This year, Coeliac Awareness Week is running from 13th-20th March and is putting a spotlight on the connection between iron deficiency and coeliac disease.
Did you know that iron deficiency is the most common nutritional deficiency in Australia? It is estimated that one in three women of child-bearing age experience iron deficiency. Iron is a necessary component of heamoglobin contained in red blood cells and is required for the transport of oxygen around the body. Therefore, iron deficiency and iron deficiency anemia can have significant health implications, including symptoms such as;
- Shortness of breath
- Feeling cold easily
- Inability to concentrate
Whilst iron deficiency is commonly attributed to inadequate dietary iron intake, issues of poor iron absorption (e.g. coeliac disease) are often overlooked.
Coeliac disease is an autoimmune condition in which the body’s immune system attacks the intestinal lining when exposed to gluten. This results in chronic damage to the walls of the small intestine, whereby the villi (small finger-like projections on the intestine wall) become flattened and can no longer effectively absorb nutrients (such as iron, B12 and calcium). Coeliac disease is estimated to account for approximately 1 in 20 cases of iron deficiency, however, many individuals are not aware of the connection between iron deficiency and coeliac disease. Healthcare providers do not always undertake further investigations, meaning that ceoliac disease continues to be under-diagnosed.
What to do if you think you have Coeliac Disease?
It is estimated that 4 in every 5 individuals with coeliac disease in Australia are undiagnosed, which can severely impact quality of life and heightens the risk of long-term complications such as infertility and osteoporosis. It is for this reason, that iron deficiency should ALWAYS be investigated further by your GP or other healthcare provider, as it can be an important warning sign of coeliac disease. We encourage all patients to advocate for their own health and prompt further investigation by healthcare professionals if you are experiencing chronic iron deficiency with no other apparent cause. This is particularly important if you have additional symptoms of coeliac disease such as;
- Abdominal pain and cramping
- Unintentional weight loss
- Brain ‘fog’
How can your healthcare provider help?
If you or your healthcare provider has reason to suspect that coeliac disease may be present, the following testing can be undertaken;
- Coeliac serology: Blood test is performed to test for the presence of ceoliac antibodies which suggest an active autoimmune response. Note: coeliac disease should not be diagnosed on serology alone. A small bowel biopsy should subsequently be done to confirm the diagnosis.
- Small bowel biopsy: gastroscopy is performed in which tiny samples (biopsies) of the small intestine are taken and tested for signs of damage to the villi caused by coeliac disease.
If presence of coeliac disease is confirmed, dietary management involves complete removal of ALL gluten containing foods and beverages from the diet to prevent continued immune activation. This includes avoiding any risk of gluten contamination when eating out or sharing utentils (e.g. toasters). A dietitian can help provide guidance regarding how to adjust to dietary changes, including label reading and avoidance of cross-contamination. Once gluten is removed from the diet, the gut lining will begin to repair, allowing for a return to normal gut function and nutrient absorption with symptom resolution.
So this Coeliac Awareness Week (13-20th March 2022), we encourage everyone to spread the word about iron deficiency and coeliac disease and advocate for your own health if you are concerned about chronic iron deficiency. If you are someone who has been diagnosed with coeliac disease, we also encourage you to speak to an Accredited Practising Dietitian (APD) for personalised support with dietary management.