Essential Guide to Celiac Disease Self-Care and Living Gluten Free

Understanding Celiac Disease

Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. Gluten is a protein found in wheat, barley, and rye. In celiac disease, gluten triggers an immune response that attacks the small intestine, leading to damage and inability to absorb nutrients properly.

Some of the common symptoms of celiac disease include:

• Diarrhea
• Abdominal pain and bloating
• Fatigue
• Unexplained weight loss
• Failure to thrive (in children)

However, celiac symptoms vary greatly from person to person. Some individuals may not have any gastrointestinal symptoms at all, and may instead present with issues like joint pain, fatigue, depression, migraines, nerve damage, infertility, and more.

Getting Tested for Celiac Disease

Since celiac can cause such an array of symptoms, getting tested is important, especially if you have a family member with celiac or if you have related conditions like Type 1 diabetes or autoimmune thyroid disease.

There is no single test that can diagnose celiac. Usually your doctor will test blood for certain antibodies, do an endoscopy to take a biopsy of the small intestine, or both. Make sure to still be eating gluten before getting tested; otherwise, test results may be inaccurate if no antibodies are present at the time of testing.

Treatment Basics

There is no cure for celiac disease, but following a strict gluten free diet does allow your intestine to heal. This is the only treatment and cornerstone of celiac disease self-care.

Following a Gluten Free Diet

There are many delicious gluten free options available, but sticking to a strict gluten free diet does take dedication. Lets review foods to embrace and those to avoid.

Foods to Eat

Many nutritious foods are naturally gluten free:

• Fruits & vegetables: All fresh fruits and vegetables are gluten free, focus on produce like leafy greens, broccoli, citrus fruits, berries, etc.
• Dairy: Milk, cheese, yogurt and other dairy products are safe as long as they dont contain any additives with gluten.
• Meats, fish, poultry & eggs: All fresh meat, fish, seafood, poultry and eggs are gluten free. Seek out lean grass-fed organic varieties when possible.
• Beans, nuts & seeds: Beans, lentils, nuts, seeds and nut butters without additives are gluten free protein powerhouses.
• Gluten free whole grains: Whole grains like brown rice, quinoa, buckwheat, certified gluten free oats, amaranth, etc. provide important nutrients like fiber, B vitamins, iron, etc.

Foods to Avoid

Avoiding all food and products containing:

• Wheat (including varieties like spelt, farro, einkorn, emmer, durum, semolina, couscous, bulgur, farina)
• Barley
• Rye
• Triticale

is imperative. Also steer clear of oats unless they are certified gluten free, as they are often cross-contaminated with wheat. Wheat substitutes like seitan should always be avoided as well.

Beyond the obvious bread and pasta, there are many common foods and products that contain hidden gluten sources, like sauces, dressings, batter fried foods, broths/stocks, desserts,beer and more. When in doubt, check the label carefully.

Cross-Contamination Risks

Cross-contamination is also a real concern. Using the same cookware, utensils and cooking surfaces for gluten free and non-gluten free foods can transfer over gluten particles. Take care to thoroughly wash cookware, utensils and surfaces after using for gluten containing foods.

At restaurants there is also risk of cross-contamination from shared cooking and prep areas. Check with your server to understand their precautions before ordering.

Celiac Disease Nutrient Deficiencies

Following a strict gluten free diet helps heal intestinal damage and resolve symptoms, but many other challenges come up. Nutrient deficiencies are very common since celiac makes it hard to absorb nutrients properly.

Some of the main nutrient deficiencies include:

• Iron
• Calcium
• Vitamin D
• B Vitamins (especially B12)
• Zinc
• Copper
• Magnesium
• Fiber

Working with a dietitian knowledgeable in celiac disease to understand your individual deficiencies can help guide your celiac disease self-care plan. Lets explore some of the main nutrients affected and foods to focus on.

Important Nutrients in Celiac Disease

Iron

Iron deficiency and iron deficiency anemia are some of the most common nutrient issues, since iron is absorbed in the damaged small intestine. Excellent gluten free dietary sources of iron include:

• Meats like grass-fed beef and organic chicken
• Seafood, especially clams, oysters and sardines
• Beans and lentils
• Dark leafy greens like spinach and swiss chard
• Iron-fortified gluten free grains
• Dried fruits like apricots, prunes and raisins

Pairing iron-rich foods with vitamin C sources helps boost absorption. If diet alone cannot restore iron levels, an iron supplement may be recommended by your physician.

Calcium

Calcium is vital for bone health. Many grain products like cereals and breads are calcium-fortified, so avoiding gluten means missing out on those sources. To boost calcium intake focus on:

• Dairy products like milk, yogurt and cheese
• Canned fish with edible bones like sardines
• Fortified non-dairy milks like almond, soy or rice milk
• Leafy greens like collard greens, bok choy and broccoli
• Calcium-set tofu
• Beans

If your diet cannot meet calcium needs, a supplement may be required. Discuss options with your physician.

Vitamin D & B Vitamins

Malabsorption means missing out on important water soluble vitamins. Key vitamin D sources include fatty fish, egg yolks, UV sunlight and fortified foods. For B vitamins, gluten free whole grains, meats, fish, dairy and leafy greens can help fill gaps.

Supplements for vitamin D, vitamin B12, folate and other B vitamins assist with maintaining adequate levels if diet and sunlight exposure are insufficient. Your physician can advise on appropriate dosing.

Fiber

Gluten free substitute foods often lack the same fiber content as their gluten containing counterparts. To boost fiber intake:

• Enjoy gluten free whole grains like brown rice, buckwheat, teff, quinoa, amaranth, etc.
• Eat ample vegetables, fruits, nuts/seeds
• Try gluten free oats, one of the best sources of fiber
• Use nut flours high in fiber in baking like almond flour
• Add chia seeds or flaxseeds to smoothies or gluten free oatmeal

Increasing fluid intake as you amp up fiber can ease any potential digestive discomfort.

Living Well Gluten Free

Learning to live gluten free for life may feel overwhelming initially. But focusing first on avoiding main gluten sources, eating ample produce, protein and gluten free whole grains will set you up for success. Identifying any deficiencies unique to your case and maintaining open communication with your healthcare team ensures proper celiac disease self-care.

Over time, best practices become second nature and you will likely feel so much better than you did before your celiac diagnosis. Support groups and certified gluten free seals on product labels help along the way too. The celiac community continues to grow and foods and tools to manage the condition safely keep improving.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.