According to Haematogica up to 50% of adults with Celiac Disease have Iron Deficiency Anemia. Often they may present without any of the common gastrointestinal symptoms, usually associated with Celiac Disease, like diahorrea and malabsorption. They most common symptom is fatigue and then a diagnosis of iron deficiency anaemia. The other common feature is the refractoriness to oral iron treatment, which means that despite taking iron tablets, their serum iron levels never improve. This is caused by the atrophy of the villi in the small intestine which prevents the absorption of vital minerals such as Folate, Iron and Vitamin B12.

Iron is the key component in haemoglobin, the protein that carries oxygen in the body. The body needs to get iron from our diet and if there is not enough iron, haemoglobin cannot carry enough oxygen around the body and to our cells. Oxygen is needed by every cell in our bodies to sustain life.

What Are The Symptoms of Iron Deficiency Anemia?

Fatigue. The most common symptom, due to not enough oxygen in the cells.
Shortness of breath
Dizziness
Headaches
Pale skin colour
Sore Tongue
Unusual Food Cravings (Pica)
Hair Loss
Irritability
Weakness
Poor Concentration
Low Immune Function
Rapid Heart Rate

There are many reasons for iron deficiency including

Blood loss. This may be caused by heavy menstrual bleeding, or bleeding fibroids, or there may be internal bleeding such as a bleeding ulcer, polyps, haemorrhoids or colon cancer.

Certain medications such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) cause internal bleeding leading to low iron levels or ant-acids may prevent iron absorption.
Another reason for iron deficiency may be a poor diet, not eating enough iron rich foods, such as red meat or eggs. Often a vegetarian diet which doesn’t include enough animal proteins which are high in iron, may lead to anaemia.
Poor Absorption of iron in the body due to intestinal surgery, or chronic diseases such as Crohn’s Disease or Celiac Disease.

So many people with Iron Deficiency Anemia have Celiac Disease, but many are not tested for it or are not aware they have it. It is one of the most unrecognised causes for low iron and yet it is incredibly common. A lot more common than people realise.
The ingestion of gluten in a person with Celiac Disease, causes an auto-immune reaction, resulting in damage to the villi, in the small bowel. The villi, the small finger-like projections in the small intestine are were the absorption of nutrients occur and when this area is damaged, vital nutrients are mal-absorbed. This includes, iron, calcium, folate, important vitamins, and minerals and all nutrients that sustain an individual. Once on a gluten free diet, the gut will begin to heal and all of these nutrients will begin to be absorbed and the patient’s health improves drastically,
People may have Celiac Disease without having any of the so called classic Gastro Intestinal complaints. Celiac Disease often can be asymptomatic except for iron deficiency. Even if you have no GI symptoms, it is important to be checked for Celiac Disease, with a gastroscopy and biopsy of the small intestine and blood tests that test for anti-tissue transglutaminase antibodies (tTGA) and anti-endomysium antibodies (EMA).
So if you are Iron deficient and unwell and not responding to iron treatment, get tested for Celiac Disease. It is one of the most overlooked causes for Iron deficiency anemia and yet one of the most common.

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