Guest author: Diana Lee, graduate student at San José State University
Autoimmune diseases can be super overwhelming to manage, especially the ones that attack your gut. Our digestive tract is how we get all of our amazing nutrients from food. When that is compromised, it is more than likely that a nutrient deficiency will occur. Here are the most common autoimmune diseases that attack our gut and the nutrients to keep an eye on.
Gut-related autoimmune disease nutrient deficiencies
The three most common autoimmune diseases of the gut are ulcerative colitis, Crohn’s disease, and celiac disease.
Ulcerative colitis is when the immune system attacks the rectal and colon lining to cause ulcers. The mucosa layer experiences inflammation. People with ulcerative colitis experience abdominal pain, diarrhea, anemia, fatigue, rectal bleeding, fever and constipation (1).
Those with ulcerative colitis tend to have lower levels of iron, calcium deficiencies, vitamin D deficiencies, and/or vitamin B deficiencies (1). One study found that those with ulcerative colitis also had significantly lower selenium levels than those without ulcerative colitis and found that adequate selenium status helps to maintain iron status (2).
Crohn’s disease is when the immune system attacks the entire digestive tract and causes inflammation, swelling and scarring. People with Crohn’s disease experience abdominal pain, diarrhea, fever, loss of body mass and fatigue (1).
A study found that those with Crohn’s disease also had significantly lower selenium levels than those without Crohn’s disease which was associated with poor iron status (2). Those with Crohn’s disease commonly have iron deficiencies, calcium deficiencies, vitamin D deficiencies, vitamin B deficiencies, zinc deficiencies, and magnesium deficiencies (1).
One study confirmed that individuals with Crohn’s disease had lower Dietary Reference Intake values of protein, fats, fiber along with calcium, iron, potassium, magnesium, selenium, and zinc than those without the disease. In terms of serum vitamin deficiency, those with Crohn’s disease had the lowest values for vitamin A and vitamin E (3).
Celiac disease is when consumption of the protein gluten, found in wheat, rye and barley food items, stimulates the immune system to attack on the villi or intestinal epithelial cells. As a result, people with celiac disease experience diarrhea, vomiting, weight loss and abdominal pain (4).
As the intestine gets partially destroyed through celiac disease, this impacts iron absorption, making it a frequent nutrient deficiency for celiac disease (5). In addition to iron deficiency, those with celiac disease may also experience folate, vitamin B12, vitamin D, zinc, and magnesium deficiencies due to the deterioration of the intestinal absorptive ability of these nutrients (4). It is important to treat the deficiencies as they can cause signs and symptoms of celiac disease (4). Throughout these examples, iron, vitamin D, zinc and possibly selenium emerge as overlapping nutrient deficiencies.
How to Fix these Nutrient Deficiencies
For those with ulcerative colitis and Crohn’s disease, which fall under the umbrella term of inflammatory bowel disease. It is generally recommended to eat small frequent meals of low-fat, low-fiber, high-protein, and high-calorie components during times of exacerbation, in addition to vitamin D, zinc, calcium, magnesium, folate, vitamin B12, and iron supplements. A normal diet should be resumed as soon as the flare calms down.
For people with celiac disease, they must follow a gluten-free diet, avoiding wheat, barley and rye, cross- bred varieties, oats, and processed foods with these grains. Gluten- free products have low iron content so it is recommended to eat foods rich in iron like fruits, vegetables and red meat (4). Most refined gluten- free food products are not enriched with thiamin, riboflavin, niacin, folate and iron, unlike their wheat-based counterparts. This means that it is important to consider these nutrients when planning meals for those with celiac disease to ensure adequate nutrition.
If diet is not adequate on its own, supplements may be necessary. You can shop for high quality supplements at Annie’s Fullscsript Dispensary.
For those with these autoimmune deficiencies, it is important to plan a proper diet and follow dietary advice to ensure healthy living and minimize symptoms of the diseases. Although the information may be overwhelming at first, there are great resources of information out there to rely on. For more information on autoimmune nutrition health, please visit Annie’s BlogBlog. You can also follow Annie Rubin on her Facebook @annierubinnutrition or on her Instagram @the.autoimmune.dietitian.