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Celiac.com 05/15/2025 - For people with celiac disease or soy allergies, avoiding gluten and soy in food is a daily challenge. However, many may not realize that these allergens can also hide in medications. A recent study examined how often gluten and soy appear as inactive ingredients (called excipients) in common medicines sold in Portugal. The findings raise important concerns about medication safety and labeling for those with food sensitivities. What the Study Investigated Researchers analyzed 308 different medications across three categories: Pain relievers and fever reducers (like paracetamol/acetaminophen) Anti-inflammatory drugs (like ibuprofen) Asthma and breathing medications They checked the official medication information (called Summary of Product Characteristics) to see whether these drugs contained gluten or soy-based ingredients. Key Findings Gluten in Medications Pain relievers and fever reducers had the highest gluten content—44.4% contained gluten-derived excipients. Over half (51.2%) of pill-form medications in this group had gluten. 40% of liquid medications (like syrups) also contained gluten. Anti-inflammatory drugs (NSAIDs) had much less gluten—only 8.2%. However, 26.7% of liquid NSAIDs contained gluten. Asthma and breathing medications had no gluten at all. Soy in Medications Anti-inflammatory drugs (NSAIDs) had the most soy—14% contained soy-based ingredients. 26.7% of liquid NSAIDs had soy. Pain relievers and fever reducers had less soy (6.5%). 30% of liquid pain relievers and 33.3% of rectal suppositories contained soy. Asthma medications, again, had no soy. Why This Matters for People with Celiac Disease or Soy Allergies The study shows that gluten and soy are surprisingly common in medications, especially in pain relievers and liquid formulations. Since these ingredients are not always clearly labeled, patients may unknowingly consume them, risking allergic reactions or worsening celiac symptoms. Problems with Current Medication Labels Some labels list "starch" without specifying if it comes from wheat (which contains gluten) or another source like corn. Soy-based ingredients (like soy lecithin) are not always highlighted as allergens. Laws require certain allergens to be disclosed, but loopholes exist, leaving patients in the dark. What Should Patients Do? Ask pharmacists or doctors about gluten and soy in medications before taking them. Check labels carefully, but be aware that not all allergens are clearly listed. You can search this site for prescriptions medications, but will need to know the manufacturer/maker if there is more than one, especially if you use a generic version of the medication (to see the ingredients you will need to click on the correct version of the medication and maker in the results, then scroll down to "Ingredients and Appearance" and click it, and then look at "Inactive Ingredients," as any gluten ingredients would likely appear there, rather than in the Active Ingredients area): https://dailymed.nlm.nih.gov/dailymed/ Liquid and pill forms may differ—some liquid medicines have more allergens than their pill counterparts. Push for better labeling so that medication ingredients are as transparent as food labels. Conclusion: A Call for Safer Medications This study highlights a hidden risk for people with celiac disease or soy allergies—medications that may contain these allergens without clear warnings. While asthma medications were safe in this analysis, common pain relievers and anti-inflammatory drugs often contained gluten or soy. For those with food sensitivities, the findings emphasize the need for: Stricter labeling laws to ensure allergens are always disclosed. More research into how often these ingredients appear in medications worldwide. Greater awareness among doctors, pharmacists, and patients about hidden allergens in medicines. By improving transparency in medication ingredients, pharmaceutical companies and regulators can help protect sensitive individuals from accidental exposure, making treatment safer for everyone. Read more at: nature.com Watch the video version of this article:

Celiac.com 05/06/2025 - For individuals with celiac disease or gluten sensitivity, avoiding gluten is essential for maintaining good health. While many are aware of the obvious sources, such as bread, pasta, and baked goods, gluten often hides in unexpected places. Consuming even trace amounts of gluten can trigger serious health consequences for those with celiac disease. This guide explores surprising foods and everyday products that may contain gluten, helping you make safer choices. Unexpected Food Sources of Gluten Sauces, Dressings, and Condiments Many condiments and sauces contain hidden gluten due to thickeners, preservatives, or cross-contamination. Soy Sauce – Most soy sauces contain wheat unless specifically labeled gluten-free. Salad Dressings – Some dressings use wheat-based thickeners or malt vinegar. Gravy and Sauces – Pre-made gravies and sauces often use wheat flour as a thickening agent. Ketchup and Mustard – While often gluten-free, some brands contain malt vinegar or other gluten-containing additives. Barbecue Sauce – Some brands add wheat-based ingredients for texture and flavor. Deli Meats and Processed Foods Lunch Meats and Hot Dogs – Fillers and flavor enhancers may contain gluten. Meat Substitutes – Many plant-based meat alternatives use seitan (wheat gluten) as a protein source. Pre-Seasoned or Marinated Meats – Marinades and spice blends sometimes contain wheat-based additives. Snack Foods and Candy Potato Chips and Crackers – Some flavors contain wheat-based seasonings. Chocolate Bars and Candy – Some chocolates contain malt or gluten-containing fillers. Chewing Gum – Wheat starch is sometimes used as a binding agent. Beverages Beer and Malt Beverages – Traditional beers contain barley and are not gluten-free. Flavored Coffee Drinks – Some syrups and additives may contain gluten. Distilled Alcohol – While pure distilled spirits are gluten-free, flavored versions may contain hidden gluten. Non-Food Products That Contain Gluten Medications and Supplements Many over-the-counter and prescription medications use gluten-based fillers or binders. Prescription Medications – Some pills contain wheat starch or other gluten-containing excipients. Vitamins and Supplements – Capsules and tablets may use gluten-derived ingredients as fillers. Cosmetics and Personal Care Products While gluten cannot be absorbed through the skin, certain products pose a risk if they come into contact with the mouth. Lipsticks and Lip Balms – Some brands contain wheat-based ingredients. Toothpaste and Mouthwash – Gluten may be present in some formulations. Shampoos and Conditioners – While not a direct ingestion risk, gluten-containing hair products may transfer to hands and be accidentally ingested. Household and Miscellaneous Products Playdough and Craft Supplies – Many types of modeling dough contain wheat. Envelopes and Stamps – Most are gluten-free, but to be safe we recommend that you don't lick either, as some adhesives may contain gluten. Pet Food – Some pet foods contain gluten, which may pose a risk for cross-contact in the household. How to Avoid Hidden Gluten Read Labels Carefully Always check ingredient lists for terms like “wheat,” “barley,” “rye,” “malt,” and “hydrolyzed wheat protein.” Look for certified gluten-free labels when available. Research Brands and Products Some brands are more transparent about gluten content than others. Utilize manufacturer websites or customer service hotlines to verify gluten-free status. Use Gluten-Free Databases and Apps Several mobile apps and websites track gluten-free products, making it easier to find safe choices. Communicate with Healthcare Providers Ask your doctor or pharmacist about gluten in medications, and request gluten-free alternatives when necessary. What This Means for People with Celiac Disease or Gluten Sensitivity For individuals with celiac disease, even tiny amounts of gluten can trigger serious health reactions, including intestinal damage and long-term complications. Awareness of hidden gluten sources helps prevent accidental exposure and ensures better health outcomes. Those with gluten sensitivity may also experience significant symptoms, reinforcing the need for vigilance. Conclusion Gluten can lurk in unexpected places, from condiments and medications to cosmetics and household products. Understanding where gluten hides and how to identify safe alternatives is crucial for those managing celiac disease or gluten sensitivity. By staying informed, reading labels, and researching product ingredients, you can reduce your risk of accidental gluten exposure and maintain a healthy gluten-free lifestyle.

Celiac.com 02/20/2025 - Gluten-free living is essential for individuals with celiac disease or non-celiac gluten sensitivity. While most people focus on avoiding gluten in food, another significant source of gluten exposure often goes unnoticed: medications and supplements. This guide explores the hidden risks of gluten in these products and provides practical advice for navigating them safely. Why Gluten in Medications and Supplements Matters For individuals with celiac disease or gluten sensitivity, even trace amounts of gluten can trigger a range of symptoms, from digestive distress to neurological complications. The stakes are high, as accidental exposure can lead to intestinal damage and other long-term health issues. Medications and supplements may not immediately come to mind as a source of gluten, but they often contain excipients (inactive ingredients) derived from wheat, barley, or rye. These ingredients serve various purposes, such as acting as fillers, binders, or coatings, but they can pose serious risks for those who must avoid gluten entirely. How Gluten Makes Its Way Into Medications Many medications and supplements contain inactive ingredients that may be derived from gluten-containing grains. Here are some common culprits: 1. Fillers and Binders Fillers and binders are used to bulk up pills and hold their ingredients together. Common fillers include: Starch: Often derived from corn, potato, tapioca, or wheat. If labeled as "starch," it may be difficult to determine its origin without further inquiry. Dextrin: A compound that can be derived from wheat or other sources. Dextrin is often used as a stabilizer in both tablets and liquid medications. 2. Coatings and Glazes Some pills and capsules are coated to make them easier to swallow or to provide a time-release mechanism. Gluten-derived ingredients, such as modified food starch, may be used in these coatings. 3. Flavorings Medications, especially chewable or liquid forms, may contain flavorings to improve taste. These flavorings can sometimes include malt extract or other gluten-containing additives. 4. Cross-Contamination Even if a medication does not intentionally include gluten, cross-contamination during manufacturing is a potential risk. Facilities that process gluten-containing products alongside gluten-free ones may inadvertently introduce trace amounts of gluten. How to Identify Gluten in Medications and Supplements Identifying gluten in medications and supplements can be challenging because labeling laws for these products are not as stringent as for food. However, there are steps you can take to ensure your safety: 1. Read the Label Carefully While the U.S. Food and Drug Administration (FDA) requires food products to declare allergens, medications and supplements are not held to the same standard. Look for terms like "wheat," "barley," or "rye," as well as ambiguous ingredients such as "starch," "dextrin," or "malt." 2. Check the Manufacturer’s Website or Contact Them Most pharmaceutical and supplement companies have customer service lines or websites that provide ingredient information. Reach out to confirm whether their products are gluten-free. 3. Use Reliable Databases and Apps You can search this site for prescriptions medications, but will need to know the manufacturer/maker if there is more than one, especially if you use a generic version of the medication: https://dailymed.nlm.nih.gov/dailymed/ To see the ingredients you will need to click on the correct version of the medication and maker in the results, then scroll down to "Ingredients and Appearance" and click it, and then look at "Inactive Ingredients," as any gluten ingredients would likely appear there, rather than in the Active Ingredients area. 4. Consult Your Pharmacist Pharmacists can be invaluable allies in identifying gluten-free medications. Be proactive in discussing your needs, and ask them to investigate questionable ingredients on your behalf. Specific Risk Areas for Gluten in Supplements Supplements, including vitamins, minerals, and herbal products, can also contain hidden gluten. Below are some key areas to watch: 1. Multivitamins Multivitamins often include fillers and coatings that may contain gluten. Opt for certified gluten-free options whenever possible. 2. Protein Powders Some protein powders use malt extract or wheat-based thickeners. Always check the ingredient list and look for gluten-free certification. 3. Probiotics Probiotics are often encapsulated using starches or other fillers. Verify the source of these ingredients before purchasing. 4. Herbal Supplements Herbal products, particularly those in tablet or capsule form, may include gluten-derived binders. Check with the manufacturer for clarity. Practical Tips for Staying Safe Navigating the hidden risks of gluten in medications and supplements requires vigilance. Here are some practical tips to help you avoid accidental exposure: 1. Seek Out Certified Gluten-Free Products Whenever possible, choose medications and supplements that are labeled as gluten-free. Certification by a trusted third party adds an extra layer of confidence. 2. Maintain a Medication and Supplement Log Keep a detailed record of all medications and supplements you use, including the manufacturer’s contact information. This can help you quickly identify potential risks. 3. Advocate for Yourself Do not hesitate to ask questions and demand clear answers. Whether you are speaking with your doctor, pharmacist, or a supplement manufacturer, ensure they understand your need to avoid gluten. 4. Stay Informed About Gluten-Free Guidelines Regulations and product formulations can change over time. Stay up to date by following reputable organizations and resources dedicated to gluten-free living. What This Means for People with Celiac Disease or Gluten Sensitivity For individuals managing celiac disease or gluten sensitivity, avoiding gluten is not just a lifestyle choice—it is a medical necessity. Hidden gluten in medications and supplements presents a unique challenge, but with awareness and proactive measures, it is possible to minimize this risk. This issue highlights the need for greater transparency in labeling and manufacturing practices. Advocacy from the gluten-free community has already led to progress in food labeling, and similar efforts could improve safety standards for medications and supplements. By understanding where gluten may be hiding and taking steps to verify the safety of the products you use, you can better protect your health and well-being. Empowered with this knowledge, people with celiac disease and gluten sensitivity can navigate these hidden dangers with confidence, ensuring they remain safe and symptom-free.

Celiac.com 12/19/2024 - For individuals with celiac disease or gluten sensitivity, managing a gluten-free lifestyle often goes beyond just food choices. While most people are aware of the need to avoid gluten-containing foods like wheat, barley, and rye, fewer realize that gluten can hide in non-food products as well. From skincare items to medications, gluten can unexpectedly be present in everyday items that many wouldn’t think to check. Understanding these hidden sources is critical for maintaining a fully gluten-free lifestyle. Gluten in Skincare and Beauty Products One of the least suspected places for gluten to appear is in skincare and beauty products. While gluten cannot be absorbed through the skin, individuals who are highly sensitive to gluten or have celiac disease may accidentally ingest gluten-containing products through their lips or hands. Here's where gluten might hide: Lipsticks and Lip Balms: Since these products are applied directly to the lips, they are easily ingested. Lipsticks and balms often contain gluten-derived ingredients such as wheat germ or barley. Lotions and Creams: Some moisturizers, creams, and body lotions may include hydrolyzed wheat protein, which is derived from gluten grains. While applying these to your skin may not directly cause an internal reaction, they can still pose a risk if transferred to your mouth or ingested indirectly. Shampoos and Conditioners: Hair care products can sometimes contain wheat proteins, especially those that focus on hydration and strength. Individuals should be cautious of washing their hair and inadvertently swallowing some of the product or touching their face afterward. Checking the ingredient list on beauty products for terms like "Triticum vulgare" (wheat), "Hordeum vulgare" (barley), or "Secale cereale" (rye) can help avoid unintentional exposure. Additionally, many companies now offer certified gluten-free beauty products, making it easier for those with sensitivities. Gluten in Medications and Supplements Many people overlook the possibility of gluten in medications, but the truth is that gluten can appear in prescription drugs, over-the-counter medications, and dietary supplements. This occurs because some pills and tablets use gluten as a binder or filler. Key areas to be aware of include: Prescription Medications: Certain drugs may contain gluten as an inactive ingredient. In some cases, starch-based fillers used to bind the tablet together could be derived from wheat or other gluten-containing grains. Search for inactive ingredients and allergens contained in prescription medications at https://dailymed.nlm.nih.gov/dailymed/. Vitamins and Supplements: Gluten is sometimes used in vitamins and supplements, especially in products that contain grain-based additives. While many supplements now advertise as gluten-free, it’s crucial to check labels or consult the manufacturer for confirmation. Over-the-Counter Medicines: Commonly used medicines like ibuprofen, cough syrups, or antacids can sometimes contain gluten. It's important for people who require a strict gluten-free regimen to seek out certified gluten-free alternatives when purchasing over-the-counter medications. For safety, always consult your pharmacist or doctor to ensure the medications you're taking are gluten-free, particularly if the product labeling is unclear. Gluten in Household Products Surprisingly, household items can also be a source of gluten. Although these products aren't consumed directly, they can still pose a risk through accidental ingestion, inhalation, or cross-contamination. Playdough: Traditional playdough is typically made with wheat flour, making it an obvious source of gluten. While children might not eat playdough, the risk of transferring gluten from hands to mouths during playtime is high. Fortunately, gluten-free playdough options are available. Cleaning Products: Some household cleaning products, especially those with plant-based ingredients, may use wheat or oat extracts. This is more of a concern for individuals who are extremely sensitive to gluten, as they may touch surfaces and later touch their mouths. Laundry Detergent: While the risk of gluten transfer through clothing is minimal, some laundry detergents do contain gluten-based ingredients. For those who are highly sensitive, choosing a gluten-free detergent may provide peace of mind. Gluten in Arts and Crafts Materials Another often-overlooked source of gluten is arts and crafts materials, especially for children and hobbyists. Craft supplies can pose a hidden risk, and many individuals with gluten sensitivity may not consider these items as potential hazards. Craft Glue and Adhesives: Certain glues, especially those marketed for children or used in arts and crafts, may contain wheat-based ingredients. Since children often use their hands while crafting and may accidentally ingest gluten, it’s worth checking for gluten-free alternatives. Paper Mache: Traditional paper mache recipes frequently involve flour, typically wheat, as a base for creating the paste. Gluten-free alternatives can be made using rice flour or gluten-free pastes. Finger Paints and Clay: Some finger paints and clays, similar to playdough, use wheat as a binding agent. For sensitive individuals or children with gluten intolerance, gluten-free crafting products are a safer option. Avoiding Hidden Gluten: Best Practices Navigating a gluten-free lifestyle means staying vigilant not only about what you eat but also what you use on your body and in your home. To minimize the risk of exposure to hidden gluten, follow these tips: Always Check Labels: Just as you would with food, check the labels of non-food products like beauty items, medications, and household products. Look for certified gluten-free labels when possible. Consult with Manufacturers: If the label isn't clear, don’t hesitate to contact manufacturers to ask whether their products contain gluten. Many companies now have dedicated customer service lines to address allergen concerns. Opt for Certified Gluten-Free Products: In recent years, more companies are recognizing the need for gluten-free versions of everyday products. Opt for certified gluten-free brands when buying skincare, medications, and household products. Be Cautious with DIY Products: For crafting, opt for homemade, gluten-free versions of items like playdough or paper mache. Recipes using gluten-free flours or starches can be a safe alternative for sensitive individuals. By staying informed and checking ingredient lists carefully, those with celiac disease or gluten sensitivity can reduce their exposure to hidden gluten in non-food items and maintain their health. Hopefully we've shed some light on how gluten can be found in a variety of unexpected products beyond food. With the right knowledge and precautions, those living with celiac disease or gluten sensitivity can better manage their daily exposure and protect their health. Watch the video version of this article:

Celiac.com 01/27/2024 - We've done many articles that cover nutrient deficiencies that are associated with untreated celiac disease, but many people do not realize that celiac disease can also lead to malabsorption of medications and supplements. Celiac disease damages the lining of the small intestine, where both nutrient and certain medication absorption takes place. This damage can result in decreased absorption of various substances, including both over the counter and prescription medications, and supplements. Medications that are taken orally and absorbed in the small intestine may be affected by malabsorption in individuals with untreated celiac disease. As a result, the effectiveness of these medications might be compromised. It's essential for individuals with celiac disease to maintain a strict gluten-free diet to allow the small intestine to heal and improve nutrient absorption, including medications. Common Medications Affected by Celiac Disease Malabsorption Here are some common medications that may be affected by celiac disease-related malabsorption, but many more medications might also be affected: Thyroid Medications: Medications used to treat thyroid disorders, such as levothyroxine, may have reduced absorption in individuals with untreated celiac disease. Certain Antibiotics: Some antibiotics, including tetracycline and doxycycline, are absorbed in the small intestine. Malabsorption issues may affect their effectiveness. Anti-Inflammatory Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, commonly used for pain and inflammation, may have altered absorption in individuals with celiac disease. Certain Anticonvulsants: Medications used to treat seizures, such as phenytoin, might be impacted by malabsorption in untreated celiac disease. Oral Contraceptives: Birth control pills, which are taken orally, may be affected by malabsorption in individuals with celiac disease. Blood Pressure Medications: Calcium Channel Blockers: Medications like amlodipine, which are calcium channel blockers used to treat high blood pressure, may be affected by impaired calcium absorption. Beta-Blockers: Some beta-blockers, such as metoprolol, may have altered absorption due to malabsorption issues. Cholesterol-Lowering Medications: Statins: Medications like atorvastatin and simvastatin, commonly prescribed for managing cholesterol levels, might be impacted by malabsorption in the small intestine. Pain Medications: Opioids: Medications containing opioids, such as codeine or oxycodone, may have absorption challenges in individuals with untreated celiac disease. Diabetes Medications: Metformin: This common medication for managing diabetes may be affected by impaired absorption in individuals with celiac disease. It's important to note that individual responses to medication can vary, and the severity of malabsorption can differ among those with celiac disease. Therefore, open communication with healthcare providers is crucial to monitor medication effectiveness, adjust dosages when needed, and explore alternative treatments if necessary. Common Supplements Affected by Celiac Disease Malabsorption Here are some common supplements that may be affected by celiac disease-related malabsorption, but many more supplements might also be affected: Calcium Supplements: Calcium carbonate or citrate: Individuals with celiac disease may experience difficulty absorbing calcium, impacting bone health. Supplementing with calcium is common to address potential deficiencies. Iron Supplements: Iron sulfate or ferrous fumarate: Celiac disease can lead to iron deficiency anemia due to impaired iron absorption. Iron supplements are often recommended to address low iron levels. Vitamin D Supplements: Cholecalciferol (Vitamin D3): Malabsorption of fat-soluble vitamins, including vitamin D, can occur in celiac disease. Supplementation is often necessary to maintain adequate vitamin D levels. B Vitamins: B12 (Methylcobalamin): Deficiencies in B vitamins, particularly B12, may occur in individuals with celiac disease due to malabsorption. B12 supplements can be prescribed to address deficiencies. Folate (Folic Acid or Methylfolate): Methylfolate: Similar to B12, folic acid absorption may be compromised. Supplementing with methylfolate can be considered. Zinc Supplements: Zinc citrate or picolinate: Zinc absorption may be reduced in celiac disease. Zinc supplementation is recommended for those with zinc deficiencies. Magnesium Supplements: Magnesium citrate or glycinate: Malabsorption issues can affect magnesium levels. Supplementing with magnesium is common to address deficiencies. Omega-3 Fatty Acids: Fish Oil (EPA and DHA): Essential fatty acids may be poorly absorbed. Omega-3 supplements can help maintain a balance of these crucial fats. Summary Individuals with untreated celiac disease may experience malabsorption of various medications and supplements due to damage to the small intestine's lining. This can impact the absorption and effectiveness of certain drugs and supplements that are commonly taken or prescribed for various conditions. It's essential for individuals with celiac disease to be aware of potential interactions and work closely with their healthcare providers, including pharmacists, to ensure appropriate adjustments in medication dosage or explore alternative forms of administration when necessary.

Celiac.com 11/30/2021 - We all know symptoms of celiac disease are activated by the consumption of gluten, which can be found in wheat, barley, rye, and even oats that aren’t certified gluten-free. Most individuals who go on a gluten-free diet will think about food only, not necessarily medications. However, the truth of the matter is you need to be careful with both nutritional supplements, and over-the-counter and prescription medications, as they could contain gluten. More often than not, excipients, which are binding agents or inactive ingredients in pills, tend to contain wheat, potato, corn, or rice. Additionally, even if a brand name drug is gluten-free, this does not mean that its generic version is. Nutritional supplements tend to be easier because a lot of companies now label their bottles "gluten-free", or list all ingredients used in them on the packaging. For supplements that are not clearly labelled, checking the product on their company Web site is the best way to be sure, and sometimes you may need to call the manufacturer directly. Currently, however, prescriptions don't include "gluten-free" on their labels, and, unlike foods, are also not required to list any of the top eight common food allergens that they might contain. If you know your pharmacist well, they might be able to assist you, or you could reach out directly to the manufacturer. Another option is the Dailymed Web site which allows you to search for most prescription medications, including their generic equivalents, to find out what inactive ingredients are used to make them. Search for inactive ingredients and allergens contained in prescription medications: https://dailymed.nlm.nih.gov/dailymed/ Below are some potential suspect inactive ingredients that could contain gluten if their source is not specified: Modified starch Pregelatinized starch Pregelatinized modified starch Dextrates Dextrin Dextrimaltose Caramel coloring So, the next time you have to refill a prescription keep this information handy. That way, you protect your villi from further damage. Reference: beyondceliac.org