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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