Going gluten free? It may be wise to supplement

By Karen Appold

Going gluten free is a fairly common trend these days. Some people consider a change in diet for nutritional benefits, while others, like those with Celiac disease, are required to eliminate gluten for specific health reasons.

“For people with this autoimmune disease [Celiac disease], eating gluten sets off an immune response that causes damage to the lining of the gastrointestinal tract,” explained Lisa Cimperman, MS, RD, LD, registered dietitian, University Hospitals Case Medical Center, Cleveland, Ohio, and spokesperson for the Academy of Nutrition and Dietetics. “This damage can lead to deficiencies in calcium, B12, iron, and fat soluble vitamins, including A, E, D, and K.”

For otherwise healthy individuals who are following a gluten-free diet due to perceived health benefits, there is less potential for deficiencies. Gluten-containing foods, such as those made from wheat, rye, or barley, are typically fortified with B vitamins, Cimperman said. A variety of other grains (e.g., quinoa, millet, and brown rice) are gluten-free and provide many of the same nutrients as wheat, but they may or may not be fortified with additional B vitamins.

However, deficiencies can always occur when eliminating food groups.

“This is why proper planning and education are so important when following a gluten-free diet,” Cimperman said. “Weight loss, ‘cleansing,’ and ‘clean eating’ are mostly trends and are simply not well-informed reasons to follow a gluten-free diet.”

In the absence of Celiac disease, gluten itself is neither essential to the diet nor detrimental to health. Individuals with Celiac disease should talk to their doctors about checking for iron and vitamin D deficiencies.

“Both iron and vitamin D can be toxic if taken in high doses when a deficiency is not present,” Cimperman said.

Iron deficiency can cause anemia (a lack of red blood cells), and vitamin D deficiency can impair calcium absorption, leading to an increased risk of brittle bones. Additional B vitamins and calcium may be required, as well, but absolute recommendations require an inventory of current food intake and an individual assessment of the severity of disease.

For individuals following a gluten-free diet for other reasons, a standard multivitamin and mineral supplement can fill any potential holes.

“But with proper planning, it’s possible to require no additional vitamin/mineral supplementation at all,” Cimperman added.

Karen Appold is a writer based in Lehigh Valley, Pennsylvania.