One of the most frequent questions I get from people with celiac is how to heal celiac. More specifically, how to heal your gut when you have celiac.
Gut health is so important and I understand why this question comes up often. Healing after a celiac diagnosis is the priority because people are desperate to feel better.
And people want to know, what’s the fastest way to feel better.
Healing your gut when you have celiac is a good place to start, but how do you do that?
Before I dive into how to heal celiac, I want to say there is a difference between healing and curing.
Healing celiac is about reducing symptoms, renourishing the body, finding a better relationship with food, and repairing the small intestine. (That’s right, your small intestine is not the only thing that needs healed after a celiac diagnosis.)
Curing celiac is about getting rid of it all together.
There is no current cure for celiac. The only treatment is healing the small intestine and preventing further damage by living gluten-free.
So how do we heal celiac? Well, it’s a lot more than just living gluten-free. Below are a few ways you can start healing celiac.
Before I dive into specific steps to heal celiac disease, I want to say a celiac diagnosis is a heavy one. Not a lot of people talk about celiac disease and grief but grieving is such a huge aspect of the healing journey
Being diagnosed with an autoimmune disease that changes your entire way of life is a lot, and that’s what celiac does. Celiac changes your entire way of life.
Food is fuel, but food is also connection, community, love, comfort, celebration and more. Not grieving the way living gluten-free impacts all of these things can lead to trouble down the line.
So one way to help heal celiac is to grieve your old way of living.
Mastering and feeling confident with a gluten-free life is so important to healing celiac. If you’re not avoiding gluten, nothing else you do to heal matters.
Because gluten is what’s triggering the physical damage to your body. Gluten is what’s triggering your symptoms. So the best way to start healing is to master and build confidence in a gluten-free life.
If you need help with building confidence, check out the Confident Celiac Group Program.
One of the most important things to healing with celiac is eating enough.
Your body needs energy to heal and if you’re not eating enough, you can delay or prevent healing.
Energy is so important to healing, yet 90% of my clients come to me not eating enough.
Why? There are a lot of reasons, often people have trouble easily finding gluten-free meals to make or their hunger/fullness cues are unreliable.
Alternatively, they got bad advice from another healthcare provider and are trying to lose weight before healing.
Either way, a lot of people don’t realize it but most people are not eating enough to heal.
On top of eating enough, fiber is also important to healing (though in some cases this may be contraindicated so as with all healing, it’s important to collaborate with your healthcare team on this).
Fiber not only keeps your digestive system moving but it also helps feed your microbiome. Your microbiome is essential to a healthy gut as it helps with digestion and immunity.
Foods rich in fiber include whole gluten-free grains, fruits, and vegetables.
There are many supplements for celiac healing to consider. The main ones would be Iron and B12 if you are deficient (which often people healing their gut after a celiac diagnosis are).
You might also consider probiotics for celiac healing. Though I’ll say the effectiveness of probiotics vary by strain and by symptom so work with a specialist to know what to take.
For more supplements to consider, I wrote a post discussing 10 supplements for celiac disease.
Your relationship with food impacts so much about your healing journey.
Specifically with gut health, often if your relationship with food is bad then you likely will struggle with things like:
Your relationship with food matters and if this relationship is strained, it’s going to be hard to heal physically.
It helps makes sure you’re not getting burnt out on taking care of yourself (because celiac burnout is real).
Some easy ways to practice self-care with celiac disease is to:
Celiac can quickly drain your cup, make sure you’re practicing self-care to refill it.
A lot of people come to me at their wits end when it comes to healing. They’ve tried everything, done everything, and yet they still don’t feel better.
Here’s the thing, your healing journey is not a job for google, social media, or that influencer you follow on social media.
In fact, trying everything can make the healing journey worse because a lot of healing recommendations out there can actually complicate things.
With most of my clients, we end up undoing a lot of what they’ve done to try to heal before we can actually get down to doing the things that will actually help.
For example, many people try to do elimination diets by themselves and execute them incorrectly, then they are unnecessarily restriction or impairing their normal digestion because they didn’t do the elimination diet right, or it’s not the appropriate elimination diet, etc.
There are a lot of ways for healing to go wrong, a dietitian can help you cut through the noise and find the right path.
Physically, the best way to know if your gut is healed after a celiac diagnosis is with celiac disease testing.
More specifically, a follow-up endoscopy to check to see if your small intestinal damaged has healed.
However, this can be expensive and hard to get insurance to cover in the USA.
You might also compare your follow-up celiac labs to the ones at diagnosis to see if they are improving or normalized. However, it’s important to note that normalized celiac labs do not always correlate to a healed small intestine. While they’re not the best indicator, sometimes, they’re the best you’ve got.
Additionally, another tell is if you are feeling better (though feeling better doesn’t always mean healed and not feeling better doesn’t always mean you’re NOT healed). And if your asymptomatic, feeling better physically isn’t really something you can bank on because you have no symptoms! However, your emotions, social life, and more can also be good tells.
Ultimately, following-up with your doctor with your concerns is your best bet to knowing if your celiac is healed.
If you were officially diagnosed with celiac disease and your follow-up biopsy comes back negative that does not mean you no longer have celiac.
All this means is that you’ve done a good job at healing the damage from celiac and should keep up the good work of staying gluten-free.
A reminder, there is no cure for celiac so if you recieve a celiac diagnosis, that is a lifelong diagnosis.
If you were officially diagnosed with celiac and your follow-up tTG comes back negative that does not mean you no longer have celiac.
All this means is that you’ve done a good job at staying gluten-free and your labs are reflecting that.
Also something to note is that your celiac labs are not sensitive to accidental occasional glutenings but more so your overall adherence – kind of like A1C for blood sugar management.
If you’re having trouble getting your doctor to do follow-up testing or don’t have access to a doctor, you can order follow-up testing from imaware.
Here’s an affiliate link to their celiac monitoring tests to help you know if you’re doing enough to stay gluten-free.
How long does healing celiac take? Well this answer depends because healing celiac is complex.
If you have symptomatic celiac, it can take a few few weeks to a few months to see symptom improvement. If you’re concerned with how long it’s taking to feel better, work with a celiac specialized dietitian to figure out what’s going on.
Gut health wise, it can take a few months to a few years.
Food relationship wise and renourishment wise, it often varies widely.
Basically, it depends on the person and their unique circumstances and what exactly needs healed.
It can take the villi of your small intestine a few months to a few years to heal with celiac.
In some rare cases, some people have what’s called non-responsive celiac which means more interventions are necessary beyond a gluten-free diet to heal. If this is you, please see a celiac dietitian like myself.
In other rare cases some people have what’s called refractory celiac, where the small intestine is permanently damaged. Basically, they can not heal.
Again, healing depends on the person, but usually it takes anywhere from a few months to a few years for villi to heal.
The gold standard for testing for healed villi is through a follow-up intestinal biopsy. Again, normalized tTG doesn’t always mean healed villi.
The protein gluten stays in your body for a couple of days. There is a myth that gluten stays in your body for months and that you have to detox it out but this is false.
First gluten is a complex protein made up of many amino acids. During digestion gluten is deconstructed into these amino acids that are absorbed in the body and used to make OTHER proteins but never gluten.
So gluten is only really in your body for as long as it takes to digest it (which is at most a few days).
People get confused by this because they react for sometimes a week to even a month. To understand why this happens let’s talk about what’s causing the symptoms.
Celiac symptoms usually are caused by the autoimmune response to gluten OR the damage caused by gluten.
The celiac autoimmune response to gluten can last a few days to a few weeks. Furthermore, the damage caused by gluten can last a while too.
So if you’re still having symptoms, it’s not because you need to detox your body of the gluten, it’s because your body is trying to recover after the gluten, and everyone’s gluten recovery time is different.
Ultimately, healing celiac is complex and not as simple as just going gluten-free.
And healing celiac isn’t just about the gut but the gut is a huge part of it.
If you need help healing, if you’re feeling stuck with symptoms, or feeling stuck with living gluten-free, working with a celiac dietitian can help. I can help.