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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.
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To All, A recent thread asked about this (What could be the cause of their Low Vitamin D levels) ..and the someone was taking Seroquil.....so that set off the researscher in me to see if the medicine they were taking could of been the cause of their low Vitamin D levels......and indeed it could! As most know (on this forum) I have had my own bad reactions in the past from medicines I had been taking at the time...... Well it turns out.....recent medicine I begin to take again was also affecting my Vitamin D levels (I really shouldn't be surprised by now)......but somehow I still am... @knitty kittyprobably can find you the original research on this topic......I haven't had the time lately. But here is the article from Pharmacy times that talks about a whole class of drugs than can make someone low in Vitamin D. https://www.pharmacytimes.com/view/drug-interactions-with-cyp3a4-an-update It turns out my new BP medicine I had recently started does interfere with my (your) Vitamin D levels. I had taken it in the past.....but it had begin to bother me after a couple years (as most drugs do)......so I was cycling back to it.....because my other BP medicine I had been transferred too.....Ramipril was causing a "Chronic Cough" instead.....it did both as Linsopril and Ramipril.....so I was looking for shelter from Amlodopine.....(little did I know it.....I was going from the frying pain and into the fire again).....see below for more information about how it was affecting me) So it was back on the Norvasc etc.... Sometimes you can't win for loosing.... I probably don't need it anyway.....but was just taking it for a maintenance medicine as a precaution.... Turns out it caused me to feel a little "Glum" shortly after taking it.....it wasn't until I recently found out this connection between Norvasc aka Amlodopine Besylate could also be causing my low Vitamin D levels.....which I have struggled with before.....from time to time.....and you guessed it was when I was on Amlodopine but I didn't put 2+2 together until now..... So I am back on the Vitamin D again......and my moods has perked up again already.... Medicine mugs us of our Vitamins! I hope this is helpful but it is not medical advice. Posterboy,
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To All, I just wanted to start this thread as a resource for other to access. We talk about B-Vitamin deficiencie alot on this forum and it will give others a resource to quote or find a link that might help them see if any of the medicines/drugs they are taking might be creating a B-Viamin deficiency (without them knowing).... Here is a nice article on it. https://www.livonlabs.com/blog/medications-that-deplete-b-vitamins/ And here is a nice searchable database by Pharmacy Solutions that let's you search by your Medicine or the Vitamin deficiency you might suspect. https://pharmacysolutionsonline.com/drug-induced-nutrient-depletion.php It is worth noting that many Anitbiotics can trigger B-Vitamin defcieincies in many different B-Vitamins. I hope this is helpful but it is not medical advice. Posterboy
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Celiac.com 04/15/2019 - A new report says pills often contain so-called “inactive” ingredients that can cause allergic or gastrointestinal reactions in some people sensitive to specific compounds, and gluten and lactose are at the top of the list of offenders. Researchers from the Massachusetts Institute of Technology and Boston’s Brigham and Women’s Hospital analyzed data on inactive ingredients from a database of more than 42,000 prescription and over-the-counter medicines. An average pill contains eight inactive ingredients, but some contain 20 or more. For the patient of one doctor, Dr. Giovanni Traverso, a Brigham gastroenterologist, hidden gluten in a new prescription was causing a reaction and making him sicker. The man had celiac disease. “There’s a tremendous under-appreciation of the potential impact that inactive ingredients may have,” said Dr. Traverso. As per Neergard's report, the team found that: Nearly half of the analyzed medications contained lactose. Usually, not enough for most lactose-intolerant people to notice, but enough that someone taking common medications for high blood pressure and cholesterol could ingest about a thousand milligrams a day. A third of medications contained a food dye associated with allergic reactions. This is a concern for anyone with allergies to food dyes. More than half of medications contained at least one kind of sugar that irritable bowel syndrome patients should avoid. Nearly twenty percent of drug makers said their products contain gluten, usually in the form of wheat starch. This is a potential problem for people with celiac disease, who should try to avoid gluten altogether, but who can have reactions to as little as 1.5 milligrams a day. Worse still, drug labels may list nothing more than 'starch.' Most people don't need to worry in general. These reactions remain extremely rare. For most people, even those with sensitivities, the amount of gluten, or lactose, or other inactive ingredients is too small to trigger a reaction. However, Dr. Traverso reminds the public that refills can sometimes use differently formulated drugs from a different company, and advises patients to check the label every time. Your doctor or pharmacist can be a useful resource for helping to make sure your drugs and medications are free from gluten, dairy, lactose and other allergens. Still they are not infallible, a recent report suggests that local pharmacists may need more training to get up to speed on gluten in drugs and medicines. One takeaway here is that celiac patients should remain vigilant. Check with doctors and pharmacists, but be ready to do your own detective work. Check directly with manufacturers, or ask your doctor or pharmacist to help. Read more at APNews.com
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Celiac.com 05/12/2015 - The current treatment for celiac disease is the avoidance of gluten-containing foods, beverages, and other products by means of a strict gluten-free diet. Following such a diet can be challenging, but recent FDA labeling rules go a long way toward helping people with celiac disease know with pretty good certainty whether a food product contains gluten, or is gluten-free. However, When it comes to prescription drugs, medicines, OTC products, supplements, and vitamins, people with celiac disease currently have little guidance. The FDA rules that mandate the labeling of gluten and other known allergens on food product labels does not apply beyond food. There are currently no rules mandating the labeling of gluten in drugs and medicines. That means that your average person with celiac disease might have a hard time finding out which medications, OTC products, supplements, and vitamins may contain gluten, and may experience adverse symptoms from continued gluten ingestion. A team of researchers set out to assess the role of pharmacists in educating patients and evaluating their medication use to ensure the optimal management of celiac disease. The research team included Ashley N. Johnson, PharmD, BCPS, Angela N. Skaff, BS, PharmD Candidate, and Lauren Senesac, PharmD. They are affiliated with the Pharmacy Practice Drug Information Center, and the Lloyd L. Gregory School of Pharmacy Palm Beach Atlantic University West Palm Beach, Florida. The team celiac disease review included Etiology and Risk Factors, Clinical Presentation and Diagnosis, Factors That May Impair Drug Absorption, Legislation, Management, and Resources. They found that pharmacists do indeed have an essential role to play in educating patients and evaluating their medication use to ensure the optimal management of celiac disease. This often can be accomplished by evaluating the ingredient list, contacting the manufacturer, or utilizing a variety of other resources. Gluten can potentially be introduced and contaminate otherwise gluten-free products during the manufacturing process, although the likelihood is low. Key points to consider are that even if a brand product is confirmed to be gluten-free, it cannot be assumed that the generic version is also gluten-free, and that if a product has a new formulation, appearance, or manufacturer, it is prudent to reassess it and confirm that it remains gluten-free. When evaluating the gluten content of prescription and OTC products, it should be remembered that gluten can be masked in an excipient. Starches used as excipients in pharmaceutical products are often derived from rice, potato, or tapioca, which are gluten-free. However, if the source of the starch is not explicitly stated, the excipients may contain gluten. Sources of excipients that contain gluten include barley, farina, kamut, rye, spelt, triticale, and wheat. Pharmacists play a pivotal role in educating patients about gluten-containing foods, medications, and supplements in order to help them adhere to a GFD and in ensuring that patients receive additional follow-up care, if needed. Source: US Pharmacist. 2014;39(12):44-48.
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How To Find Out if Your Drugs or Medicines Contain Gluten
Jefferson Adams posted an article in Additional Concerns
Celiac.com 05/06/2015 - Gluten is a common ingredient in many commercial food products. Less commonly known, however, is that many manufacturers use gluten as an inert ingredient in such products as medications, supplements, and vitamins. For people with celiac disease, exposure to as little as 30 to 50 mg of gluten per day can damage the mucosa of the small intestine. So, it is important to know the gluten content of prescription and nonprescription medications, even though a lack of labeling laws can make it challenging to find products that are gluten-free. Given the lack of resources to verify the gluten content of prescription and non-prescription medications, it is best to check with the manufacturer. Your pharmacist can help make the process a bit simpler than doing it yourself. There are three things you and/or your pharmacist can do to determine the gluten status of any prescription drug. First is the use of a package insert (PI). You or your pharmacist can use the PI to review drug formulations, and find contact information for pharmaceutical manufacturers. Gluten is used in numerous medications, supplements, and vitamins, often as an inert ingredient known as an excipient. For prescription medications, the PI should include a detailed listing of excipients; however, if this information is not readily available, the FDA provides drug labeling information for prescription and some OTC medications at DailyMed (dailymed.nlm.nih.gov). For non-prescription products, there often is nothing in the PI regarding gluten content, which means you will likely need to check with the manufacturer to be sure. Second, you or your pharmacist can visit company websites to help determine whether a medication potentially contains gluten. Third, you can find manufacturer contact information on the product or its packaging, by conducting an Internet search using the manufacturer's name, or by accessing online drug-information resources such as Clinical Pharmacology, Facts & Comparisons, and Martindale. When requesting information from a manufacturer, it is helpful to provide the lot number. Recent research by Mangione and colleagues showed that information about the gluten content of non-prescription products is usually available and easy to access through the manufacturer. Fourth, there are some third-party websites, such as GlutenFreeDrugs.com, which is maintained by a clinical pharmacist, contains a detailed chart listing selected brand and generic medications that are gluten-free, as well as those free of lactose or soy. However, this is not a comprehensive or definitive list of products, as ingredients and formulations can change from lot to lot in the manufacturing process. Lastly, Celiac.org, the Celiac Disease Foundation offers a variety of resources and provides information on the treatment of celiac disease, tips on living gluten-free, and support-group contact information. Source: US Pharmacist. 2014;39(12):44-48. -
Celiac.com 03/18/2015 - A man who suffers from celiac disease has sued the FDA for allowing gluten to be used as a coating on prescription drug and over-the-counter medicine capsules. Remember, people with celiac disease can suffer intestinal damage when they consume gluten. This can damage can lead to neurological, among other disorders. The man, Michael Weber, was taking a generic drug seven years ago, and developed side effects consistent with ingesting gluten. Weber says he was unable to determine the drug’s gluten status through his pharmacist, and Weber went on to petition the FDA to either eliminate wheat gluten in medicines or require new labeling on drugs containing the protein. In 2011, the FDA sought public comments about the issue. In 2014, the FDA issued gluten-free definitions and labeling standards for commercial foods, but has failed to act on drugs. So Weber has now filed a lawsuit to demand the FDA do something. The complaint can be read here. This raises a couple of questions: Do people with celiac disease deserve to know if there is gluten in their medicine? Do they deserve access to medicines that are gluten-free? Should the FDA definitions and labeling standards also apply to drugs and medicines?
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Celiac.com 08/22/2018 - There’s been some data to support the idea that local pharmacists might have an important role to play in helping people with celiac disease to remain gluten-free by providing information about possible gluten in drugs, and even liaising with manufacturers for gluten information on the patient’s behalf, as needed. But how solid is your local pharmacist when it comes to celiac disease awareness? A team of researchers recently set out to evaluate pharmacists' knowledge of celiac disease, and to look for areas where further information may be beneficial. The research team included Carmela Avena-Woods, PharmD, BS Pharm; Robert A. Mangione, EdD; and Wenchen Kenneth Wu, PhD, MBA. They are all with St. John's University in Queens, New York. To gather data for their evaluation, their team sent a survey to community pharmacists who practice in a national chain pharmacy in one region of New Jersey and New York. A total of 418 pharmacists, just under 40%, responded to the survey. Sixty percent of the responses correctly noted that there are currently no federal regulations requiring manufacturers to designate medications as gluten-free. Still, forty percent got that wrong. Perhaps most alarmingly, of the pharmacists who claimed a basic or advanced understanding of celiac disease, only 27% correctly indicated that celiac disease is both an autoimmune and a chronic lifelong disease. Interestingly, twenty percent of pharmacists said they often suggested a change of diet to people with suspected celiac disease before a clinical diagnosis was made. This study suggests that community pharmacists have some understanding of celiac disease, but that additional celiac education is advisable if they are to play an integral role in helping people with celiac disease to maintain a gluten-free diet. Read more at: Am J Pharm Educ. 2018;82(2)
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Forum Members, This is a follow up question to a link posted in this thread I have read the Patient Celiac site before but she noted the possible use of Losartan (Potassium) contributing to Villi Blunting? This concerns me because I am now taking Losartan for blood pressure. Can any one describe their experience with Losartan and/or provide the link that states Losartan's could be a contributing factor in Villi Blunting. The Patient Celiac did not site her source and I couldn't find it. Any help as to the source would be helpful because I would like to read it for myself. Also what other blood pressure medicine's do others on this forum take instead of Losartan. My BP seems to be under control now that I have been taking Folic Acid but don't won't to stop cold turkey until I have another BP medicine I can take in it's place that won't contribute to possible Villi Blunting. I recently had to "catch up" on Vitamin D for my prediabetes so I know absorption is still a problem and thought it was curious because years ago after my celiac diagnosis I had caught up on Vitamin D once before so I was surprised to find I was again low in it again. The Losartan and Villi blunting (if indeed they are linked) could explain why I am still low (again) in Vitamin D. I knew NSAIDS could cause and why I don't take them generally unless I am in unbearable pain but wasn't aware common BP medicines other than Benicar (olmesartan) could cause similar villi blunting. Here is the link on the NSAIDs study. http://www.thedailybeast.com/research-shows-link-between-nsaid-use-and-gut-disease but the cureceliac.org site does not mention Losartan as other causes of Villi Blunting. http://www.cureceliacdisease.org/faq/what-else-can-cause-damage-to-the-small-intestine-other-than-celiac-disease/ So does any body know if Losartan has also been linked to Villi blunting. If it has I need to get off of it for good and find another BP medicine without this severe side effect. Thanks in Advance. posterboy,
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So my doc. recommended me to take Gas X. And of course I constantly read conflicting reports if it contains gluten here and on the internet. Whether they are chewables or gel caps form. I've read that 'Gas X' gel caps by Novartis are gluten free. But on store shelves I only see 'Gas X' gel caps by GSK (glaskosmithkline). Maybe GSK bought Novartis??????? Can anyone, who has done recent verification, tell me if 'Gas X' gel caps by GSK are gluten free.
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Will Congress Act to Label Gluten in Medicines?
Jefferson Adams posted an article in Product Labeling Regulations
Celiac.com 10/19/2015 - People who must avoid gluten for medical reasons just got a reason to be hopeful that gluten in medicines, which are not regulated under the current FDA law, might soon be labeled by law. U.S. Representatives Tim Ryan (D-OH) and Nita Lowey (D-NY) recently introduced a bill to make it easier for people with gluten-related disorders to identify medications that contain gluten. Their bill, the Gluten in Medicine Disclosure Act of 2015 would change the Federal Food, Drug, and Cosmetic Act so that the label of any medicine intended for human use must divulge any ingredient, besides sugar alcohol, that is derived from a grain or contains gluten. The bill is intended to help people with Celiac disease avoid gluten. "Americans deserve to know what is in their food and drugs," agreed Lowey. "Providing uniform standards for food and drug labeling will make a world of difference to the quality of life for people with celiac disease. People want medicine labels to provide "the information they need to protect their health and wellbeing," Ryan added. Keep an eye on congress to see how this proceeds, and check back with celiac.com to follow progress on this important issue. Source: CBS News
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