Celiac disease is a potentially severe autoimmune condition that affects .07% of the worldwide population.
In the United States, it has been on a steady rise in the last 50 years. It now affects 1% of the U.S. population.
However, up to 98% of those individuals do not even know they have it. (Ludvigsson et al., 2013)
Celiac disease is an often under-diagnosed and misdiagnosed condition.
- Under-diagnosis is due in part to many physicians treating symptoms and not conducting further testing for a root cause.
- Misdiagnosis occurs because of the many manifestations it presents.
This is why celiac disease is sometimes referred to as "The Great Pretender.”
Celiac disease doesn’t affect only the gastrointestinal tract. It also affects other systems within the body. (Lebwohl et al., 2015)
With celiac disease, the body attacks itself — specifically destroying sections of the small intestine. These portions are referred to as villi and are responsible for absorbing vital nutrients.
The lack of these nutrients eventually turns into malnutrition and damages other parts of the body that rely on these nutrients to continue functioning and thriving.
The main trigger for celiac disease is gluten, found in wheat, rye, barley, malt, and brewers yeast.
When you ingest gluten, it sets off a chain of negative events within the body. The villi found within the small intestine becomes inflamed to protect it. Eventually, this inflammation can destroy the villi — potentially leading to nutrient deficiencies.
The extent and speed of the damage often depends on how much gluten an individual consumes.
Symptoms and Complications
Celiac disease can be challenging to diagnose due to its wide range of symptoms.
If celiac disease is suspected, your health care provider will conduct an intestinal biopsy. This will help in obtaining an official diagnosis and will aid in determining which category of celiac disease is present.
The three categories of celiac disease are:
- Classic celiac disease — Concentrated within the gastrointestinal tract
- Atypical celiac disease — Occurs in the upper part of the gastrointestinal tract only
- Silent celiac disease — Gastrointestinal issues are unnoticeable until a complication occurs
There are red flag symptoms and/or related conditions to look for that may be an indication of celiac disease:
- Pain and abdominal bloating
Issues Caused by Malabsorption
- Vitamin deficiency
- Mineral deficiency
- Weight loss
- Muscle loss
Systemic Inflammatory and Autoimmune Diseases
- Rheumatoid Arthritis
- Systemic Lupus Erythematosus
- Multiple Sclerosis
- Inflammatory Bowel Disease
Malignancies or Cancer
Other Miscellaneous Symptoms
- Bone pain
- Joint pain
- Neuropathy of hands and feet
- Itchy rash
Despite the occurrence of some of these symptoms, proper diagnosis can still take up to 10 years. This is an issue because prolonged under-diagnosis or misdiagnosis can lead to complications and comorbidities.
Best Foods for Celiac Disease
Diet is the most effective way to control celiac disease. However, a gluten-free diet may not necessarily help sufferers experience immediate relief.
Continued pain and discomfort can last a few months following dietary changes — until the body can achieve balance.
Along with eating gluten-free foods, it is essential to also focus on healing the body from the damage gluten has done. Consume whole foods that are anti-inflammatory, rich in probiotics, and organic. These include:
- Grass-fed beef
- Wild-caught fish
- Pasture-raised turkey and chicken
- Free-range eggs
- Fruits and vegetables (anti-inflammatory produce includes tomatoes, peppers, mushrooms, dark leafy greens, strawberries, blueberries, cherries, and oranges)
- Cooking oils that contain healthy fats (virgin olive oil, avocado oil, hemp oil, and unrefined/cold pressed virgin coconut oil)
- A wide variety of nuts and seeds
- Organic or raw goat or cow’s milk
- Gluten-free flours such as almond flour, coconut flour, and chickpea flour
- Gluten-free grains such as millet, buckwheat, quinoa, and brown rice
- Most spices are okay, but make sure they are labeled gluten-free
- Vinegar is typically gluten-free. Malt vinegar is not
Always double check all food labels to ensure they are gluten-free.
Because the skin is the largest organ in the body, it is best to avoid household or cosmetics that are made with gluten, as well. Products to be cautious include:
- Toothpaste and mouthwash
- Chapstick or lip gloss
- Soap and shampoo
- Foundation, concealer, blush, and facial powder
- Laundry detergent
- Medications and vitamins
Foods to Avoid
Sadly, many foods contain gluten or are at risk of cross-contamination. It's incredibly easy to accidentally consume food containing gluten. Many brands now produce convenience foods that are certified as gluten-free.
The following foods either always contain gluten, or are gray-area foods, and should be strictly avoided by anyone with celiac disease unless a certified gluten-free option is available:
- Any product containing wheat, barley, rye, durum, farina, graham, semolina, spelt, wheat germ, wheat bran, and triticale
- Processed foods such as pasta, bread, and other baked goods. Even if you choose a gluten-free product, be aware that cross-contamination can occur. For example, oats are the most susceptible to cross-contamination
- Flours such as wheat flour, enriched flour, farina, plain flour, self-rising flour, and white flour
- Beer and any alcohol that contains malt
- Any food containing preservatives, stabilizers, and other additives such as salad dressing, marinades, soy sauce, and syrups
- Bouillon cubes
- Pasta sauce
- Coffee creamer
- Instant coffee
- Flavored teas
- Meat alternatives including imitation crab
- Hot dogs
- Frozen meatballs
- Deli meat
- Candy and gum
- French fries
- Condiments such as ketchup, mustard, mayonnaise, and bbq sauce (unless certified gluten free)
Some foods “cross-react” with gluten — meaning that the immune system recognizes them as containing gluten even though they do not.
This may mean someone with celiac disease may still experience symptoms even though they removed all gluten from their diet. These foods include dairy, corn, oats, yeast, rice and millet.
An elimination diet or the Cyrex Array 4 gluten cross-reactivity test are both options for determining if this is an issue.
When celiac disease goes undiagnosed, it destroys the gastrointestinal tract. This prevents the absorption of vital nutrients from the foods you are eating.
When the gastrointestinal tract is damaged, it can impact the immune system because they are so closely entwined.
When the gut is damaged through gluten intolerance or comorbidities often seen with celiac disease, such as inflammatory bowel disease, the digestive system suffers.
What this means is that several nutrient deficiencies can occur. The most common deficiencies are typically iron, zinc, vitamin D, and B vitamins such as B6 and B12. Supplementing will help to heal the body from the damage caused by celiac disease.
Some supplements worth considering include:
- Sublingual vitamin D and C
- A multivitamin that is gluten-free and contains calcium, magnesium, zinc, potassium, iron, copper, niacin, riboflavin, and folate
- Digestive enzymes, especially one containing dipeptidyl peptidase-IV - an enzyme that helps breakdown and digest gluten protein fragments (to be used for accidental consumption)
If you and your doctor agree that supplements are right for you, we recommend any of the following: