Common Nutrient Deficiencies

Signs You May Need to Supplement

It probably comes as no surprise that Americans eat an unhealthy diet. If you’re reading this magazine, you represent a facet of the population that takes health more seriously. Keep up the good work!

While this magazine focuses on optimizing the health of those suffering from celiac disease and non-celiac gluten sensitivity, it is interesting that most of the nutrients found to be deficient in celiacs are not too different from those found to be deficient in the average American.

Why are those with an autoimmune disease that temporarily destroys the lining of their small intestine (celiac) not so different nutritionally from an average American?

If you’re thinking it’s all about diet, health of the gut, and exposure to environmental chemicals, toxins and pesticides, you’re right.

Let’s begin with nutrients for those of you recently diagnosed with celiac. If this is you, there’s still a lot of inflammation in your intestinal lining and damage that requires healing. If you are a celiac suffering with diarrhea, you most likely have some acute deficiencies.

You should consider getting tested for and supplementing with the following:

• Calcium
• Fiber
• Folate
• Iron
• Vitamin B12
• Vitamin D
• Magnesium
• Niacin
• Riboflavin
• Zinc

You may also need to address your food intake to ensure you’re getting adequate calories and protein considering the malabsorption associated with celiac and/or if you are over the age of 65.

There are additional nutrients to consider if you’ve suffered with diarrhea and fatty stools. When you malabsorb fats, your stool will float due to the excess fat in the stool itself. It can also be a paler brown to yellow color instead of the normal dark brown and be greasy looking and/or smelly.

If this is the case, supplementing with the fat-soluble vitamins A, D, E and K is a good idea, while ensuring you’re working with a clinician who monitors your levels and healing.

If you’re the parent of a child recently diagnosed with celiac, look at supplementing B vitamins, iron, and folate (vitamin B9), as those are some of the most common deficiencies reported. But if your child suffers diarrhea and weight loss, getting adequate protein, calories, and fiber should also be stressed.

A 2002 study validated that a delay in puberty with children suffering from celiac could be related to low amounts of B vitamins, folate, and iron.

Another study tracked adult celiacs following a gluten-free diet for 10 years. Half of them had poor vitamin status despite their gluten-free lifestyle. The authors checked homocysteine levels, a blood marker for folic acid, vitamin B6, and B12 deficiency to evaluate and confirm their poor nutrient status.

The conclusion was that clinicians should more carefully evaluate celiac patients’ nutritional status. Elevated homocysteine is not only a gauge of nutrient levels, but also a marker for increased heart disease risk.

The Center for Disease Controls’ 2017 Nutrition Report concludes that Americans are lacking significantly in key nutrients. The advent of unhealthy foods and trendy diets apparently leaves nine out of 10 Americans suffering from an imbalanced diet.

What are those nutrients and how do they differ from those commonly deficient in celiac patients?

Out of the 10 nutrients commonly deficient in celiacs, 6 are identical in all Americans. The remaining nutrients – zinc, magnesium, and the B vitamins niacin and riboflavin – are frequently fortified in cereals and flours containing wheat, perhaps explaining why they are less deficient in those consuming gluten.

What this means is whether you have celiac disease, gluten sensitivity or not, it is very important to evaluate your nutrition status and improve your diet. It’s always best to get your nutrients from fresh, whole foods.

The best diet?

Whole-foods including ample fresh vegetables, fruits, beans, peas, lentils, nuts, seeds, and a small amount of low-mercury fish (once or twice per week). Avoid all sugar, trans fats, artificial sweeteners, pre-packaged/pre-prepared foods, junk food, and fast food.

Supplement accordingly, depending on what nutrient testing reveals. Symptoms associated with common deficiencies include:

Calcium

Calcium contributes to strong bones, but it’s also associated with nerve, muscle and heart health.
If you tend to drink soda or eat a diet with few dark green leafy vegetables, you’re at a higher risk of deficiency. Supplement, if required, as part of a multiple vitamin mineral.
Deficiency symptoms include fatigue, anemia, weakened immune system, and depression.

Vitamin D

Vitamin D3 regulates your calcium absorption, making calcium usable for your body. It plays a role in immune system strength and cancer protection. Symptoms of a deficiency include a low immune system, fatigue, osteoporosis/osteopenia, hair loss, and joint and muscle pain.

Americans are often deficient, making it worthwhile to measure your levels via a blood test. When you do supplement D3, consider an addition of vitamin K2, another chronically deficient fat-soluble vitamin. D3 regulates calcium absorption, but K2 ensures the absorbed calcium is delivered to the correct areas – your bones vs. inappropriate deposition in arteries, gall bladder, or kidneys.

Iron

Abundant in foods of both animal and plant. If you are deficient, or anemic, you can feel quite exhausted and lethargic. You can also feel light-headed, suffer shortness of breath, chest pain, and headaches.

Women with heavy periods or those bleeding internally for whatever reason, can suffer low iron. During pregnancy, it’s important to have stable levels due to iron’s role in brain development.

Folic acid

Folic acid, or vitamin B9, plays a role in keeping red blood cells healthy. It’s critical during pregnancy to prevent spina bifida. It helps prevent anemia and protect you from heart disease.

Seven to nine servings of fresh fruits and vegetables should be adequate, but few Americans reach that target. Folic acid is so important that breads and cereal products are fortified with the nutrient. Certain medications or imbibing excess alcohol could create deficiency.

Deficiency symptoms are similar to those caused by lack of iron, with the addition of mouth sores and irritability.

Vitamin B12

B12 is commonly deficient among vegans, but it’s also on the list of the most frequent deficiencies of all Americans, not to mention those with celiac, making B12 an equal opportunity deficiency!

B12 helps to form red blood cells, is critical for nerve function, and provides a foundation for hormones, protein, and DNA. Symptoms associated with deficiency include anemia, fatigue, shortness of breath, memory loss, and tingling feet.

The best blood test to measure your B12 levels is methylmalonic acid.

It’s an effortless supplement to take; most people enjoy the sweet, pink liquid taken sublingually a few times per week. Those with compromised intestinal tracts, including celiacs, may need B12 injections until their gut heals.

Fiber

If you strive to eat seven to nine servings of vegetables and fruits, while enjoying some legumes, your fiber quotient should be addressed nicely. Fiber is believed to help heal the gut and feed the “good guys” – the 10 trillion organisms making up your microbiome.

Signs you may need more fiber include bloating, gas, feeling overly full, constipation or diarrhea, and weight gain.

The remaining nutrients – magnesium, zinc, riboflavin, and niacin – are more commonly deficient in celiacs, but may also be deficient in the general population.

Magnesium

This nutrient can be found in fruit, nuts, seeds, spinach, avocado, and is abundant in healthy plant foods. Deficiency is likely less about inadequate intake as it is related to absorption.

Symptoms of a magnesium deficiency include muscle cramps or twitches, fatigue, muscle weakness, irregular heartbeat, and high blood pressure.

Issues with diabetes, diarrhea, malabsorption, and celiac are associated with increased risk of deficiency.

Zinc

Zinc is abundant in a variety of foods, from meat and shellfish to legumes, seeds, nuts, and whole grains.

Foggy thinking, nausea, diarrhea, trouble sleeping, or a weak immune system, resulting in you getting ill more often, are key signs of a zinc deficiency.

Those most at risk are pregnant women, dieters, vegans, the elderly, and those consuming too much alcohol.

Riboflavin and niacin

Beyond tuna, which is too high in mercury to be on a recommended list, mushrooms, peanuts, avocados, and green peas will provide you with these specific B vitamins. They are also found in enriched cereals and grains.

Riboflavin deficiency can create redness and swelling inside the mouth and throat and cracks on the outside of the lips or corners of the mouth. Niacin deficiency can cause canker sores, fatigue, depression, and indigestion.

Issues with malabsorption can cause deficiency.

I prefer whole food, but it’s a good idea to augment your diet with a well-made multiple vitamin mineral to help prevent these common deficiencies. However, if you’re not absorbing nutrients adequately, you will still have a problem.

Find a clinician who can measure your nutrient values and follow up on anything that seems less than ideal. If altering your diet and supplementation isn’t helping, the next step is identifying why your gut is not doing its job.

Don’t Eat Gluten-Free Junk Food

It would be remiss of me to not urge you to avoid gluten-free junk food. Regardless of whom you talk to about health, whether they encourage a whole food plant-based diet, keto, Paleo, etc., all doctors agree refined carbohydrates and sugars are unhealthy.

I know it’s fun to discover a gluten-free brownie mix or other dessert you’ve been missing, but gluten-free doesn’t make a sugary dessert any healthier. It’s still full of sugar, refined grains, and may contain other unhealthy ingredients such as stabilizers, preservatives, etc.

Much of what we need to focus on to regain optimal functioning is the restoration of our gut health. Sugar and refined grains do not support a healthy gut microbiome.

Enjoy home-made desserts utilizing dates or coconut sugar, as an example. There is an abundance of great ideas in this magazine.

References

Alimentary Pharmacology & Therapeutics. 2002; 16: 1333-1339. Evidence of poor vitamin status in coeliac patients on a gluten‐free diet for 10 years. Hallert C, et al.

Hormone Research. 2002;57 Supplement 2:63-5. Mechanisms of abnormal puberty in coeliac disease. Bona G, et al.

Journal of Parenteral and Enteral Nutrition. 2012;36:68S-75S. Celiac Disease, Wheat Allergy, and Gluten Sensitivity: When Gluten Free Is Not a Fad. Pietzak, M.

Journal of the American Dietetic Association. 2011;111(11):1796. Is there evidence to support the claim that a gluten-free diet should be used for weight loss? Marcason, W.

Dr. Vikki Petersen, winner of the “Gluten-Free Doctor of the Year” award, is a Doctor of Chiropractic, Certified Clinical Nutritionist, internationally published author, speaker, and co-founder of Root Cause Medical Clinic. She is the author of The Gluten Effect, a best-seller on gluten sensitivity and celiac disease.