Diagnosis requires the physician to evaluate symptoms, medical history, and perform an exam. If celiac disease is suspected, blood and biopsy tests are done to confirm the diagnosis. While AGA (antigliadin antibody) is used in diagnosis in our country, more reliable results have been obtained with IgA and IgG. Many people around the world struggle with lifelong celiac disease, which damages the lining of the small intestine and prevents the absorption of nutrients important to health. The surface of the intestine contains structures called villi that aid in the absorption of nutrients. In people with celiac disease, these structures are damaged. Damage is caused by consuming gluten, a protein found in foods such as wheat, barley, and rye. Some individuals are sensitive to gluten even though they are not diagnosed with celiac. Symptoms may include abdominal pain and bloating, diarrhea, joint pain, reflux or fatigue. Unlike celiac disease, people with gluten sensitivity do not have atrophy of their intestinal villi, but may have impaired intestinal microbiota.
A gluten-free diet is the primary treatment for celiac disease and gluten sensitivity. Personalized changes with the support of a nutritionist / dietitian can ensure success. Because even small intakes of gluten (50 mg/day) can be immunogenic, only diets containing less than 20 ppm gluten are considered gluten-free; therefore, strict adherence to a gluten-free diet can be challenging for patients. A gluten-free diet can reduce socialization, causing severe restrictions in daily life. Long-term adherence to gluten-free diets without a balanced diet can cause obesity, insulin resistance and metabolic syndrome. In addition, it has been observed that some autoimmune diseases such as Hashimoto and rheumatoid arthritis have positive results with the application of gluten-free diet, for example; Improved thyroid function and decreased thyroid antibodies were observed. When people with celiac disease consume foods or products containing gluten, their immune system reacts by damaging the villi. This causes the body to be unable to digest food properly. No matter how much food individuals consume, insufficient macro-micronutrient deficiency can be observed. The most commonly affected vitamins and minerals include iron, calcium, folate, vitamin B12 and all fat-soluble vitamins (A,D,E,K). A diet poor in fiber can also be observed. As the intestinal surface begins to heal, nutrient absorption increases, but reduced gluten-free food intake increases deficiencies. In the case of non-celiac gluten sensitivity, the absorption of nutrients is not compromised, but the food consumed may be deficient in nutrient content. Some people with celiac disease may also be lactose intolerant in the early stages of their treatment with a gluten-free diet, so they may have low intakes of many of the nutrient groups provided by dairy products (such as calcium, magnesium, and vitamin D). Apart from these, micronutrient deficiencies such as iron, zinc, selenium, phosphorus, potassium, folate and some B vitamins (B1/thiamine, B2/riboflavin, B3/niacin) are observed. In a group of celiac patients who received vitamin B supplementation (400 mcg folic acid, 500 mcg B12 (cyanocobalamin) and 3 mg B6 (pyridoxine) daily) for 6 months, it was observed that the psychological state improved and homocysteine levels decreased. In another study, daily use of 1000 mg calcium and 400 IU vitamin D supplements for 24 months resulted in an increase in blood values and physiological well-being. While gluten can be toxic for someone with celiac disease, it’s not unhealthy for everyone else. Perhaps the best way for many people without celiac disease to feel better, adopt a healthier lifestyle, or achieve athletic gains is by continuing to focus on minimally processed foods (gluten-free or non-gluten-free) and richer (fruit-rich) foods.
vegetable and gut-friendly) is to adopt a diet. If you need to cut out gluten, you have to make sure you do it in a healthy, conscious way and by making up for the necessary deficiencies.
Food sources that can be used for micronutrients deficient in gluten-free diet
Thiamine: Sunflower seeds, black beans, green peas, lentils
Riboflavin: Mushrooms, cooked spinach, soybeans
Niacin: Mushrooms, avocados, broccoli, tuna, salmon, chicken breast
Folate: Green leafy vegetables (spinach, lettuce, turnip), asparagus, lentils, beets, broccoli
Iron: Red meat, lentils, soybeans, tofu
Calcium: Green leafy vegetables (spinach, turnip greens, collard greens), sardines, almonds, sesame,
seaweed (nori, kelp)
Magnesium: Green leafy vegetables (spinach, chard), pumpkin seeds, sunflower seeds, black beans
Vitamin B12: Red meat, poultry and fish, eggs, dairy products
Vitamin A: Green leafy vegetables (spinach, turnip greens), sweet potatoes, carrots, red peppers
Vitamin E: Green leafy vegetables (spinach, mustard greens, turnip greens), sunflower seeds,
almonds, hazelnuts
Vitamin K: Green leafy vegetables (kale, spinach, chard, collard greens), broccoli, Brussels sprouts
