Why Is Gluten Cross Contamination In Supplements Such A Problem
Many supplement manufactures process multiple products in their facilities. Often times, grain is used as a filler or additive. Wheat germ is a common example of a gluten based ingredient being used in supplement processing. This same problem can be seen in a number of prescription and over the counter medications. Below is a list of commonly used terms that may be grain based fillers in vitamin supplement products:
What If A Gluten
If you continue to have celiac disease symptoms while you are following a gluten-free diet, talk with your doctor or a registered dietitian, who can help you find the cause. In about 20 percent of people with celiac disease, symptoms continue or come back even while they are following a gluten-free diet.7 Symptoms may be caused by consuming small amounts of gluten, other health problems, or refractory celiac disease.
Supplementation Is Critical For Those With Gluten Induced Gut Damage
Why are vitamins and minerals so important? They are the tools your body uses to function. Think of nutrients as the building blocks to all of your tissues. Without them, your body cant heal, repair, or maintain itself. Multiple studies have shown the relationship between vitamin and mineral deficiencies and gluten intolerance and celiac disease. It is well established that damage to the intestinal cells can lead to malabsorption and poor digestion. One study showed that celiac patients following the gluten free diet still had vitamin and mineral deficiencies after 10 years of compliance. Add to this the fact that the chronic autoimmune inflammatory damage taxes the nutritional status of the body and we are left with chronically ill patients who need supplementation as part of their recovery process. Many with gluten sensitivity have persistent health issues like heart burn, depression, IBS, low hormones, etc and take natural supplements and medications for their symptoms. Now add to this that almost 1/4 of all supplements and even prescription medications contain hidden gluten and we have a major medical disaster.
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Consuming Small Amounts Of Gluten
If your symptoms continue or come back after you start a gluten-free diet, you may still be eating or drinking a small amount of gluten. Keep a food journal and talk with your doctor and a registered dietitian about your diet and products you use that might contain gluten. Finding and avoiding all sources of gluten may help your symptoms improve. Hidden sources of gluten include additives made with wheat, such as
- modified food starch
Database Search For Ingredient Source
One common excipient is starch. The most common type of starch used is from corn, however potato, tapioca, and wheat derived starches are also used. A recent search of medications listed on a National Library of Medicine database, managed in conjunction with the National Institutes of Health, showed that there were 8,379 individual products or dosage forms that contained the word starch.
Searching specifically for the word corn reveals 6,518 records, potato reveals 2,934 records, tapioca reveals 17 records, while the word wheat reveals 11 records. The total adds up to more than the 8,379 records because many products have more than one starch contained within the product. This database is called MedlinePlus, and can be accessed here.
A second database maintained by the same government organization lists a total of 70,776 drug records however, not all of the records have been categorized allowing a full search of a drug product based on their ingredients. This database is called DailyMed, and can be accessed here. Both of these sites are extremely helpful in determining the potential for gluten contamination.
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Almost 25% Of Supplements Contain Gluten
Now imagine you are supplementing your diet in an attempt to support your recovery, and you are taking vitamins that contain hidden gluten. A recent study investigated over the counter vitamin and mineral supplements for the presence of gluten, and the results were alarming. Almost 24% of the products tested had enough gluten in them to create inflammatory damage. Here is a quote directly from the study:
we investigated the presence of gluten in twenty one common dietary supplements from the national market using the immunochromatographic assay. This visual assay proved to be an efficient rapid tool for gluten screening as an alternative to the ELISA techniques. The results have shown the presence of gluten in 23.8% of the investigated samples .
The Importance Of The Right Diagnosis
Because of the complexity of each of these conditions, those who suspect they have symptoms for any of these should consult with a healthcare provider rather than self-diagnosing. In addition to the tests that could be performed, your provider will do a full workup, discuss your health history, and take into consideration any other symptoms you have noted. Before you visit your provider, it might be helpful to keep a journal of the foods you eat, as well as the symptoms and observations you make from day to day.
Knowing specifically what your condition is will make a substantial difference in the way youre treated. Because a gluten or wheat allergy can cause anaphylaxis, you might receive a prescription for an EpiPen or epinephrine, which is something that you wouldnt need for celiac disease. And if its only wheat youre allergic to, you might not have to avoid eating everything that contains gluten. You will likely work with a dietitian, who can help you maintain the right amount of nutrition while still avoiding ingredients that trigger a reaction.
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How To Detect A Nutrient Deficiency
Researchers have found vitamin and nutrient deficiencies to be highly prevalent in newly diagnosed celiac disease patients.
Telltale signs of nutrient deficiencies can look like brittle nails, hair loss and unhealthy pale skin. People with nutrient deficiencies also find themselves catching every cold that goes around and feeling chronically fatigued.
To know, for sure, if a nutrient deficiency is at play, I recommend requesting or purchasing a simple blood test.
Ive learned that many insurance companies dont cover vitamin check blood tests if this is the case, I highly recommend this test and this test, both of which can be taken at-home without a doctors supervision or prescription.
Avoiding Medicines And Other Products That May Contain Gluten
In addition to prescribing a gluten-free diet, your doctor will want you to avoid all hidden sources of gluten. If you have celiac disease, ask a pharmacist about ingredients in
- herbal and nutritional supplements
- prescription and over-the-counter medicines
- vitamin and mineral supplements
Medicines are rare sources of gluten. Even if gluten is present in a medicine, it is likely to be in such small quantities that it would not cause any symptoms.
Other products can be hidden sources of gluten. You may take in small amounts of gluten if you consume these products, use them around your mouth, or transfer them from your hands to your mouth by accident. Products that may contain gluten include
- childrens modeling dough, such as Play-Doh
- toothpaste and mouthwash
- communion wafers
Reading product labels can sometimes help you avoid gluten. Some companies label their products as being gluten-free. In the United States, products labelled gluten-free must have less than 20 parts per million of gluten, which should not be a problem for the vast majority of people. If a label doesnt tell you what is in a product, ask the company that makes the product for an ingredients list. You cannot assume that the product is gluten-free.
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Fact #: Vitamin Deficiencies May Worsen Restless Leg Syndrome
Better known as Willis-Ekbom disease or RLS/WED, restless leg syndrome is a neurological condition in which the person experiences uncomfortable and unpleasant leg sensations, as well as the irresistible urge, to move the legs. This condition affects twice as many women as men, and as per the National Institute of Neurological Disorders and Stroke, roughly 10 percent of people in the US are affected by RLS. While iron deficiency is the main cause, vitamin C deficiency may also lead to restless leg syndrome. In addition to a gluten-free diet, celiacs should load up on vitamin C-rich and iron-rich fruits and veggies.
Are You At Risk
New research on vitamin D shows that the average person needs between 2,000 and 6,000 IU of vitamin D per day! Many nutritionist recommend large amounts of dairy as a source of vitamin D. Unfortunately, trying to get your vitamin D by eating dairy is the equivalent of trying to spit out a forest fire! Protect yourself by getting adequate sunshine daily. Have your doctor measure your 25 OH D levels to assess you for deficiency.
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Hidden Gluten In Vitamins And Supplements
Youve gone gluten-free and are proud of yourself for sticking to a strict diet. Youre off the breads and avoiding foods that scream gluten — a protein that is in anything made from wheat, rye or barley. But did you know that, although rare, some vitamins and supplements can contain traces of gluten?
No, you say.
You are not alone. In a study of nearly 1,000 American consumers, we found that 62% did not think that dietary supplements can contain gluten. However, wheat is often used as a filler in dietary supplements. There are many certified supplements, including multivitamins and prenatal and probiotic vitamins, that contain gluten. Whats more, experts in the Celiac Disease Center at Columbia University found that more than half of the probiotics tested contained gluten, the protein that could cause gastrointestinal inflammation for those suffering from celiac disease or gluten sensitivity.
The issue is important because in the last decade, the dietary and nutritional supplements industry has grown tremendously and new products entering the market are not regulated or tested in the same way as prescription drugs. With limited information, its not always clear which supplements contain gluten.
So, how can you tell if vitamins or probiotics contain gluten?
NSFs Consumer Information Specialist can answer any questions you may have about gluten-free certified products at or +1 800 673 8010.
Gluten In Vitamins And Supplements
Vitamin and mineral therapy can be used in addition to the standard gluten-free diet to hasten a patients recovery from nutritional deficiency. However, certain ingredients in vitamins and supplements typically the inactive ingredients can contain gluten, so extra care must be taken to avoid any gluten exposure.
There is a variety of nutritional deficiencies associated with celiac disease, primarily caused by the inability of the damaged small intestine to properly absorb enough of the nutrients our bodies need. People recently diagnosed with celiac disease are commonly deficient in fiber, iron, calcium, magnesium, zinc, folate, niacin, riboflavin, vitamin B12, and vitamin D, as well as in calories and protein.
Deficiencies in copper and vitamin B6 are also possible, but less common. A study from 2002 by Bona et. al. indicated that the delay in puberty in children with celiac disease may partially be due to low amounts of B vitamins, iron, and folate.
Patients with celiac disease frequently report non-specific dermatological issues, including dry skin, easy bruising, brittle nails, and thinning hair. Zinc deficiency is particularly associated with these skin lesions. Iron, zinc, and fat-soluble vitamins are most often deficient in patients with newly diagnosed celiac disease.
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The Relationship Between Celiac Disease And Vitamin Deficiencies
Celiac disease is an autoimmune disease that is triggered explicitly by gluten sensitivity. Gluten is a protein found in various items, most notably bread made from wheat, barley, or rye. When foods containing gluten are eaten, the small intestines can be damaged because the bodys immune system treats the protein as an invader. Over time, the sustained injuries caused by this autoimmune response can lead to nutritional deficiencies, leading many celiac patients to turn to supplements to correct vitamin deficiencies.
Can I Eat Casein
If you have celiac disease, you might also wonder if you need to avoid casein, which is a protein in milk, butter, and cheese. If youâre allergic to casein, definitely keep it out of your diet. But if you donât have a casein allergy, you might not need to worry about it.
There hasnât been a lot of research on whether casein has the same effects as gluten. The theory got its start decades ago, when some people thought that casein, gluten, and autism might be linked. That theory isnât proven.
One thing to keep in mind is that if milk upsets your stomach, it could be due to lactose, which is the natural sugar in milk. Casein and lactose arenât the same, and your sensitivity may have nothing to do with casein. Anyone can have lactose intolerance, including people who have celiac disease and people who donât.
You can ask your doctor to test and see if youâre allergic to casein. If you remove casein from your diet, youâll want to focus on getting enough vitamin D and calcium.
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Thiamin Riboflavin And Niacin For Energy
Thiamin, riboflavin, and niacin are all B vitamins, and all play a role in converting the food you eat into energy. As with vitamin B12, studies have shown that people following a gluten-free diet don’t get enough of these vitamins. although medical testing doesn’t indicate they’re necessarily deficient.
All three typically are added to conventional fortified gluten-based cereals and breads, which explains why people might get less of them on the gluten-free diet.
Beans tend to be a good source of thiaminhalf a cup of green peas or lima beans will give you about 50% of what you need each day. Acorn squash and potatoes also contain significant thiamin.
For riboflavin, you can turn to dairy products: A glass of milk plus a cup of yogurt every day would cover you. Meat also is a good source of riboflavin. If you don’t eat meat or dairy, look to almonds and soy nuts for your riboflavin .
Finally, for niacin, all types of meat, poultry, fish, and dairy are high in the nutrient. If you follow a vegetarian or vegan diet, look to portobello mushrooms, pumpkin or squash seeds, tempeh, peanuts, or beans to get the niacin you need each day.
Should Those With Celiac Disease And Non Celiac Gluten Sensitivity Take Supplements
Even though vitamin and mineral deficiencies are extremely common for those with celiac and non celiac gluten sensitivity , the issue is largely ignored by doctors when a celiac diagnosis is made. Because nutrients are an essential part of the healing and recovery process, this article will discuss What supplements you should take if you have celiac or NCGS. In short, this article will help you understand:
- How common nutritional deficiencies are in those with gluten issues
- Why supplementation may be needed
- Gluten cross contamination in supplements
- How to identify hidden gluten fillers in supplements
- What supplements you should take if you have celiac disease or NCGS
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Niacin Riboflavin And Thiamine
Vitamin B plays an important role in converting the food we eat into energy. Riboflavin, niacin, and thiamine are all vitamin B. You can find all three of these vitamins in gluten-based foods. Thus, individuals who are diagnosed with celiac disease also seem to suffer from vitamin B and vitamin B12 deficiency.
Beans are said to be a good source of thiamine, wherein half a cup of green peas would provide about 50 percent of the daily nutrition of vitamin B. Potatoes also contain a significant amount of thiamine while dairy products are known to contain riboflavin. A cup of milk or yogurt would make up for any deficiency of vitamin B.
Riboflavin is also found in meat. If you are a vegetarian, then you can go in for soy nuts or almonds. When it comes to niacin, one can find this vitamin in meat, fish, poultry, and dairy items. Vegetarians can also consume peanuts, beans, or squash seeds to make up for the low levels of niacin each day.
Best Supplements For People With Celiac Disease
If you have recognized nutrient deficiencies, your doctor may advise that you take one or more the following supplements. Keep in mind that once you restore these nutrient levels and your intestines heal, youll likely no longer need to take that specific vitamin or mineral. Many nutrients have store houses in the body once you replete the stores, you can go off the supplement, says Beringer.
Your doctor should also monitor you periodically to ensure that your body is properly nourished, adds Mukherjee. Dont supplement unless recommended by your doctor or registered dietitian. Your doctor may advise:
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Vitamin B6 For Preventing Infections
Vitamin B6 is one of the best supplements for celiac disease. You need vitamin B6 to fight off infections, maintain normal nerve function, carry oxygen throughout your body, and keep your blood sugar within normal limits. Unfortunately, studies have shown that many people with celiac disease who follow a gluten-free diet are low in vitamin B6.
There are plenty of healthy foods that can give you a boost in this important nutrient. Start with chickpeas a cup will give you more than half of the vitamin B6 you need in a day. You can mix chickpeas into salads or eat them in the form of hummus .
You also can get significant amounts of B6 from tuna, salmon, chicken, and turkey. Even one medium-sized banana has 20% of the vitamin B6 you need each day.
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