Celiac Disease does much of its damage in the proximal portion of the small intestine. The small intestine is made up of three portions: The Duodenum, the Jejunum, and the Ileum. Proximal, is the closest, or “top” portion of the intestines, which would be the Duodenum and beginning of the Jejunum. I, personally, had my first complication and presentation of Celiac Disease at around 14 years of age. I began having a lot of stomach complications, and my parents took me to a pediatric gastroenterologist. After an endoscopy, he found that I had inflammation of my Duodenum, and diagnosed me with a food allergy (20 years ago, and still today, Celiac Disease is not a diagnosis that first comes to mind.) Because of the damage caused to the small intestines, malabsorption (inability for the intestines to absorb nutrients properly) of vitamins and nutrients occurs. The most common deficiencies in Celiac patients are: Iron (ferritin,) Calcium, Vitamin A, Vitamin D, Vitamin E, and Vitamin K. A further breakdown of these vitamins can be seen below:
Iron (ferritin:) Stored in the liver and bone marrow, helps in the carrying of oxygen in the blood and aids in energy production, cellular respiration, and immune function. Decrease in Iron in the blood is the cause of anemia. This is why we are always so tired! It is so very important we eat a well-balanced protein diet. At times, our anemia can be related to an Iron, B12, or folic acid deficiency, so have your Dietician or Primary Care Physician check your levels regularly (mine are checked every 6-12 weeks.)
Calcium/Vitamin D: Osteoporosis and Osteopenia (reduced bone mass less severe than osteoporosis) are common complications of Celiac Disease due to Calcium malabsorption. With lactose-intolerance a common complication, it is important to replace calcium in other ways (I drink Calcium enriched Orange Juice, and Lactaid Milk, etc.) Vitamin D is a very important factor in intestinal absorption of calcium and bone growth. A deficiency can cause deformed and brittle bones. It is hard to eat enough foods rich in Vitamin D, so your physician may prescribe a supplement. These levels will have to be watched closely too!
Vitamin A is important in vision and renal function, as well as bone development, immune health, and normal growth. A deficiency can contribute to anemia, cause night blindness, loss of taste, and inhibit growth.
Vitamin E: This is a vitamin that protects cells from damage. A deficiency has been associated with neurological problems such as numbness or weakness in extremities, loss of full control of body movements, and anemia.
Vitamin K: Helps blood clot. A deficiency results in impaired clotting factors occurring in the liver, causing bruising and bleeding easily.
Now, why have I given you this lecture in Vitamin importance, and the effect Celiac Disease has on the absorption of these Vitamins? Because not only is it important to pay attention to what you put into your body, but know what good it will do for you as well! We have to eat more Vitamins and Nutrients since we have a harder time absorbing them. For example: this AMAZING breakfast, along with one glass of Orange Juice has:
Vitamin C: 180%
Not only is it EXTREMELY tasty, but it is good for you too! You can eat it as a snack, breakfast, or a dessert (add some Hershey’s All Natural Chocolate Syrup over the top to sweeten it up!) This is a breakfast you can take to school or the office. Pack up a jar of peanut butter, box of organic raisins, bag of GF granola, and a bunch of bananas, and you’re good to go for the whole week!