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Vitamin D Deficiency May be Affecting Celiacs' Immune Systems by Laura Wesson

This article appeared in the Winter 2007 edition of Celiac.coms Scott-Free Newsletter.

Celiac.com 04/26/2007 - My fingernails were shredding and I was a bit out of it mentally, missing obvious things. I’ve had to stop eating many foods because I have intolerances to almost everything I used to eat before I went gluten-free, and I wondered if I had dropped some essential nutrients when I cleared all of those foods out of my diet. So I checked my diet for nutrient deficiencies, using the USDA nutrients database at www.nal.usda.gov/fnic/foodcomp/search. I’m sure there’s software that works with this database but I wrote a little computer program to analyze my diet. I have an electronic food scale, so weighing food is easy.

The most important thing I found is that I’m low on vitamin D. You can get vitamin D from food, or from a supplement, and from the ultraviolet B in sunlight; many of us, like me, may get almost none from any of those sources. And—this is important for a lot of us—vitamin D deficiency can cause a lot of symptoms including immune system problems! I went looking on Medline and it was mentioned as having anti-inflammatory properties, as preventing cancers such as colon cancer and lymphoma; preventing infections, and helping with autoimmune diseases. Gluten intolerance is less common in the middle east and more common in northern Europe. I’ve seen this explained as the result of evolution, since wheat has been used for longer in the Middle East. But I wonder if people in the north are also more likely to be gluten intolerant (an autoimmune disease) because they don’t get as much vitamin D. It may also explain why people get more colds during the winter season when there’s less sunlight. Vitamin D deficiency is best known for causing rickets in children and osteomalacia (softened bones, muscle weakness and pain, tender sternum) in adults. Osteomalacia is often misdiagnosed as fibromyalgia, because the symptoms are similar. Rickets is increasing in the U.S., especially among black children. Most post-menopausal bone loss in women occurs during the winter. It can take months of increased vitamin D intake to correct the health problems caused by deficiency.

There are only a few significant dietary sources of vitamin D. In the U.S., almost all milk is fortified with vitamin D to 100 IU per cup, so you should get the recommended daily intake of 400 IU if you drink 4 cups of milk per day. However, milk often doesn’t have as much vitamin D as is claimed on the label. Some cereals, like Kellogg’s Cornflakes, have small amounts of added vitamin D. Typically, 10 cups of fortified cereal would give you the RDI. The government encourages fortification of milk and cereal so that fewer children will develop rickets. Otherwise—you would get the RDI from nine oysters, or about 4 ounces of fatty fish like salmon or tuna, or a teaspoon of cod liver oil. Many other kinds of fish have only small amounts. You’d have to eat 2 pounds of cod to get the RDI. The only natural vegan source of vitamin D is Shiitake mushrooms. Just like people, mushrooms make vitamin D when they’re exposed to ultraviolet. About 13 sun-dried shiitake mushrooms contain the RDI. And that’s it. Many of us on gluten-free diets are also not eating dairy or fortified cereals, so unless we have a passionate love-affair with fish or oysters or shiitake, we would be getting almost no vitamin D from food.

You can get vitamin D the natural way, from the sun. It takes exposure to sunlight outside (not under glass) on your hands and feet for about fifteen minutes a day. I was not sure what was meant by “direct sunlight”. I read someplace that ultraviolet is scattered over the whole sky. Unlike visible light, the whole sky shines with ultraviolet. Clouds would filter out some of it. People with dark skin require more time in the sun, so many black people develop a deficiency. Using even low-SPF sunscreen prevents your body from making vitamin D. The farther from the equator you live, the less UVB there is in the winter sunlight, because the sun is closer to the horizon in the winter and the sunlight filters through more atmosphere before it gets to you. At the latitude of Boston, and near sea level, there isn’t enough UVB radiation between November and February for one’s body to make vitamin D.

You have probably heard the public health advice to wear sunscreen—the same ultraviolet B that generates vitamin D in your body also causes skin cancer and ages skin. The small amount of exposure to sunlight required is probably only a very small cancer risk and would cause little photo-aging of the skin. Unfortunately I wasn’t able to find quantitative information about how carcinogenic fifteen minutes’ daily sun exposure would be. There are also vitamin D lights, which are probably also a healthful choice.

I have severe immune system problems. I tested positive for 53 inhalant allergies—my body had developed allergies to almost all the allergens around. I get sick for days if I eat almost any of the foods that I ate while I was eating gluten. I even get sick from a couple of foods that, so far as I can remember, I only started eating on a gluten-free diet. So I live on an exotic-foods diet. I’ve had a hellish time trying to get allergy shots. At a concentration of 1 part in 10 million they make me sick for a couple of days while the normal starting concentration for allergy shots is 1 in 100,000. I’m plagued by bladder infections. With cranberries being one of my intolerances, I can’t even use them to help prevent the infections.

I’ve certainly been short of vitamin D. I live in the north, and I’m always careful to use high-SPF sunscreen when I go outdoors. I can’t eat milk, fish, shellfish or mushrooms, so I can’t get a significant amount of vitamin D from food. I haven’t been taking any vitamin supplements, because almost all have traces of protein from some food that makes me sick. It would be lovely if vitamin D deficiency turned out to be part of the cause of my very burdensome immune problems. I’m skeptical because I was getting vitamin D from a supplement and/or from my diet up until 2 years ago, when I found I had a vast number of hidden food intolerances, and I started having reactions to vitamin pills. Fortunately there is a vitamin D supplement that I can take—vitamin D3 made by Pure Encapsulations. The ingredients in the capsule are made from wool and pine trees. I’ll find out if it helps over the next few months.

Vitamin D causes disease when taken in large amounts, so if you think you are deficient, don’t take too much to make up for it. Vitamin D is a hormone—it’s not something to take in mega-doses, any more than, hopefully, one would take a mega-dose of estrogen or testosterone. If your doctor recommends a high dose, they should do regular blood tests to keep track of your vitamin D level. It’s pretty safe to take up to 2000 IU per day on your own. Dr. Michael Holick, a vitamin D researcher at Boston University and author of The UV Advantage, believes that people need about 1000 IU per day. I asked a family doctor, who said they suggest 400-800 IU per day for middle-aged women. However, it might be a good idea for gluten intolerant people to take more, about 1000 - 2000 IU per day, since we may have difficulties absorbing vitamins and celiac disease is an autoimmune disease.

Vitamin D is very important, just as all the vitamins are. But we are conditioned by the media, and tend to think more about vitamins C and E, which get a lot of attention because they’re antioxidants. Vitamin D was the absolutely last one I looked at. Then I found that it was my most serious deficiency!  And nutrient deficiencies are not a trendy topic, so the possibility of developing deficiencies is something people tend to forget while trying to improve their diets. Many people who avoid gluten also have other food intolerances, or are on some other kind of special diet, and it would be an excellent idea to go to the USDA database and find out whether their new diet is giving them enough vitamins and minerals. It certainly helped me. I feel more cheerful and alert, like my mind woke up on a sunny day.

It’s best to get as much as possible from one’s diet, too. Whole foods have a lot in them that’s good for the body that research hasn’t yet identified, and if your diet gives you the RDA of  all the vitamins and minerals, it will also be giving you other healthful nutrients that will do you a lot of good. This might also be true of vitamin D. Maybe it’s better to get a small amount of ultraviolet, like an iguana sitting under a UV lamp, instead of taking pills. UVB might be healthy in ways we don’t yet know about.

Vitamin D is a bit like stored-up sunlight. You can catch it for yourself from the sun when it’s high in the sky, you can eat the sunlight the fish have gathered for you, or you can take a supplement and keep packed sunlight on your shelf.

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22 Responses:

 
Elena Stan
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said this on
05 Nov 2007 2:01:06 PM PST
What a pleasure to read the article. It seems that you did your research good and I like your style of writing. I agree with you that sunlight is vital. And with everything else you talked about. Good job! My daughter is allergic to wheat, eggs and milk, but none of the doctors we saw for this wanted to help with advice. Celiac disease is a plague that most doctors don't even want to admit. I diagnosed my daughter myself initially, just by symptoms. I hope we will get it under control. The doctors only made the situation harder...

 
Bobbi
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said this on
25 Nov 2007 6:20:47 PM PST
This article is very informative, helped me so much. Thank you!

 
Judy
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said this on
01 Jan 2008 6:16:00 PM PST
Great article, but I'd lose the sunscreen part. Especially in the northern climes, the time you need in the sun isn't likely to cause skin cancer. The ingredients in the product would probably cause you more trouble than the sun!

 
Gord
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said this on
27 Jan 2008 3:19:56 PM PST
Very informative. You mentioned Kellogg's corn flakes as a possible small source of Vitamin D . My understanding is that this product contains Maltodextrin (or something similar to that), and is not a gluten free item. I actually really liked this stuff, so I phoned their 1-800 number and they confirmed the non-gluten free status for this product.

 
Irene
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said this on
21 Mar 2008 3:00:55 PM PST
Thanks for this article. I sympathize with you about your immune problems. I am the same way - plagued by bladder infections and facial cellulitis. My urologist recently started me on D-Mannose. It is a sugar molecule that attracts, like a magnet, bacteria in the bladder so it passes right through and doesn't get an opportunity to burrow into the bladder wall. It might be worth a try to see if it works for you.

 
val
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said this on
11 Jul 2012 5:13:54 PM PST
I too have been diagnosed with celiac disease and consistently get facial cellulitis, for which I am always on antibiotics. What did your doctor tell you to do about this? I am just curious because I hate taking antibiotics as it consistently hurts my stomach.

 
Anita Lesniak
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said this on
06 Apr 2008 4:50:06 PM PST
I'm so glad that I read this article as I am taking 50,000 of vitamin D a month and I have asked the doctor if he thought it was safe and he told me that it was now--I'm a little leary about taking it has anyone taken that much.

 
Kim
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said this on
02 Oct 2009 10:40:23 PM PST
I was recently diagnosed with several different disorders, celiac being one... but that have nothing to do with doctor prescribed 50,000 per week of vitamin D--NO dr. has ever discussed with me the connection..... hope you are doing well.

 
Fatima
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said this on
05 Oct 2009 10:21:37 PM PST
Hi Anita,
My name is Fatima, and I live overseas in Jordan. I had an elevated PTH and vitamin D deficiency for over 10 years! and just recently my PTH level came down to normal, and my vitamin D is up to normal level by using a 50,000 powdered vitamin D once every week for 2 months, and then 5000 every other day for another month. And this is how my deficincies and PTH were corrected. Hope this help.

 
kAY
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said this on
20 Feb 2013 4:41:12 PM PST
I have been taking 50,000 milligrams of vitamin D once a week for 9 months and my level is only 17. They say it won't hurt you because you don't have enough to begin with. My Level was only 7 when I started.

 
david
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said this on
14 Jul 2008 9:16:48 AM PST
You forgot to mention pure cod liver oil - perfectly safe - read great articles about vitamin D.

 
flannery
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said this on
07 Jul 2010 8:33:50 PM PST
Cod liver oil is not safe in large doses because of the Vitamin A.

 
Dr S Dabhade
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said this on
18 Oct 2008 7:32:49 AM PST
Perhaps the best article I have read with reference to Vitamin D and immunity and diet. It was more useful to me than any medical article I could put my hands to. It gives more solid facts without talking gibberish. Thanks.

 
Sarah
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said this on
12 Mar 2009 12:47:32 PM PST
This article is helpful.

 
Christie C
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said this on
28 May 2009 1:39:39 PM PST
Anita I am taking 50,000 every 2 weeks for the next 5 months. I believe this is the norm when the deficiency is severe.

 
hanka
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said this on
15 Jun 2009 11:53:13 AM PST
fish oils like Tran are good source of Vitamin D if you live up north like me. I moved to Norway and I notice I tend to get ill if I 'forget' my Tran in a longer period of time. Norwegians say that you should take it all months including 'R' in their name: September to April.

 
Ann
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said this on
08 Jul 2010 5:18:34 PM PST
I beg to differ regarding this sentence: "Vitamin D causes disease when taken in large amounts". In reality, you'd have to take a lot before that would happen (most people would not take more than 20 000iu per day). However, when taking large doses, you need to get enough magnesium, as well as some zinc, K2 and calcium - either from diet or supplements. With magnesium, you'd need supplements, though. About 400-1000mg per day, and your body will usually tell you how much you need. Get a good bio available brand.

 
Karen
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said this on
29 Nov 2010 12:46:51 PM PST
I have read that celiac CAUSES low D. Not the other way around. Celiacs blocks D. Not sure it won't cause more pain when you take supplements. It caused more pain for me. I am still searching.

 
latvianlass
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said this on
17 Mar 2012 8:58:10 PM PST
I just read the informative book "Wheat Belly" by William Davis, MD. The author points out the relationship of celiac disease to the prevalence of wheat in the American diet, and he means all wheat, including "healthy" gluten-free bread. I think this book is a good read for anyone with nutrition and digestion problems. Will keep you posted on how I do on a (challenging!) wheat-free diet.

 
chris
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said this on
23 Mar 2012 8:39:42 AM PST
A very helpful article. I am newly diagnosed and am just now realizing why, for as long as I can remember my nails would peel like paper and I couldn't grow them except in the summer!

 
restorationgirl
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said this on
15 Jul 2012 5:02:04 PM PST
I did an elimination diet to find out what was making me like a narcoleptic. After I started adding foods back in, the symptoms for all food groups across the board were out of control - I seemed to be allergic to everything. Your article gives me renewed hope. One of the supplements a doctor had given me after doing testing was Vit D3-5 from Bio-Tech. I had stopped taking it along with 5 other supplements for reasons I won't bore you with. I think I'll add in the vitamin D and see if that makes a difference. I'm also vitamin C deficient to the point of scurvy, but can juice with my Omega 8400 Juicer with no problem (when I'm awake!)

 
Amit
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said this on
06 Aug 2013 7:56:35 AM PST
Informative article. My daughter has recently been diagnosed with celiac disease at a tender age of 1.5 years. Doctor has assured that egg yolks and pure cow milk may be taken. From the article and comments followed, I cannot understand if celiac patients can digest egg or milk.




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