Celiac disease is an intolerance to gluten, a protein found primarily in wheat, barley, and rye (and potentially oats, depending on their source and whether they’ve been contaminated by wheat products). It’s critical to understand that people can be sensitive to gluten without having celiac disease. While those with the disease have to give up gluten, people who are sensitive to it have the option of cutting it out or living with the side effects (there are major pros and cons to consider before you take the leap to being gluten free, though).
Many patients tell me they just feel better going gluten free; they have more energy and less fatigue. Turns out, what they had simply accepted as “normal”—in terms of how they felt on a daily basis and how they reacted to food— wasn’t normal at all! This happens all the time. Then there are the people who don’t have celiac disease or a gluten sensitivity but get a good placebo response from going gluten free. At times, eating less gluten means you eat less food—often less junk food—which can also lead to weight loss and feeling better.
A blood test (called a tTG test) can help determine if you have celiac disease, and if the test is positive, your doctor may want to take a biopsy of the lining of the small intestine. If that is positive as well, then you can be sure you have celiac disease (you don’t want to cut out a huge part of your diet without being absolutely sure you have it!). The blood test and biopsy aren’t reliable if you’re already gluten free, so get tested before you make a change. (The odds of having celiac if your blood test for it is negative are about one in 300, which is a very small chance.)
In people with celiac disease, gluten causes an autoimmune reaction that damages the small intestine and leads to nutrient absorption problems. Up to 1 in 100 people in the United States have it, and when a first-degree relative has the condition, the incidence increases to 1 in 22. The only treatment is avoiding foods made from wheat, barley, rye, and possibly some oats. (Many surprising products contain gluten, including some prescription medications, dietary supplements, tomato sauce, chips, and lipstick.) In children with celiac disease, the small intestine can heal within 3 to 6 months after being exposed to gluten, but in adults the damage can take years to heal (although symptoms may improve within days or weeks).
Symptoms include abdominal bloating or pain; chronic diarrhea; vomiting; constipation; pale, smelly, or fatty stools; and weight loss. Adults may have unexplained anemia (low red blood cell count), fatigue, bone or joint pain, arthritis, bone loss/osteoporosis, anxiety or depression, numbness or tingling in the hands and feet, or an itchy rash called dermatitis herpetiformis.
There aren’t really many supplements I would recommend for celiac disease, unless deficiencies exist. That’s why the smartest thing to do if you’re diagnosed with celiac disease is to get tested for basic vitamin and mineral deficiencies: Fat soluble vitamins (A, D, E, and K); folic acid; vitamins B1, B2, B6, and B12; iron; calcium; and magnesium should be high on the list.
It’s also important to meet with a dietitian who specializes in this area and to ask your doctor about getting a dual-energy x-ray absorptiometry, or DEXA, scan for osteoporosis since people with celiac disease often have a higher rate of bone loss.
What is Celiac Disease?
Celiac disease, sometimes called celiac sprue or gluten-sensitive enteropathy, is an immune reaction to eating gluten, a protein found in wheat, barley and rye.
If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine’s lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.
In children, malabsorption can affect growth and development, besides causing the symptoms seen in adults.
There’s no cure for celiac disease — but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing.
Home Remedies For Celiac Disease
This is the one promising area in terms of celiac disease supplements. Probiotics are finally receiving good clinical trials (they’re being initiated as we publish), including common strains such as Bifidobacterium infantis.
A commercial probiotic called VSL#3, which contains eight different bacteria, has preliminary results that it may reduce gluten toxicity (for example, from accidental ingestion), so it’s worth discussing with your doctor. In time, taking a probiotic may even help people who are extremely sensitive to even a minute amount of gluten because it has the potential to digest the gluten protein. (Those sufferers who may have a negative response to even 1 milligram of gluten; one slice of bread can have as much as 4,000 milligrams of gluten, to give you some perspective.)