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  • Tina Turbin
    Tina Turbin
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    Side Effects of a Gluten-Free Diet and How to Manage Them

    If you’ve been diagnosed with celiac disease, you probably know all about the painful and often uncomfortable physical and mental symptoms and are fortunate to be rid of them with a gluten-free diet. However, avoiding gluten doesn’t mean that your health and well-being are guaranteed, but fortunately you have taken a major step in preventing serious and potentially fatal complications of long-term, untreated celiac disease. There are a few side effects, you could say, associated with a gluten-free diet, but thankfully there are solutions to manage them as you adjust to your new lifestyle.

    First, it’s not uncommon to gain weight when you cut gluten out of your diet. Many celiac patients are thin and sickly-looking before their celiac diagnosis, as the damage caused to small intestine prevents the absorption of food. After being on a gluten-free diet for some time, when the intestines have begun to heal, the nutrients and calories in foods get absorbed better. Even though you may not be consuming any more calories now than in your gluten-eating days, it's likely that you're going to gain some weight. In fact, studies have shown an increased risk for obesity for gluten-free dieters. However, some people actually lose weight, as the changes to your diet may cause a decrease in caloric intake. Watching your caloric intake and regular exercise can help deal with any weight gain you may experience.

    Patients who are newly diagnosed with celiac disease often find that they have nutritional deficiencies, and what’s worse, gluten-free products are often low in B vitamins, calcium, vitamin D, iron, zinc, magnesium, and fiber and aren’t fortified in these nutrients. When Swedish researchers studied adult celiac patients who had been gluten-free for ten years, they found that half of them had vitamin deficiencies, including low levels of vitamin B-6 or folate, or both, and high levels of homocysteine, a risk factor for heart attacks, vascular disease, and strokes. Before the study, all the patients had biopsies to prove their intestines were in healthy condition, so these vitamin deficiencies could not be explained by malabsorption. Italian researchers have found similar deficiencies in gluten-free adolescents. I recommend that at your annual check-up, you should ask your doctor whether your vitamin status needs to be measured and whether you should be taking folic acid and vitamin supplements.

    Another thing to watch out for is increased cholesterol levels. For the first part of my life, when I was eating gluten-containing foods, doctors were amazed by my low cholesterol levels. The reason for this was that my intestines weren’t absorbing the cholesterol in my food. Now I need to pay attention to my cholesterol levels just like other people. This means checking food nutrition labels for not only gluten but also fat and cholesterol content, selecting low-fat, low- low-cholesterol foods. Watch out for packaged gluten-free products, which often have more fat than the gluten-containing foods they substitute, especially gluten-free cookies, crackers, and cakes. The American Heart Association recommends eating high-fiber foods to help lower cholesterol.

    Other side effects of a gluten-free diet include constipation, gassiness, and diarrhea. When you replace the bread and pasta in your diet with only processed white rice, you reduce the fiber in your diet, which may cause constipation. On the other hand, adding foods rich in fiber, such as quinoa, in large amounts and too quickly, can cause gassiness and diarrhea.

     I was diagnosed with celiac disease many years ago, and since then I have adopted a healthy, gluten-free lifestyle. This was initially quite a challenge, but now I’m reaping the benefits of this new way of life. As a celiac advocate I stay connected to the celiac community and keep abreast of the latest research. This is the first and fundamental step I recommend to celiac patients as they adjust to and manage their gluten-free diet—stay informed.


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    Another thing to watch out for as your intestines heal - improved absorption of medications! You may find you are able to/need to reduce your pre-celiac diet dosage (after discussing with your doctor).

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    Another thing to watch out for as your intestines heal - improved absorption of medications! You may find you are able to/need to reduce your pre-celiac diet dosage (after discussing with your doctor).

    This is absolutely correct and a very good point. You can also receive tests to determine your increased or lack of absorption of minerals and vitamins as you attempt the healing process as mentioned. Thank you for this input and a very important point.

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    Gluten free dieting has been a life long struggle for me. I find there is no quick and easy solution to this. I have tried many different things and diet and exercise seem to work the best. Although, I have found a few supplements and programs that seem to work better than others or at least aid in this never ending endeavor, it is a lifestyle more than anything.

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    I have a very weak stomach and cannot in fact stand taking in gluten. Thankfully there are now gluten free products (though they are very expensive, but compromising one's health is never an option for me), now I need to reorganized my life and you are right Tina when you said that one needs to do checking for cholesterol level and fat content products. I just wish I am still young again.

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    Celiac disease has been very tough for me. I am only 15 years old and love the cakes and cookies, but i can't really have any of those sweets unless they are gluten-free. But i have noticed that I am living a healthier lifestyle. Sadly, I am still rather short and skinny, and so far this gluten-free diet hasnt helped me grow.

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    I am 23 and just found out I have celiac disease. I am only on the gluten-free diet one week now and my symptoms have worsened. Stomach cramps are crippling and I have constant diarrhea and have lost even more weight and I amstill drained! i was wondering are these symptoms normal? Is it because my body is detoxing? I have been strict with the diet so I'm confused as to how I'm feeling this poorly! Any help/advice would be much appreciated.

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    I am 23 and just found out I have celiac disease. I am only on the gluten-free diet one week now and my symptoms have worsened. Stomach cramps are crippling and I have constant diarrhea and have lost even more weight and I amstill drained! i was wondering are these symptoms normal? Is it because my body is detoxing? I have been strict with the diet so I'm confused as to how I'm feeling this poorly! Any help/advice would be much appreciated.

    Yeah. I had the same thing. It's normal and it sucks. You MUST take dairy out of your diet until your intestines are healed, or you will feel even worse and you may not be able to tolerate milk. Plus taking it out of your diet may cause you to heal faster. Make sure to get a strong DAIRY-FREE probiotic. I recommend the Cocobiotic drink if you are not allergic to coconut. Whole foods also carries many non-dairy probiotics such as coconut kefir and almond yogurt. Lemon water and ginger is also a godsend for the gut. Also try to avoid foods high in acid such as tomatoes, fried food, chocolate, and tofu till you feel much better.

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    In response to Denise, feeling worse one week after giving it up is normal. Your body is going through withdrawal. Gluten or anything you are allergic to acts as if it is a drug. Your body adapts and becomes dependent on it, so when you take it out of your system initially many feel worse. This is what my doctor explained to me, so I was prepared when I went through withdrawal effects.

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    So glad I found this article. Like Denise said, I'm on day 4 of my diet change and I feel my symptoms are worse now then when I had the gluten. Hoping week 2 I feel better. Also, I've been a bigger girl for some years now so I was hoping I would lose weight with the change. Sad to hear most gain.

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    Unfortunately, my doctor has advised me that the "withdrawal" symptoms can go on for months. So, be sure to check in with your doctor if you feel these symptoms have gone on for too long, but your body can talk much longer than a couple of weeks to adjust.

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    I went to ER a couple weeks ago with overwhelming stomach pains, like starting in between my rib cage and just rolling on down. I woke up with urgent diarrhea running to the bathroom several mornings in a row. I tried antacids, Advil, Pepto, nothing worked. So to make a long story short, I thought it was my gallbladder. They did a sonic, nothing there. Gave me an IV for slight dehydration, some medications to settle stomach and sent me home with meds. The doctor asked for very little history, even after I told him my brother has celiac. I am just grateful to find sites like this. Many people say I need allergy testing but I really do not have a lot of faith in 'modern medicine'. I know my body better than anyone. I decided to try the gluten-free diet on my own and the first week I felt AMAZING. I did not feel 'heavy', mind was more clear. The second week I splurged for just ONE day. One cup of coffee, one piece of bread and one small piece of sausage(it was gluten free). I was in same pain again for two days and could not get it under control without meds AND Pepto. Lesson learned!

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  • About Me

    Tina Turbin is a world-renowned Celiac advocate who researches, writes, and consults about the benefits of the gluten-free, paleo-ish, low carb and keto diets, and is a full time recipe developer and founder of PaleOmazing.com. Tina also founded and manages the popular website, GlutenFreeHelp.info, voted the #2 .info website in the world. Tina believes that celiacs need to be educated to be able to make informed decisions and that Paleo needs to be tailored to the individual’s physiology to obtain desired results. You can reach her at: INFO@PaleOmazing.com.

  • Related Articles

    Scott Adams
    This article originally appeared in the Summer 2002 edition of Celiac.coms Scott-Free newsletter.
    Celiac.com 03/29/2006 - I recently reviewed the results of a Celiac.com survey, and was surprised to learn that 37 percent of 472 respondents do not believe that there will ever be a cure for celiac disease, while 32 percent think there will be, and 31 percent are unsure. After reading the question again I realized that it might be loaded—does the gluten-free diet count as a cure? Some people think so. Others think that the diet is a curse, or at best just a treatment. With the vast improvement that has taken place during the last few years in the quality of gluten-free foods I like to think of the diet as really good tasting cure. Of course the diet isnt really a cure, but the proof is in the pudding, and the diet has allowed my body to become healthy again and make me feel as though I am cured, and that is what counts—isnt it?
    Like most people, however, I still hold out hope that all the celiac disease research that will be done in the future will yield a cure—one that does not include a special diet. But be careful what you wish for because if you are like me your diet is probably healthier now than it ever was, mostly due to the necessary avoidance of most fast and processed foods. Perhaps the diet is really a blessing in disguise for many of us, and we will actually live longer and healthier lives due to it, in spite of having a "disease." But at the rate they are currently spending money on celiac disease research there will never be a cure—you say? After reading Laura Yicks summary of this years Digestive Disease Week International Conference in San Francisco (pg. 8), which includes a proclamation made by Dr. Alessio Fasano that celiac disease is "by far the most frequent genetic disease of human kind," I have renewed confidence that there will be a lot more money spent on research in the future, and eventually a cure will be found.
    More surprises in the survey results came when 6.5 percent of respondents said spelt was safe for a gluten-free diet, while 32.3 percent were unsure. I like to interpret this result as 38.8 percent of respondents were just diagnosed and are on their first visit to Celiac.com—but this is wishful thinking. Unfortunately this result means that we have more work to do (spelt is not safe!). The most surprising response, however, was how many people cheat on their diets—a full 43 percent! Some 13 percent actually cheat 20-40 times per year or more. The main excuses for cheating: 1) People missed a particular item too much to go without it; and 2) Gluten-free foods are not always available or are too expensive. These were the same folks who got the spelt question wrong—the ones who were just diagnosed, right? We have more work to do...
    There are just too many great alternatives out there to knowingly eat gluten. After learning so much over the years about food ingredients and preparation I like to think that I could walk into a restaurant called "House of Gluten" and order a gluten-free meal. Educating yourself about how food is prepared and which ingredients are safe or not safe is really the key to enjoying life while on this diet. Remember, the next time you are tempted, say to yourself over and over—this diet is a really good tasting cure—and dont cheat! Oh no...65 percent of respondents dont know that buckwheat is safe, and 58 percent dont know that Quinoa is safe...time for me to get back to work—enjoy Scott-Free!

    Paul Smith
    Celiac.com 05/04/2009 - Nowadays every type of food you can desire is available in a convenient form, ready to be popped into a microwave or an oven. This demand for convenience has caused grain consumption to escalate. If you think you don’t eat that much grain (and gluten), think again: much of the gluten that you consume is hidden - you don’t even know you're eating it!
    For example:

    Food Manufactures add “vital gluten” (gluten that is specifically processed from high-gluten-contained wheat) to wheat flour to give it more binding power. Gluten is used in the manufacturing of virtually all boxed, packaged and tinned processed foods to create textures that are more palatable to our taste buds, and are used as binders, thickeners and coatings. Gluten is even used to make many commercial glues such as those used on envelopes and stamps. Even if you were consuming the same amount of grains today as you did last year or 10 years ago, you would be ingesting more gluten. That’s because bio-engineers continually work to improve gluten and make it a larger and more potent part of edible grain. It is estimated that today’s wheat contains nearly 90 per cent more gluten than wheat did from a century ago.
    To get an idea of how much hidden gluten you might be consuming, take a walk down the aisles in your supermarket and stop to read the labels. You’ll find wheat, barley and / or rye in products like:
    Barbecue sauce Biscuits and cakes Breaded fish, chicken and seafood Bread - even potato bread and rice bread Cereal Couscous Crackers Potato crisps Most frozen dinners Pies and Pasties Rice Mixes Sauce and gravies Some ice creams Some salad dressings Some soy sauces Teriyaki sauce Tinned and dried soups And many, many more items!

    Jefferson Adams
    Celiac.com 04/11/2011 - After years of being relegated to the specialty foods category, gluten-free foods have gone mainstream.  Since 2005, sales of gluten-free products have more than doubled, and the number of new gluten-free goods is expanding rapidly.
    Rockville, Md.-based research firm Packaged Facts, calculates that U.S. retail sales of gluten-free products rose from just under 1 billion dollars in 2006 to $2.3-billion dollars in 2010. 
    The firm's 2011 Gluten Free Foods and Beverages report projects those sales to to top $2.6 billion dollars by 2012, and to nearly double to $5.5-billion by 2015. A similar trend is under way in Canada, although precise national figures are not available.
    Recently, cereal giant General Mills transformed its popular Rice Chex cereal into a gluten-free product without any change to the taste, simply by substituting molasses for barley-based sweetener. General Mills also acquired the Larabar brand of gluten free nutrition bars with an eye toward expanding that brand. As of November 2010, General Mills claims to offer 250 gluten-free products, including five varieties of Chex and numerous products under the venerable Betty Crocker and Bisquick brands.  
    As vastly more people buy gluten-free foods as part of a healthier lifestyle choice, rather than just to address celiac disease or dietary intolerances, those products are no longer "regarded as a niche product that was only of interest to people who couldn’t tolerate wheat, gluten-free foods and beverages."
    Rather, this newfound interest beyond the traditional gluten-free market has quickly transformed gluten-free products into what Packaged Facts calls a "mainstream sensation, embraced by consumers both out of necessity and as a personal choice toward achieving a healthier way to live."
    While many market researchers looking into the growth of the gluten free market have speculated that under-diagnosis of celiac disease is a major driver, Packaged Facts found that this may not be the case.
    Packaged Facts conducted a online nationwide survey of 1,881 adults in fall 2010, including 277 consumers of gluten free products. Survey results showed that nearly half of people (46%) who buy gluten-free foods and beverages did so based on a perception that they are ‘generally healthier’. Thirty percent of gluten free consumers said they did so in an effort to manage their weight and 22 percent said they thought gluten free products were ‘generally higher quality’.
    Only about ten percent of gluten free consumers said they bought gluten free products because they or a member of their household has celiac disease or an intolerance to gluten, wheat or other ingredients.
    “Interestingly, 13 percent buy gluten free foods to treat other conditions that may or may not be associated with diet,” the report notes.
    Packaged Facts also found that food manufacturers are blending more ancient grains, such as quinoa and amaranth into their gluten free products, whites increases nutrition, and may enhance flavor.
    “Enrichment and fortification are smart marketing under just about any circumstances, but for gluten-free foods it’s a more critical issue, as gluten-free diets are often lacking in essential nutrients,” the report said.
    Further reading:

    http://www.prlog.org/11268541-gluten-free-foods-and-beverages-become-mainstream-sensations-as-part-of-healthy-lifestyle-choice.html http://www.theglobeandmail.com/life/food-and-wine/gluten-free-has-gone-mainstream-but-how-long-will-that-last/article1890365/

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    Thank you for responding. No I have not been tested for celiac disease. My ths free t3 free t4 were all normal. My reverse t3 was a bit high and my tg antibodies were high. Also I have low blood pressure and low testosterone. The whole reason I went to see the doctor in the first place was because I had nausea and acid reflux for no apparent reason which I hve recently discovered is connected to hashimotos. I have just been to a dentist because I have untreated periodontal disease which we suspect may be causing everything. We are in the process of fixing that as well. So far the gluten free diet along with probiotics and L glutamine are helping a lot with the stomach issues.
    In my saga to get diagnosed, I had an IgA blood test (I had been eating gluten for a few months). It came back negative. I managed to see the dermatologist yesterday (woo hoo!) who said my rash is "consistent with DH" but he would not say it was DH. He did two punch biopsies which will be ready in about a week. My primary care sent me an email saying that because the IgA is negative, I do not have celiac disease. So hoping the biopsy shows something. Why will no one give me a diagnosis??? I'm going out of my mind. I do not want to go gluten free unless I have to because I already have several restrictions on what I can cook for my son with multiple food allergies, and wheat is a big part of his diet (he is allergic to peanuts, tree nuts, soy, eggs and sesame). I'm at my wits end.   Thanks for being so supportive everyone!
    According to the Celiac Disease Foundation, as many as 1 in 100 people suffer from celiac disease worldwide, an autoimmune disorder that attacks ... View the full article
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