Some folks who have celiac disease find themselves in an ironic situation. They eat a balanced diet of meat, dairy, fruits, vegetables, and whole-grain foods, yet their guts growl constantly with gas, diarrhea, and stomach cramps, alternating with constipation. It’s as if their insides were rebelling against what, for most people, would be a healthy and nutritious diet. If you have celiac disease, you’re intolerant of gluten, the protein in wheat, rye, barley, and oats that makes dough sticky and gooey. Unless the condition is treated, your system can’t absorb enough nutrients from food to carry on body functions, a condition known as malabsorption. If you lose weight, become listless, and appear malnourished, you may have celiac disease.
"If left untreated, it can become life-threatening. People can waste away," says Kristin Stiles, N.D., a naturopathic doctor at the Complementary Medicine and Healing Arts Center in Vestal, New York. That’s why it’s important to get a proper diagnosis from your doctor if you experience these symptoms.
Get the Gluten Out
Fortunately, the treatment is fairly simple once you know the cause. The disease, which often runs in families, was initially identified in the first century a.d. It wasn’t until World War II, however, that a Dutch pediatrician discovered that his patients improved because there was no bread available. It seems that some people lack an enzyme that breaks down and helps digest gluten. When this enzyme is absent, a toxic substance builds up and damages the mucous membrane lining the small intestine. Frequently, the damaged area becomes inflamed.
When injured, the intestinal lining has difficulty soaking up the nutrients in food. That’s why people with celiac disease may also develop anemia. Anemia often results from a lack of iron in the blood, and that’s one of the nutrients that is blocked when the intestinal lining can’t do its job. Other deficiencies may show up, too, such as shortages of folic acid and other B vitamins and vitamins D and K.
The first and most effective treatment is to eliminate gluten from your diet. This isn’t quite as easy as it sounds because so many processed foods use wheat, which contains gluten, for filler and flavoring. If you’re aware of risky food products and avoid them, a gluten-free diet can restore small intestine function within a few days to a few months. Once the mucous membrane is no longer inflamed, the absorption problem usually disappears.
Replace Lost Nutrients
In the meantime, until the healing process does its work, it’s a good idea to take vitamin and mineral supplements to prevent deficiencies and malnutrition, says Pamela Taylor, N.D., a naturopathic doctor in Moline, Illinois.
At the very least, you’ll want to take a multivitamin/mineral supplement that includes calcium and magnesium, says Dr. Taylor. Magnesium deficiency often occurs in malabsorption syndromes and may contribute to osteoporosis, the rapid bone loss that can lead to hip fractures and other skeletal problems. This mineral is also important for proper tissue healing, so you need to get enough to help your body heal itself. To make sure that you get magnesium, be sure that your diet consists of moderate amounts of protein and plenty of steamed leafy green vegetables like kale, collard greens, and mustard greens. These greens are also good sources of calcium, she adds.
In addition to a multivitamin each day, Dr. Stiles tells her patients to take a high-potency B-complex supplement. This type of supplement contains 50 milligrams or the equivalent of B vitamins like niacin, thiamin, and riboflavin, as well as 400 to 800 micrograms of folic acid. Typically, one or two tablets daily with food are sufficient, she says. Your doctor can determine through blood tests how much you should take, she adds. If you take more than 35 milligrams of niacin, though, be sure to let your doctor know.
"You definitely want to supplement B vitamins, because those are not well-absorbed when the intestines are aggravated," says Dr. Stiles. "Also always take the supplement with food. If you take it on an empty stomach, you won’t absorb it."
Even after your intestinal inflammation has subsided and you’re absorbing nutrients the way you should, you probably should continue taking a multivitamin, says Dr. Taylor. On a gluten-free diet, you might not be getting enough vitamins and minerals through your food. "A good multivita min/mineral tablet can catch and fill in the deficiencies and make sure you’re getting what you need each day."
Speed the Healing
The inflammation in the intestine won’t go away until you eliminate gluten, but you may be able to speed healing by taking an herbal combination of echinacea and goldenseal, says Dr. Stiles. These two immune system boosters are often packaged together in capsule form. Take one capsule three or four times a day, she suggests. If you use tincture, take 10 to 15 drops of each herb in water or juice three or four times a day, with or without food.
You may also find echinacea and goldenseal in combination with slippery elm, marshmallow, geranium, and other herbs. If you can’t find this combination at a drugstore, check at a health food store. This supplement goes by the generic name of Robert’s Formula, which is made by a number of different supplement makers. It is a naturopathic mixture that treats the digestive tract by creating a slimy goo that is healing to gut tissues.
Echinacea and goldenseal are important healers because they have anti-inflammatory and antibacterial properties. One cautionary note, however: Don’t take these herbs continuously. Dr. Stiles recommends two weeks on and two weeks off for a period of one to two months. "You quickly build up a tolerance to echinacea, and it’s no longer effective," she says.
Vitamins can also speed healing. Dr. Taylor often recommends that her patients take a combination supplement of vitamins A, E, and C, along with a chelated form of zinc supplement. She suggests that you follow the dosage directions on the bottle. A typical dose, for example, is 5,000 to 10,000 international units (IU) of vitamin A in the form of fish oil, 200 to 500 milligrams of vitamin C, 100 to 400 IU of vitamin E, and 15 to 30 milligrams of chelated zinc. You’ll need to check with your doctor before taking more than 20 milligrams of zinc, however.
Dr. Taylor recommends taking the supplements with food. You may need to continue supplementation for two to four months, she says.
