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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.

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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. welcomes your comments below (registration is NOT required).

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12 Responses:

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said this on
17 May 2010 1:33:54 PM PDT
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).

Tina Turbin
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said this on
19 May 2010 3:02:02 PM PDT
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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said this on
21 Jan 2011 8:57:50 AM PDT
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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said this on
09 Jul 2011 11:15:59 PM PDT
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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said this on
08 Jun 2012 5:25:46 PM PDT
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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said this on
08 Sep 2012 9:01:24 AM PDT
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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said this on
08 Apr 2013 8:23:32 PM PDT
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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said this on
09 Jun 2013 6:13:36 AM PDT
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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said this on
05 Sep 2013 7:25:36 PM PDT
Very good information. I found every point helpful. Even the comments are helpful. Thank you.

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said this on
10 Oct 2013 12:13:04 PM PDT
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.

Denise too
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said this on
23 Jan 2014 8:09:23 AM PDT
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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said this on
03 Jun 2014 10:13:04 AM PDT
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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