Amy Keller, MS, RDN, LD, is a dietitian and celiac support group leader from Bellefontaine, Ohio.
My daughter, who is in college, was diagnosed with celiac over the summer. Her doctor told us that she also has iron-deficiency anemia, which she said could be caused by the damage done by the celiac. She’s so tired—is there anything she can eat to improve her energy levels? She tried iron supplements, but they upset her stomach.
Your daughter’s doctor is correct that celiac can cause iron-deficiency anemia. This is due to the malabsorption of iron in the intestine. In addition to the fatigue your daughter has experienced, other symptoms of anemia include pale skin, weakness, dizziness, headache and glossitis (an inflamed tongue). Iron supplements are best absorbed when the stomach is empty, but this can make side effects such as nausea worse.
Heme iron, which is found in animal foods such as beef, liver, chicken and turkey, is readily absorbed by the body. Non-heme iron from plant foods such as beans, tofu, dark leafy greens and cashews is not as well absorbed, but these are still good choices. Look for gluten-free bread and cereal products that are fortified with iron. To get the most iron out of food, eat it with foods that are high in vitamin C—for example, pair a baked tomato half with beef pot roast or mandarin orange slices on top of spinach salad.
