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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.

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12 Responses:

 
fiona
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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.

 
Chris
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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.

 
katzjacobs
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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.

 
Zach
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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.

 
Denise
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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.

 
Sarah
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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.

 
jen
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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.

 
Lisa
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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.

 
Amanda
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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.

 
Wyn
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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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That makes sense...I cried with relief when I got my diagnosis just because there was finally an answer. Please know that you are not weak or crazy. Keep pushing for testing. It could still be celiac, it could be Crohns. Push your Dr's to figure this out. Best wishes.

Thank you all very much. I actually cried when I got the answer. I wanted an explanation that I could "fix." Now I'm back to thinking I'm just weak and possibly crazy. I know I'm not crazy, but you know.

From what I have read online there is about a 1-3% chance of getting a false positive for celiac disease from a blood test. Was it a blood test that you got done? It may be worth your while to get a biopsy or more testing just to confirm it. I know being gluten free is a pain but it is better than getting cancer or other auto immune disorders.

I prefer edible candy. I have glaucoma and celiac so it helps me on a daily basis for all of my medical problems. I wish I could find a strain that has laxative effects so I didn't need linsess. Leafly.com has a lot of strain information and cannabist is a good resource, too. You can use CBD or THC and not get 'stoned'. I function fine on 20 mg of the candy. I refuse to drive if I smoke though. Good luck, hope it helps.

Is it NCGS or Low stomach acid misdiagnosed Low Stomach Acid and Celiac Disease Dear Gluten Intolerant please consider Low Stomach Acid as a possible Differential Diagnosis as a possible way to achieve remission of your GI symptom's. ?Consider what I say; and the Lord give thee understanding in all things? 2 Timothy 2: 7 Low stomach acid has now been linked to a probable cause of damage to the Small Intestine before and/or occurring with a Non-Celiac Gluten Sensitivity (NCGS) or Celiac diagnosis. See this research as reported on celiac.com that discusses the increased risk of/for someone to develop celiac disease after taking PPI?s. http://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html Note how the article starts quoting ?Rates of celiac disease and the use of drugs to inhibit the secretion of stomach acid have both increased in recent decades. A research team recently set out to explore the association between anti-secretory medication exposure and subsequent development of celiac disease.? If these medicine are lowering stomach acid what cause effect relationship does/ could this have on Celaic/NCGS diagnosis is what he is postulating. He goes on to say without being very technical (read the whole article for yourself) that ?The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following the use of these medicines. The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the celiac disease diagnosis suggests a causal relationship?. If even after a year OFF these medicines your chances of developing Celiac Disease (celiac disease) not to mention even NCGS which is much more prominent surely the researcher is correct in postulating that there is a cause and effect relationship between low stomach acid and NCGS and/or Celiac disease. Surely there is something we can learn here. I now postulate some homework for the reader of this blog post. Do some research for yourself and see if achlorhydia or hypochlorhydia symptoms don?t at least resemble in some manner all of the GI symptoms you have been having. (I note some of the many symptom?s low stomach acid can present with below as referenced from Dr. Myatt?s online article ?What?s Burning You? for easy reference (It might not be what you think (my words)) It is important to note here that ?some? symptoms does not mean all but many or several. It is called a differential diagnosis. It is an important diagnostic tool in medicine. Think of the tv show ?House? where they spend the whole hour/over a week times going through the ?differential diagnosis? in short any one symptom can/have many different causes. The trick is how to quickly eliminate possible outcomes as symptoms (many) go up. All is usually never meet because that would make the disease in full outbreak and obvious even to the layman a condition described as ?frank? or ?classic? Scurvy or Rickets as an example. Sadly too often after 8 to 10+ years of testing after all the differential diagnosis?s are ruled out you are said by process of elimination to have Celiac Disease if you are lucky or maybe NCGS and not some other acronym GI disease as I like to refer to them as a group. GERD,IBS,UC, Chrons etc because if they turned down that street ? . you are/could be in/at a dead end for they stop looking at the trigger (gluten) as the cause of your gastric upset/digestive disorder(s). So in summary if 3 or 4 or 5 or 6 of these symptoms overlap ?many of? these symptoms could be Low Stomach Acid related. IF that is the cause/case for you then there is hope! For remission! From Dr. Myatts? Online article what?s burning you? From Dr. Myatts? Online article what?s burning you? http://healthbeatnews.com/whats-burning-you/ Diseases Associated with Low Gastric Function Low stomach acid is associated with the following conditions: * Acne rosacea * Addison?s disease * Allergic reactions * Candidiasis (chronic) * Cardiac arrhythmias * Celiac disease * Childhood asthma * Chronic autoimmune hepatitis * Chronic cough * Dermatitis herpeteformis * Diabetes (type I) * Eczema * Gallbladder disease * GERD * Graves disease (hyperthyroid) * Iron deficiency anemia * Laryngitis (chronic) * Lupus erythromatosis * Macular degeneration * Multiple sclerosis * Muscle Cramps * Myasthenia gravis * Mycobacterium avium complex (MAC) * Osteoporosis * Pernicious anemia * Polymyalgia rheumatica * Reynaud?s syndrome * Rheumatoid arthritis * Scleroderma * Sjogren?s syndrome * Stomach cancer * Ulcerative colitis * Vitiligo When low in stomach acid we become low in essential nutrients Quoting from Dr. Myatts ?what?s burning you? online article ?Our bodies need 60 or so essential nutrients. ?Essential? means that the body MUST have this nutrient or death will eventually ensue, and the nutrient must be obtained from diet because the body cannot manufacture it. Many of these essential nutrients require stomach acid for their assimilation. When stomach acid production declines, nutrient deficiencies begin. Calcium, for example, requires vigorous stomach acid in order to be assimilated. Interestingly, the rate of hip replacement surgery is much higher in people who routinely use antacids and acid-blocking drugs. We know that people who have ?acid stomach? were already having trouble assimilating calcium from food and nutritional supplements due to lack of normal stomach acid production. When these symptoms are ?band-aided? with drugs which decrease stomach acid even more, calcium assimilation can come to a near-halt. The result? Weak bones, hip fractures and joint complaints resulting in major surgery. Jonathan Wright, M.D., well-known and respected holistic physician, states that ?Although research in this area is entirely inadequate, its been my linical observation that calcium, magnesium, iron, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum, cobalt, and many other micro-trace elements are not nearly as well-absorbed in those with poor stomach acid as they are in those whose acid levels are normal. When we test plasma amino acid levels for those with poor stomach function, we frequently find lower than usual levels of one or more of the eight essential amino acids: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Often there are functional insufficiencies of folic acid and/or vitamin B12.? Remember, these are essential nutrients. Deficiencies of any single one of them can cause serious health problems over time. Weak bones, diminish immune function, failing memory, loss of eyesight and many other ?diseases of aging? are often the result of decreased stomach function.? It is me again reader. So low stomach acid is the triggering agent (often) for low nutrients. Make too much sense! Now don?t take Vitamin?s for this condition where low Vitamins/Minerals are known to be low in patients who have this condition because . . . . (if you do you won?t need to keep coming back to the doctor) I can almost hear the doctor say now. Of course he/she doesn?t say that . . . just that the ?average person? doesn?t need to take Vitamins. Well I hate to break it too you . . . . but if you are having GI problems and reading this blog post on celac.com then you are not the ?average? person. You my friend or a sufferer or a friend of a sufferer still looking for answers. If that is you then consider taking either powdered stomach acid ? Betaine HCL or taking Niacinamide to help you reset your stress clock. A Canadian researcher wrote about this connection 15+ years ago but still most doctors? don?t understand this connection between about how ?Niacin treats digestive Problems? Here is the full link so you can research it more yourself. http://orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml And you might not after a first reading. I didn?t believe it myself for over a year . . . but every time I thought about it ? it (Low Stomach Acid) made/makes the most sense to me. **** Note: research this yourself. Here is a link about how to take Betaine HCL (powdered stomach) for maximum effectiveness. http://20somethingallergies.com/how-much-hcl-do-i-take-learn-to-test-for-your-correct-dose/ Don?t take my blog post as medical advice. It is only what I did . . . it might not work for you but I think it is worth a try especially if you are not now taking an acid reducer. (see notes below about why this might) be more difficult if you are already taking an acid reducer . . . because the rebound wall (see chris kresser link) keeps us locked in . . . sometimes for years. Since I was not taking acid reducers at the time I took Betaine HCL my stomach problems improved and I am sharing this now in the hopes it might help yours too! Now back to (really) LOW stomach acid being diagnosed as HIGH stomach acid these days. How can we know if it truly high or low? You?ve heard the phrase timing is everything well it is here too! Timeline is important in any diagnosis. IF your stomach acid was HIGH as you often hear (everywhere) you hear take a Proton Pump Inhibitor aka acid reducer?s for heartburn/GERD (medical name for heartburn) then eating food (carbs, greasy things) wouldn?t bother you. The acid would cut it up but if it is already low/weak then even a little acid can burn your esophagus which is not coated like the stomach to protect you from high acid. BUT if it is low to start with then food will WEAKEN our/your acid so that you lose the food fight your in and things (carbs/fats) become to ferment, rancidify and cause heart burn. Leading in time to Non-Celiac disease first and with enough injury (and time) to Marsh lesions qualifying you for diagnosis as a Celiac candidate / patient. See above link between/about PPI?s in the year preceding a Celiac diagnosis. If you (can) be that patient and weight the xx number of years for all this damage to occur, there is a better way it is called digestion! A virtuous cycle can replace the vicious cycle you are now in ? it is caused digestion. Digest your food with healthy stomach acid and your body will thank you for it with the God given burp. A healthy child burps (at 6 months of age normally) and a healthy adult should too and you will again after taken Niacinamide 3/day for 6 months or this is not the right diagnosis. *********Note this is not medical advice only my experience with Niacinamide and my many years researching this topic as a fellow sufferer. Let me make these disclaimer(s). If you are a) experiencing heartburn that causing vomiting (with unintended weight loss) you may have a special case of heartburn that feels like heartburn (on steroids) that is really Bile Reflux and taking Stomach is not something you should do without medical advice and supervision. See this NYtimes article that discusses the many complications often seen with Bile Reflux patients and why it is treated as Heartburn often and why Bile Reflux is especially hard to recover from. http://www.nytimes.com/2009/06/30/health/30brod.html you are already taking an acid reducer then the chance you will get better (off of acid reducers completely) is only 50/50 on your first try but going low CARB can help your transition. Otherwise most people will get better when taking BetaineHCL for gastric support and Niacinamide to help them/you reset your digestive processes. See this online article about how Jo Lynne Shane got off Nexium for good. http://www.jolynneshane.com/how-i-got-off-nexium-for-good.html and her Epilogue http://www.jolynneshane.com/epilogue.html You will see she still struggles some but is much better when she let her natural digestive juices do their job. I call it the ?Natural Order of Things?. See this article about the digestion process being a North South Affair from the bodywisdom website http://bodywisdomnutrition.com/digestion-a-north-to-south-process/ Taking it (Niacinamide) (or any B-Vitamin) should be taken 2 to 3/day (too keep up serum levels) for 3 to 4 months (the time you can store B-Vitamins) in the liver mostly. Once you have a distinctive BURP that displaces the bloating and sense of ?I am going to explode? if I eat another bite (though you haven?t eaten half your meal) then normal digestion is occurring again. If you stool did not sink before this process (of taking Niacinamide begun) and burping became your ?new normal? then it (your stool) will begin to sink too! Burping without bloating is the ?Natural Order? of good digestion. Don?t stop this process of taking B-Vitamins as Niacimaide or Slo-Niacin 2/day for at least 4 months then you should see most of your GI symptom?s go into remission. (I did not say "cure" but remission from your cross contamination's (flares/symptom's etc.) might be possible. Because our defenses are now strong enough to cut up proteins before they reach our small intestine (where most of the damage is done). Think of a castle with a moat around it (stomach acid is designed to protect us) when it is low (the moat doesn?t protect us) and when the moat is dry the castle becomes a ruin!!! So do proteins (lactose (casein), gluten, soy, seafood etc.) to our small intestines (they become ruined) when our stomach acid (moat) is low or worse dry! I repeat again Timeline is important in any diagnosis. All heartburn is not equal. IF your stomach acid is truly high then it WILL occur between meals when there is no food to tamp down the fire (occurring in your stomach) not your esophagus. The excess pressure from fermented carbs push open the trap door allowing the low acid you have to burn the lining of your uncoated esophagus. See also this online article by Chris Kresser to study this more about why/how this could be a case of medical misdiagnosis in more detail https://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd/ This is part of a 3 part series that I think you will find very informative. This (low stomach acid) is a vicious cycle. STRONG stomach acid makes it a virtuous circle/cycle. Now food benefits you because low acid not only causes heartburn it limits your body?s absorptive ability by limiting its ability to cut up your food into digestible peptides and amino acids which are no longer harmful to your Small Intestine but helpful to your overall health because nutrients can now be absorbed because the food particles are now small enough to not cause harm to your villi. I hope this is helpful and it helps you the way it helped me. Maybe it will help you in a similar manner. I write this only as a guidepost on your way. May you find your way back to digestive peace! The ?Natural Order? of things! Praise bee to God! It is not a long way if you know the way . . . . from someone who has found his way back God being his help! There are more things I could say . . . but this post is getting kind of long but you get the gest. I noticed someone else on the celiac.com noticed the same improvement when they treated their low stomach acid and thought it was time a blog post talked about it. It is so much easier to consume all this information in one setting instead of hunting and peeking through several thread posts. Search for the posterboy on celiac.com and you will find it is my focus (how low stomach acid is misdiagnosed) and how Niacinamide helped me to restore its ?Natural Order? in the digestive process because it helped me! Here is the link to the Prousky?s abstract. 15+ years is a long time for people to continue to suffer but if the research it right then Niacinamide might help you too! http://www.yourhealthbase.com/database/niacin-treats-digestive-problems.htm Let?s hope it is not another 15 years before doctor?s and people realize low stomach acid can explain many of the same symptom?s an IBS, NCGS or even a Celiac patient might experience given a long enough time for these conditions to develop from too low a stomach acid to protect our Small Intestine. See link at start of this blog post posted here again for convenience. http://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html And it is worth noting about the time Celiac disease started (began to be more prevalent) / to increase in the population Acid reducer?s became more and more popular. *** Some plot the increase in time to Roundup usage but I am not buying it. PPI?s increase seam more plausible to me based on the relatively new research (less than 5 years old) is pretty current by research standards and the near linear response to increased first H2 stomach acid reducer?s then PPI?s in the population at large. *****Note: after I finished writing this blog post new research that in my mind confirms this connection was reported on celiac.com today that notes the link between gastric pH and impaired nutrient absorption. This very topic as I was getting ready to publish my post about low stomach acid possibly being diagnosed as Celiac disease on my posterboy blog mentions how a Celiac patient?s absorption can be impaired by gastric pH. https://www.celiac.com/articles/24738/1/Can-Celiac-Disease-Impair-Drug-Therapy-in-Patients/Page1.html Where they (researchers) say/ask discussing Celiac Disease and whether it (celiac disease) can impair drug therapy in patients. Note the opening paragraph discussing this topic quoting ?Celiac disease is associated with numerous chronic conditions, such as anemia and malabsorption of some critical vitamins. Changes in the gastrointestinal tract, rates of gastric emptying, and gastric pH are responsible for impaired vitamin and mineral absorption." i.e., low gastric pH can effect absorption. It stands to make reasonable sense to me they are related conditions and one is being diagnosed for the other often or at least one is being confused as the other and treating one (raising your stomach pH) might treat the other since many of the symptoms? are the same. *** this/these opinion(s) are my own and do not reflect an endorsement by celiac.com of these ideas, comments, thoughts or opinions. I hope this helps! You the way it did me! Good luck on your continued journey, Remember **** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your regimen. 2 Timothy 2:7 Consider what I say; and the Lord give thee understanding in all things. Posterboy by the Grace of God,