Cook Once, Eat All Week Meal Plan
3 min read

Malnutrition In People With Celiac Disease

Spencer Cailas


Chances are that you associate the term ‘malnutrition’ with the plight of under nourished children in impoverished nations or ones that are reeling under war. But hidden away in your own body, unbeknownst to you, celiac disease may be causing malnutrition. You heard that right.

You may well be malnourished despite having access to the most nutritious of foods.

The immediate effect will be a difficulty in digesting foods. In due time however, this will start to weaken your immunity making you more prone to infections. Your endocrine system is affected. Your hormonal production will start to fluctuate.

In men, one of the most debilitating effects of celiac linked malnutrition is the drop in testosterone levels which can lead to low libido, reduced muscle tone, sagging skin and low energy.

It is a domino effect that starts to spread to almost every major biological process in the body. And it is a tad surprising for the person experiencing these symptoms.

Most people who are diagnosed with celiac related malnutrition are unable to reconcile the situation. It sounds contradictory.

How can one be malnourished despite eating all that you want to?’

That’s the first reaction. But if you read into the details, it all starts to fall into place. To be able to understand how celiac disease can cause malnutrition, you must first understand what causes celiac disease.

What is celiac disease?

Celiac disease is an autoimmune condition triggered by gluten. The body mistakes the gluten protein to be a foreign invader and starts to attack it, damaging the villi in the small intestine. As the condition remains undiagnosed, you continue to consume gluten in many forms unaware of the damage that it is doing to your body, and the symptoms are easily mistaken for conditions.

Eventually, it will damage the villi to such an extent that it becomes flat and is unable to absorb any nutrients from the food you consume.

This is where the connection of celiac to malnutrition begins.

Despite consuming the most nutrient dense foods, celiac patients are only able to absorb a fraction of it, or none of it at all.  Some of the nutritional deficiencies can trigger a whole range of unpleasant symptoms.

Nutritional deficiencies associated with Celiac

Untreated celiac patients are often found to be deficient in Zinc, Magnesium, Iron, Folate, Carnitine, Calcium, Fatty acids and Vitamins B6, B12 D, K, E, C.

Apart from the effect on hormonal production, this can also lead to several other problems.

Zinc: One of the first signs of Zinc deficiency is a weakened immune system. Other than this, there’s diarrhea, hair loss, loss of appetite and weakened cognitive functioning. Zinc deficiency is also one of the main reasons of low testosterone in men.

Folate: Folate is a B Vitamin that is absorbed by the villi in the small intestine, like a lot of other B vitamins. Once again, a weakened immune system is often the first sign of Folate deficiency.  But it is to limited to that. Lethargy, feeling low on energy, sudden unexplained mood swings, pale skin, anemia and premature thinning and graying of hair are some of the symptoms of folate deficiency.

Iron: Unexplained anemia is considered as a red flag for celiac by physicians these days. That’s because most people with untreated celiac are anemic and found to be deficient in RBC. This leads to the lack of oxygen to many parts of the body and the person often feels fatigued and may even experience frequent palpitations.

Vitamin D and Magnesium: Vitamin D deficiency in celiac patients is an extremely serious condition that can lessen bone mass and even lead to the early onset of osteoporosis or brittle bone disease. Unlike typical Vitamin D deficiency which can be countered with supplementation, Celiac prevents the body from absorbing the Vitamin rendering supplementation ineffective.

Calcium: Along with Vitamin D and magnesium, Calcium is the most important mineral that is responsible for developing strong bones. Deficiency leads to osteoporosis, weak and brittle hair, nails and unexplained seizures.

Carnitine: Carnitine is a vital amino acid which cannot be metabolized by Celiac patients. The symptoms include muscle necrosis, hypoglycemia, fatigue, muscle aches and cardiomyopathy.

Fatty Acids: Fats are often excreted in the stool of celiac patients as it cannot be absorbed by the small intestine. The result is that good fatty acids like Omega-3 and Omega-6 are not absorbed by the body. As is the case with other deficiencies, even supplementation does not help because the small intestine is not absorbing it. Some symptoms are fatigue, poor memory and sudden mood swings. Other than this, it can also lead to pale skin and premature thinning of hair.

Switching to a gluten-free diet

Despite sounding ominous, the obvious cure to all these deficiencies is to switch to a complete gluten-free diet. Within just months of going gluten-free, the levels of all these nutrients are known to return to their normal levels in the body.

Some physicians may also recommend supplementation to speed up recovery. But this method is only chosen in extremely rare conditions. In most cases, the villi returns to normal in a few months of going gluten-free and most of the deficiencies are cured automatically.

If you are continuing to experience symptoms of deficiencies despite stopping your gluten intake, then your physician may choose to conduct tests to check for specific deficiencies.