As you probably already know, people with Celiac disease are deficient in many (micro)nutrients. The villi in the small intestine are damaged and the consequence is malabsorption. With malabsorption comes a whole new range of problems, fatigue, depression, brain fog, skin problems, tooth decay and many more.
When you read or google about these deficiencies you’ll read a lot about iron and vitamin D. The other nutrients are usually forgotten about, though they are equally important for your health, well-being and the healing of your intestines.
The image above (from this research) already shows what most Celiacs are deficient in. At diagnosis that’s calorie/protein, fiber, iron, calcium, vitamin D, magnesium, zinc, folate, niacin, vitamin b12 and riboflavin. After a long-term gluten free diet (GFD) fiber, folate, niacin, b12 and riboflavin remain. The “problem” is, this research is based on children. Though it gives us a general idea we’re more interested in adults.
This research‘s participants had a median age of 46.1±15.1 years. I’ll put the results in a table;
| Celiac | Control | |
| Weight loss | 25.2% | |
| Zinc | 59.4% | 33.2% |
| Albumin | 19.7% | 1.1% |
| Copper | 6.4% | 2.1% |
| Vitamin B12 | 5.3% | 1.8% |
| Folate | 3.6% | 0.3% |
| Vitamin D | 19% | 18% |
| Ferritin (iron) | 30.8% |
Funny thing to note is that the classic Celiac symptom of weight loss / being skinny is only seen in 25.2% of patients. Vitamin D isn’t too bad compare to the controls. There were no controls available for iron so we’ll look further.
A quote from this research:
Analyzing the total group of patients with CD, indicators revealed deficient Fe nutritional status in 65.8% (32.9% low Hb, 43.8% low FS, 4.4% low serum Fe, and 45.8% increased FEP);
For the control group it is 2.8% low Hb, 22.2% low SF, serum Fe not available and 27.8% increased FEP.
Hemoglobin (Hb) stands out, it’s a red protein responsible for transporting oxygen in the blood. Its molecule comprises four subunits, each containing an iron atom bound to a haem group.
So concluding the research part, nutrient deficiencies are common in Celiacs at diagnosis, but also after a long-term gluten free diet. We also know which nutrients we’re probably deficient in, now how do we fix it?
Gettin’ those nutrients in
I’ll list everything per 100 gram, which is roughly 1/2 cup.
Zinc
The RDA for zinc is 8-11 mg for women-men. If you’re vegetarian or vegan you can add 50% ,so 12-16 mg, due to lower bio-availability.
Good sources for Zinc are; oysters (59.2mg), hempseed (10mg), flaxseed & pumpkin seed (8mg), cacao (7mg), liver (pig, 6.8mg), beef (6mg) and oats (4.5mg). Make sure you only buy gluten free labeled oats. Many other kinds of seeds and nuts contain Zinc as well.
Copper
The RDA for copper is 900 mcg (0.9 mg) for adults, 1300 mcg (1.3 mg) for pregnant or lactating adults.
Good sources for Copper are; oysters (7.93 mg), cacao (3.9 mg), cashew nuts (3.7 mg), liver (beef, 2.5 mg), sunflower seeds (2.3 mg), liver (other, 1.88 mg), brazil nuts (1.76 mg) and many other kinds of nuts and seeds. Lentils contain 1mg Copper.
Iron
The RDA for iron is 8mg for adult males and 18 mg for adult females. Lactating women need 9mg and pregnant women 27mg. For Celiacs it’s probably okay to go a bit higher for a while, depending on how you feel. I’m male and did 2 years of 15mg daily and felt great. Regular blood checks is a must though!
Good sources for Iron are; spirulina (28.5mg), liver (pig 21mg), raw cacao (13.3 mg), oysters (7mg), beef (2.6mg), limabeans (2.4mg), liver (beef/chicken 7mg)
Albumin
Albumin is a protein, found mostly in egg whites and milk. So eat those eggs, lots of them. I eat 2-3 eggs every day. If you think eating eggs all the time increases your cholesterol levels; that research has been outdated for quite some time.
Folate
The RDA for folate is 400mcg for adults. Folate is mostly found in green vegetables, meat and dairy. The gluten containing bread and breakfast cereals are usually fortified with folate so it’s hard for celiacs to get enough folate through foods alone.
Vitamin B12
The RDA for vitamin B12 is 2.4 mcg for adults. Vitamin B12 is found in fish, meat, poultry, eggs, milk, and milk products. Most multivitamins contain more than the RDA so you should be good.
Vitamin D
The RDA for vitamin D is only 600 IU but the safe upper limit is 4000IU (or 100 mcg). You can find it in some foods but you’d have to eat crazy amounts of it. The best way to get vitamin D is either spending time in the sun (skin exposed) or supplement. I’m in a cold climate so I take 3000IU vitamin D daily at breakfast.
Fibers
It’s suggested to eat 25 grams of fiber each day. Foods high in fiber are; oats (15g), white beans (10.5g), lentils (8g), oatmeal (7g), avocado(7g), banana (2.6g) other fruits and leafy vegetables are generally around 2g.
Niacin
The RDA for niacin is 16mg for adult males and 14mg for adult females. Niacin is another vitamin that is added to (gluten containing) bread and cereals so we definitely need this in our diet. Foods high in niacin are; tuna (15.4 mg), liver (15.3 mg), chicken breast (14.8 mg), peanuts (13.8 mg), beef (9 mg), sunflower seeds (8.3 mg), salmon (7.8 mg), white mushroom (6.3 mg)
Riboflavin
The RDA for riboflavin is 1.3mg for males and 1.1mg for females. Riboflavin is another vitamin Celiacs lack due to it being added to gluten containing bread and cereals. Foods high in riboflavin are; liver (3.2 mg), flaxseed (1mg), almonds (0.6mg), cheese (0.6 mg), eggs (0.5 mg), white mushrooms (0.44 mg).
Conclusion
To fix the malabsorption deficiencies caused by Celiac Disease you first want to start making a list of non-processed foods that you like and see what kind of numbers you get calorie/fiber/vitamin and mineral wise. The list above is only deficiencies in Celiacs, you still need all the other micronutrients.
Also make it ‘easy’ for yourself. Oyster and liver are high in all kinds of micronutrients but that’s useless if you hate the taste.You need something you can live with every day. I don’t like greens in general, cooked anyway, but I enjoy my green smoothies. So be creative, just make sure you get all your vitamins and minerals in to restore your gut, microbiome, and health.
When you’re done, add a high quality gluten-free multivitamin. I like Solgar Omnium, just 1 tablet a day. You may need other supplements, like vitamin D (probably) or ZMA (zinc, magnesium and vit B6). Good luck and don’t hesitate to ask your questions below.