Celiac disease causes vitamin D deficiency via damaging the primary site of vitamin D absorption in the small intestine. For this reason, celiacs must pay attention to their vitamin d levels and consumption.
In this post, we will talk about what celiac does to the body, why vitamin D is important, and how vitamin d and celiac are connected. More importantly, we will discuss ways for celiacs to increase vitamin D intake in their life.
Celiac disease is an autoimmune disease that causes damage to the duodenum of the small intestine when gluten is consumed.
The duodenum of the small intestine is the site of absorption for many nutrients like calcium, vitamin D, magnesium, iron, folate, and more.
This autoimmune reaction and damage to the small intestine can cause a wide-array of symptoms and complications. Symptoms of celiac include vitamin d deficiency, brain fog, malnutrition, bloating, diarrhea, constipation, and more.
Celiac disease and gluten sensitivity are not the same. There are many similarities between the two, but most importantly, with celiac, there is characteristic damage to the small intestine. With gluten sensitivity, there is not.
Vitamin D is a fat-soluble vitamin that is essential to the body. It helps absorb calcium, magnesium, and phosphate. It’s essential for celiac bone health, immunity, hormone health and more.
Per the Mayo Clinic, people ages 9-70 need 600 IU of vitamin D a day, with the upper limit being 4000 IU/day.
Dietary vitamin D is absorbed in the duodenum of the small intestine. The same portion of the small intestine can be damaged by celiac, and thus impair absorption of dietary vitamin D.
Alternatively, vitamin D can be “absorbed” through your skin. This occurs when your skin is exposed to sunshine allowing your body to convert cholesterol to vitamin D. This process is unaffected by celiac.
To increase your vitamin D absorption this way, expose your wrists and ankles to the sun during peak hours for 15-30 minutes a day. (P.s. SPF 30 sunscreen can impair vitamin D access, keep that in mind)
Vitamin D deficiency can go largely unnoticed. Though according to the Cleveland Clinic symptoms of vitamin D deficiency with celiac can include bone pain, fatigue, muscle weakness and cramps, and mood changes. Many of these symptoms overlap with celiac disease, like gluten causing chronic fatigue and muscle cramps.
Celiac disease can cause vitamin D deficiency. This is both related to changes to diet and to the role the disease plays in the body.
Why does celiac cause low vitamin D? Celiac disease involves damage to the small intestine when gluten is consumed. This damage is located where vitamin D and other important vitamins are absorbed. This damage makes it hard for the body to absorb vitamin D which puts celiacs at risk for vitamin d deficiency.
Additionally, this damage to the small intestine impacts the brush border of the small intestine. This is where the digestive enzyme lactase is released. Lactase is what helps people digest milk. This can trigger lactose intolerance in people with celiac thus limiting an entire food group that’s highly fortified with vitamin D.
Both not absorbing and limiting a large source of vitamin D put people with celiac disease at risk for low vitamin D status.
The good news is that once the small intestine is healed and a celiac diet is followed, vitamin D deficiency and lactose intolerance should resolve.
Addressing vitamin D deficiency in celiac disease can involve a variety of support measures. One of which can include balancing a gluten-free diet with vitamin D-rich foods.
Naturally containing food sources of vitamin D include cod liver oil, swordfish, sockeye salmon, tuna, fortified foods, canned sardines, beef liver, and egg yolk.
Gluten-free foods fortified with vitamin D can be a great way to boost vitamin D intake in your diet. Foods fortified with vitamin D can include milk, orange juice, yogurt, and some gluten-free cereals like Rice Chex.
Vitamin D becomes a great concern with celiac if you are also vegan or plant-based. This is because as you can see in the lists above, many of the gluten-free food sources of vitamin D are animal-based.
Some non-dairy gluten-free sources of vitamin D include fortified milk alternatives (think soy, almond, or rice milk), fortified orange juice, and fortified gluten-free cereal like Rice Chex.
If you’re looking to boost your vitamin D intake with celiac disease through cooking, below are come gluten-free recipes high in vitamin D.
Another way to support your vitamin D status with celiac disease is to consider vitamin D supplements. Keep in mind that the upper limit (the amount before which adverse effects may occur) for those 9 and up is 4000 IU/day.
Of course, be sure to include your healthcare team in any decisions you make about diet changes and supplements. That said, below are gluten-free vitamin D supplements you may consider.
Ultimately, you should monitor vitamin D levels and intake closely with celiac disease, especially as you’re healing. And if you’re looking to boost your vitamin D intake with celiac, consider including vitamin D-rich foods, getting more sun, or talking to your healthcare team about starting a vitamin D supplement.
Need help balancing a gluten-free diet for all of the nutrients you need? Work with a celiac dietitian!
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