholesterol compound in the skin which is converted by
sunlight into the precursor for vitamin D. So if you have fat
malabsorption, and your cholesterol level is low, you will
likely not produce much Vitamin D from sunshine. Fatty fish
and cod liver oil are the food sources highest in Vitamin D.
Without adequate vitamin D the calcium cannot be absorbed.
Without calcium, the body will take it from the teeth
and bones. The end result will be dental problems and/or
osteoporosis, which are very common among celiacs.
So malabsorption of vitamins and minerals is one area that
should not be ignored.
References:
American College of Gastroenterology (2008, October 13).
Vitamin D Deficiency Common In Patients With IBD, Chronic Liver
Disease.
Prescription for Nutritional Healing, by Phillis A Balch, CNC,
3rd edition, 2000. The Vitamin Shoppe.
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