Digestive Discomfort

People may experience abdominal pain, bloating, gas, and diarrhea if food is not properly digested in the small intestine. If food is not broken down properly with digestive enzymes in the small intestine, large particles continue on to the large intestine. In the large intestine our gut bacteria will metabolize these particles resulting in fermentation and release of significant amounts of gas. When this happens we end up with the symptoms discussed. Due to the lack of digestive enzyme activity, including lactase, when the small intestine is damaged, lactose intolerance is commonly seen in people who have celiac disease.

Anemia

Our bodies require iron in order for red blood cells to be able to carry oxygen to all the tissues in the body. Specifically, iron is essential to the production of hemoglobin, which is part of the red blood cell. There are a few different types of anemia but the one of concern with celiac patients is iron-deficiency anemia. If either not enough iron is consumed in the diet or there is an inability to absorb the dietary iron then our muscles and tissues will not be able to get the oxygen they need to function optimally. When this is the case people may feel fatigued, weak, and lightheaded. They also may experience headaches, shortness of breath, and an irregular heartbeat.

Osteoporosis

Building and maintaining strong bones requires many factors including the proper minerals, hormones, and a safe amount of physical stress. Bone building is carried out by two main types of cells, osteoblasts which lay down new bone, and osteoclasts which break down existing bone. Bone building activities are most active before the age of 18 (by that age we have acquired about 90% of our peak bone mass) but we are able to continue gaining bone mass up until the age of 30. During the bone building period of our lives the activity of the osteoblast cells is greater than that of the osteoclast cells. However, around the age of 35 this reverses itself and we begin to break down bone faster than we can build new bone.

Calcium is required because it is actually what makes up a large portion of bone composition and vitamin D is needed because it is one of the components that signals the osteoblasts to get to work. There are many other minerals being studied that appear to be involved in the process of bone remodelling including vitamin K, magnesium, phosphorous, boron, copper, and zinc. As already explained, with celiac disease nutrient absorption is limited and if the body isn’t able to get what it needs to build bone then bones will continue to break down without repair leaving individuals with brittle bones that are prone to fractures.

Hormone Imbalances

When malabsorption exists it results in a decreased ability of our bodies to produce hormones. Mainly, low cortisol levels are seen in celiac patients and this places a lot of stress on the adrenal glands. The adrenal glands are responsible for producing many other hormones including the male and female hormones (estrogen, progesterone, and testosterone) and the fight-or-flight hormones (epinephrine and norepinephrine). If the adrenals are overworked then it can’t make these hormones in proper proportions. When the body is in a constant state of stress and inflammation our bodies favour the production of fight-or-flight hormones over reproductive hormones. As a result people may notice irregular menstrual cycles, loss of libido, hot flashes, anxiety, depression, and infertility.

ITS SO IMPORTANT if you have any or many of the above symptoms to see your health care practitioners to find out what the cause is. Many gastrointestinal conditions (or conditions causing nutrient malabsorption) manifest themselves similarly. In many cases the symptoms can be alleviated or eliminated through simple lifestyle or diet changes. IF celiac disease is the cause then avoiding gluten,  reduce inflammation, and taking measures to promote gut repair can make the condition much more manageable.