Iron and coeliac disease

About the importance of iron in coeliac disease

Why is iron important in coeliac disease?

Iron is part of the haemoglobin in your red blood cells. Haemoglobin is used for oxygen transport in the body. If the iron level in your blood becomes low, you may become tired, short of breath, have less of an appetite, get headaches and suffer from poor concentration. Having very low iron levels is called anaemia. This is common among people newly diagnosed with coeliac disease and those with coeliac disease who do not follow a gluten-free diet.

Individuals following a vegetarian or vegan diet tend to consume less iron and therefore can be at higher risk of iron deficiency.

How much iron do I need?

The amount of iron you need depends on your age and gender. The table below shows the amount you need for various foodstuffs [reference: Dietary Reference Values for Food Energy and Nutrients for the UK, DH 1991 (RNI used)].

Which foods and drinks are rich in iron?

There are two types of iron, which are found in different types of foods. These are called ‘haem-iron’ and ‘non-haem-iron’.

Haem-iron

• from animal sources such as meat and fish
• better absorbed than non-haem iron

Non-haem iron

• found in plant sources such as dark green vegetables, beans, pulses, dried fruits, nuts, seeds, eggs, and most breakfast cereals and cereal foods

Do I need to take an iron supplement?

Your doctor and / or dietitian may recommend an iron supplement if you are unable to consume enough iron from your diet. Absorption of iron improves on a gluten-free diet.

How can I increase the amount of iron I absorb from my diet?

Not all of the iron in the food we eat is absorbed into our body. Some of it passes through our gut rather than making its way into our blood where it can be used. However there are things we can do to increase the amount of iron our body absorbs from food.

Eat more foods rich in vitamin C along with iron-rich foods

Having foods and drinks rich in vitamin C alongside foods containing non-haem iron helps increase the absorption of the non-haem iron.

Foods and drinks rich in vitamin C include:

• fruit and fruit juices – especially kiwi, lemon, orange, grapefruit, blackcurrant, strawberry, lychee, papaya
• lightly cooked green leafy vegetables and raw salad vegetables
• potatoes

Try to have food and drinks rich in vitamin C together with iron-rich foods. For example, have a glass of orange juice alongside a bowl of puffed rice breakfast cereal, or have a jacket potato with baked beans.

Limit drinks that reduce the absorption of iron when eating iron-rich foods

The tannins in tea and polyphenols in coffee and cocoa may limit the absorption of iron, so try to avoid drinking these at the same time as eating iron-rich foods.

Note: Gluten-free alternative foods can be fortified with iron, calcium and B vitamins – please see product packaging or the diet sheet ‘Nutrition information of gluten-free substitute products’.

Contacts and further information

Dietitians: 01225 216655