Celiac disease is an autoimmune condition, the symptoms of which come on after eating gluten in the diet. It can be passed down in families and presents as inflammation of the small intestine after eating a food item that contains gluten. This inflammation can result in the rapid onset of symptoms including abdominal pain, diarrhea, painful and fatty stool. Over time, consumption of gluten in those with Celiac disease can lead to nutrient deficiencies, anemia, fatigue, weight loss, migraine, failure to thrive in kids, reduced bone density, and nerve pain.¹

Gluten is a protein that is found in a number of grains including wheat, spelt, rye, barley, malt, brewer’s yeast, farro, semolina and triticale. If you’re interested, see my colleague, Dr. Aponte’s, article on eating gluten free the healthy way.

The goal of managing Celiac disease is to reduce inflammation through dietary elimination of gluten, replenishment of nutritive foods & lost vitamins, and healing the intestinal tissue with herbs and nutrients.

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Supplements to support those living with Celiac include, but are not limited to:

Probiotics

Probiotics help to lower inflammation, support immune system balance, protect against damage to cells, and promote a healthy population of gut bugs (flora) to improve digestion in the intestines.² Probiotics can come in a supplement form, or achieved through the diet by consuming fermented foods (i.e. kimchi, kombucha, sauerkraut, miso, etc.)

Betaine HCl

Our stomach produces acid to break foods, especially proteins, down. A study from 2014 showed an increased risk of Celiac disease in those undergoing acid blocking (Proton Pump Inhibitor) medication³, highlighting the potential role of low stomach acid in the development and progression of Celiac in otherwise healthy, unmedicated individuals. Betaine HCl is a form or hydrochloric acid that can be ingested and serve as a digestive aid for those who don’t produce enough acid on their own.

L-Glutamine

Glutamine is a protein building block (amino acid) that feeds the cells of the intestinal lining. Glutamine acts to keep the cells that line the GI tract close together and protects those tight cellular junctions by promoting a healthy mucus layer to coat them. This is a key nutrient needed for repair when the cells of the intestine are angry, inflamed and damaged by gluten.⁴

Vitamin B12

Deficiencies of vitamin B12 in those with Celiac have two sources. First, vitamin B12 is absorbed in the latter part of the small intestine. When the cells of the intestine are inflamed and the mucus barrier is damaged, the cells are less apt to absorb vitamin B12. Over time without treatment, this can lead to a deficiency. Secondly, vitamin B12 from the diet comes mostly from animal proteins (i.e. red meat, poultry, eggs, etc.) Adequate stomach acid is needed to separate the B12 from proteins in the stomach for eventual absorption in the intestines downstream. Lower stomach acid means lower vitamin B12 absorption, which can lead to anemia, fatigue, and nerve pain over time.^5,6

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If you have Celiac Disease, reach out to your Naturopathic Doctor today to see which supplements are a fit for you!

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References:

1. Pelkowski T, Viera AJ. Celiac Disease: Diagnosis and Management. American Family Physician. 2014;89(2):99-105

2. de Sousa Moraes LF, Grzeskowiak LM, de Sales Teixeira TF, Gouveia Peluzio Mdo C. Intestinal microbiota and probiotics in celiac disease. Clin Microbiol Rev. 2014;27(3):482-489. doi:10.1128/CMR.00106-13

3. Lebwohl B, Spechler SJ, Wang TC, Green PH, Ludvigsson JF. Use of proton pump inhibitors and subsequent risk of celiac disease. Dig Liver Dis. 2014;46(1):36-40. doi:10.1016/j.dld.2013.08.128

4. Rao R, Samak G. Role of Glutamine in Protection of Intestinal Epithelial Tight Junctions. J Epithel Biol Pharmacol. 2012;5(Suppl 1-M7):47-54. doi:10.2174/1875044301205010047

5. Bledsoe AC, King KS, Larson JJ, et al. Micronutrient deficiencies are common in contemporary celiac disease despite lack of overt malabsorption symptoms. Mayo Clinic Proceedings. 2019;94(7):1253-1260.

6. Vitamin B12: Fact Sheet for Consumers. National Institutes of Health. Accessed from: https://ods.od.nih.gov/factsheets/VitaminB12-%20%20Consumer/#:~:text=First%2C%20hydrochloric%20acid%20in%20the,is%20absorbed%20by%20the%20body..

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.