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Dietitian
Iron deficiency is a common problem with people who are initially diagnosed with celiac disease. However, once they are on a gluten-free diet and the small intestine has returned to normal, the iron requirements would be the same as for non coeliacs. The best sources of iron are red meat and offal (liver, kidney); white meats (pork, chicken, fish) and eggs contain iron as well. You should consume lean meats and fish three to five times a week. Many plant foods contain iron (non-haem iron) but the iron from these sources is not as well absorbed by the body as from animal sources (haem iron). Wholegrain breads and cereals contain more iron than refined ones. Legumes (peas, beans, lentils, and nuts) and leafy greens such as spinach and silver beet also contain iron. Including food with Vitamin C in the same meal as non-haem iron allows better absorption. Examples might be drinking orange juice with your meal, cutting strawberries into your bowl of cereal or putting tomatoes on your sandwich.
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Dietitian
•Once the villi in the small intestine has fully recovered through consuming a strictly gluten free diet, then nutritional biomarkers such as iron levels should return to normal. Depending on the level of damage this may take between 3 months to a year.
•If you are consuming a totally gluten free diet and still are suffering iron deficiency, I would recommend that firstly you should see an Accredited Practising Dietitian (find a local one at http://daa.asn.au) to have your diet checked for possible gluten contamination and have your label reading skills assessed. If cause is not found then you should seek medical advice for other causes of the low iron levels.
•It is important to remember that a lack of fibre is a common nutrient deficiency in the gluten free diet, which may also lead to constipation. However if you are on a prescribed dose of iron supplements added fibre may inhibit the absorption of the iron. This is something else to discuss with your Accredited Practising Dietitian.
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