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Malabsorption & Vitamin Deficiencies


ElizFost

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ElizFost Newbie

How do you correct the vitamin deficiencies caused by malabsorption. I take a good multivitamin daily and yet I am anemic. How does a celiac get the nutrients they need. I'm thinking liquid vitamins, or whole food vitamin or juicing? Or is the situation that your body won't absorb them whatever you do?

I'm seeing that I have gluten, lactose and fructose intolerance issues. I assumed I would recover if I got off gluten but almost 2 years later have discovered the malabsorption issue as well as lactose and fructose intolerance.

I have a 2 year old Down Syndrome daughter who is gluten intolerant and so I'm trying to figure out how to help her as well. I have a support group for her issues and they are all into the natural health medicine but I want to ask this question of you because you are more familiar with the celiac condition. Thanks.


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+jasonparker Newbie

How do you correct the vitamin deficiencies caused by malabsorption. I take a good multivitamin daily and yet I am anemic. How does a celiac get the nutrients they need. I'm thinking liquid vitamins, or whole food vitamin or juicing? Or is the situation that your body won't absorb them whatever you do?

I'm seeing that I have gluten, lactose and fructose intolerance issues. I assumed I would recover if I got off gluten but almost 2 years later have discovered the malabsorption issue as well as lactose and fructose intolerance.

I have a 2 year old Down Syndrome daughter who is gluten intolerant and so I'm trying to figure out how to help her as well. I have a support group for her issues and they are all into the natural health medicine but I want to ask this question of you because you are more familiar with the celiac condition. Thanks.

I have a injection of vitamin B every 4-6 weeks. Helps unbelievably well.

Skylark Collaborator

You have to heal your gut. A lot of us find sublingual B12 useful and sometimes iron injections are necessary.

Once you get off the fructose and the inflammation improves, you should absorb better. I'd recommend you start taking probiotics and eating probiotic food like the new Yoplait lactose-free yogurt and unpasteurized sauerkraut or other lacto-fermented veggies. Look for Bubbie's brand if you don't care to ferment your own kraut.

I'm on a diet called GAPS that is supposed to help heal but I don't see how you could do it with fructose malabsorption. Open Original Shared Link is the website if you're interested.

mushroom Proficient

I too take B12 injections, and I have some liquid Vitamin A. Many people use sublingual B12 supplementation as it bipasses the gut. When you have an intestinal system that is not absorbing it is hard to get the proper nutrients into your system. The best thing you can do is try to heal your gut with probiotics and to take digestive enzymes to aid in the breakdown of foods, in my experience, since celiac disease has a negative impact on enzyme production. The probiotics are to combat the growth of the bad bacteria in the gut which often overpower the good, and are especially important to take if you have had to take antibiotics which kill off all the good guys as well. :)

sfamor Rookie

My primary care doctor prescribed B-12 shots weekly and then monthly for a b-12 deficiency when I was first diagnosed with both celiacs and low B-12. I also had low iron and was able to get my number back up to normal by taking a vitamin tablet daily for a couple months. Until your gut is "healed" though taking vitamins in a pill form won't be useful because you won't be able to absorb them. The sublingual tablets should work though because you absorb them through the lining of the skin under your tongue. I work with a Naturopathic doctor now and she has suggested a quality liquid vitamin as it is easier to digest and absorb, but again that's only for after you've healed your gut (some say it can take 6 months to a year after going gluten free).

AVR1962 Collaborator

The multi probably will not be enough, especially if you are trying to get the benefits of the iron from it. Keep taking it but you will probably have to add an extra iron supplement. I have found Gentle iron taken after breakfast with a glass of juice works well. Some people can become a bit nauseated from iron supplements but if you take it with food on your stomach it will help absorb it. Keep in mind you ned vit C to help absorb the iron.

Part of the problem with B12 besides leaking gut, is that it needs methylcobalamin to help the body absorb it. B12 is a water soluable vit and therefore does not stay in the system. It is incredibly difficult to get enough B12, especially for those with damaged villa. Best form is thru diet and if you are not doing injections, try a B complex with methyl.....this is what made the difference for me. The regular B12 that you can buy at the grocery store will go right thru your system. Take it after a meal to help with absorbtion. Open Original Shared Link

You may find at first there are various foods the body cannot take in as so much repair has to be done. So dairy, fructose along with some food additives just might not set well. I even had a hard time with meat at first. Raw diet is the answer. I also found chicken broth in everything helped me alot, maybe just the issues I was having and may not apply to everyone. But I would boil up a chicken, save the broth and then use that broth for my rice, veggies, home made soups.

At 2 your daughter can take a child's multi. A wholoe raw food diet could also be very helpful for her as well.

plumbago Experienced

The vitamins I take are a monthly injection of B12 and a weekly mega dose (50,000) of D. However, it makes sense to get your blood tested for vitamins every once in a while just to make sure that vitamin-taking is still necessary (I am not that into it - prefer eating them). I look forward to the day when I no longer have to take these. It's probably not very likely, but one might be low on B12 due to something other than celiac disease, for example pernicious anemia, in which case B12 injections are necessary for life. Again, yearly blood tests would be helpful, and insist on what you want tested.

Plumbago


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samie Contributor

I had to take iron iv weekly till my body started healing. The pills wouldn't absorb.

ElizFost Newbie

Thanks friends. This helps me to know where to start.

  • 1 year later...
MIgrainePosterChild Newbie

I have been suffering for a long time with migraines and GI issues. Doctors kept trying to only treat the migraines yet I began to notice a connection between my migraine aura and GI issues. I became so frustrated that I decided I needed to do my own research. I know the hazards in self-diagnosing, but the definition of malabsorption could have had my picture next to it! It has probably been going on for years and only in the past few months or so become a big enough problem that I had to quit my job, have felt sick and fatigued every day, been dealing with constant constipation and flatulence, afraid to eat the wrong things to make it worse, and now I am attempting to go completely Gluten free hoping that will fix everything, but I am more confused them ever. I already know I am mildly anemic and have been taking a multi-vitamin in pill form, but I had my doctor test me for B12 deficiency today. I can't afford to see any specialists and my primary doctor does not seem to understand what I am experiencing. My hubby and I are now barely scraping by on his low income, so doctors bills and gluten free lifestyle changes really add up! I could really use some advice.

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    • SamAlvi
      Thanks again for the detailed explanation. Just to clarify, I actually did have my initial tests done while I was still consuming gluten. I stopped eating gluten only after those tests were completed, and it has now been about 70 days since I went gluten-free. I understand the limitations around diagnosing NCGS and the importance of antibody testing and biopsy for celiac disease. Unfortunately, where I live, access to comprehensive testing (including total IgA and endoscopy with biopsy) is limited, which makes things more complicated. Your explanation about small-bowel damage, nutrient absorption, and iron-deficiency anemia still aligns closely with my history, and it’s been very helpful in understanding what may be going on. I don't wanna get Endoscopy and I can't start eating Gluten again because it's hurt really with severe diarrhea.  I appreciate you taking the time to share such detailed and informative guidance. Thank you so much for this detailed and thoughtful response. I really appreciate you pointing out the relationship between anemia and antibody patterns, and how the high DGP IgG still supports celiac disease in my case. A gluten challenge isn’t something I feel safe attempting due to how severe my reactions were, so your suggestion about genetic testing makes a lot of sense. I’ll look into whether HLA testing is available where I live and discuss it with my doctor. I also appreciate you mentioning gastrointestinal beriberi and thiamine deficiency. This isn’t something any of my doctors have discussed with me, and given my symptoms and nutritional history, it’s definitely worth raising with them. I’ll also ask about correcting deficiencies more comprehensively, including B vitamins alongside iron. Thanks again for sharing your knowledge and taking the time to help. I’ll update the forum as I make progress.
    • knitty kitty
      Blood tests for thiamine are unreliable.  The nutrients from your food get absorbed into the bloodstream and travel around the body.  So, a steak dinner can falsely raise thiamine blood levels in the following days.  Besides, thiamine is utilized inside cells where stores of thiamine are impossible to measure. A better test to ask for is the Erythrocyte Transketolace Activity test.  But even that test has been questioned as to accuracy.  It is expensive and takes time to do.   Because of the discrepancies with thiamine tests and urgency with correcting thiamine deficiency, the World Health Organization recommends giving thiamine for several weeks and looking for health improvement.  Thiamine is water soluble, safe and nontoxic even in high doses.   Many doctors are not given sufficient education in nutrition and deficiency symptoms, and may not be familiar with how often they occur in Celiac disease.  B12 and Vitamin D can be stored for as long as a year in the liver, so not having deficiencies in these two vitamins is not a good indicator of the status of the other seven water soluble B vitamins.  It is possible to have deficiency symptoms BEFORE there's changes in the blood levels.   Ask your doctor about Benfotiamine, a form of thiamine that is better absorbed than Thiamine Mononitrate.  Thiamine Mononitrate is used in many vitamins because it is shelf-stable, a form of thiamine that won't break down sitting around on a store shelf.  This form is difficult for the body to turn into a usable form.  Only thirty percent is absorbed in the intestine, and less is actually used.   Thiamine interacts with all of the other B vitamins, so they should all be supplemented together.  Magnesium is needed to make life sustaining enzymes with thiamine, so a magnesium supplement should be added if magnesium levels are low.   Thiamine is water soluble, safe and nontoxic even in high doses.  There's no harm in trying.
    • lizzie42
      Neither of them were anemic 6 months after the Celiac diagnosis. His other vitamin levels (d, B12) were never low. My daughters levels were normal after the first 6 months. Is the thiamine test just called thiamine? 
    • knitty kitty
      Yes, I do think they need a Thiamine supplement at least. Especially since they eat red meat only occasionally. Most fruits and vegetables are not good sources of Thiamine.  Legumes (beans) do contain thiamine.  Fruits and veggies do have some of the other B vitamins, but thiamine B 1 and  Cobalamine B12 are mostly found in meats.  Meat, especially organ meats like liver, are the best sources of Thiamine, B12, and the six other B vitamins and important minerals like iron.   Thiamine has antibacterial and antiviral properties.  Thiamine is important to our immune systems.  We need more thiamine when we're physically ill or injured, when we're under stress emotionally, and when we exercise, especially outside in hot weather.  We need thiamine and other B vitamins like Niacin B 3 to keep our gastrointestinal tract healthy.  We can't store thiamine for very long.  We can get low in thiamine within three days.  Symptoms can appear suddenly when a high carbohydrate diet is consumed.  (Rice and beans are high in carbohydrates.)  A twenty percent increase in dietary thiamine causes an eighty percent increase in brain function, so symptoms can wax and wane depending on what one eats.  The earliest symptoms like fatigue and anxiety are easily contributed to other things or life events and dismissed.   Correcting nutritional deficiencies needs to be done quickly, especially in children, so their growth isn't stunted.  Nutritional deficiencies can affect intelligence.  Vitamin D deficiency can cause short stature and poor bone formation.   Is your son taking anything for the anemia?  Is the anemia caused by B12 or iron deficiency?  
    • lizzie42
      Thank you! That's helpful. My kids eat very little processed food. Tons of fruit, vegetables, cheese, eggs and occasional red meat. We do a lot of rice and bean bowls, stir fry, etc.  Do you think with all the fruits and vegetables they need a vitamin supplement? I feel like their diet is pretty healthy and balanced with very limited processed food. The only processed food they eat regularly is a bowl of Cheerios here and there.  Could shaking legs be a symptom of just a one-time gluten exposure? I guess there's no way to know for sure if they're getting absolutely zero exposure because they do go to school a couple times a week. We do homeschool but my son does a shared school 2x a week and my daughter does a morning Pre-K 3 x a week.  At home our entire house is strictly gluten free and it is extremely rare for us to eat out. If we eat at someone else's house I usually just bring their food. When we have play dates we bring all the snacks, etc. I try to be really careful since they're still growing. They also, of course, catch kids viruses all the time so I  want to make sure I know whether they're just sick or they've had gluten. It can be pretty confusing when they're pretty young to even be explaining their symptoms! 
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