Case Study: Liver Damage In A Patient With Celiac Disease

Gina is a 28 year old lady who came to my clinic several weeks ago. She had been experiencing increasing discomfort in the right upper portion of her abdomen for nearly a year. Gina is a dancing instructor and she regularly plays a number of sports, so she assumed the discomfort was due to a muscle strain or ligament problem.

Additionally, Gina was feeling increasingly tired. Her doctor ordered some blood tests and Gina was found to be low in iron and vitamin B12. She took supplements and felt a little better, but she was still unhappy about her consistent low energy. Gina and her husband had been trying to conceive for the last six months and were surprised that she hadn’t fallen pregnant. Her doctor advised Gina not to worry, and that infertility is not diagnosed until a couple is unable to conceive for 12 months or more.

Gina needs a lot of energy for her job, and she was becoming so tired that all she wanted to do in the evenings and weekends was lay on the couch and watch movies. She even found the housework was becoming too exhausting, and this led Gina back to her doctor. Her doctor ordered more comprehensive blood tests and found Gina to be severely vitamin D deficient. She was also found to have celiac disease.

Celiac disease can cause liver damage, and Gina did have elevated liver enzymes. This explains why Gina was experiencing discomfort over her liver, and why she was so tired. With her doctor’s guidance, Gina commenced a gluten free diet. She had been following a gluten free diet for three months when she came to see me.

Gina was worried because she was still noticing pain in her liver, and her liver enzymes were still elevated. She was worried about her liver and confused about why it wasn’t improving despite the gluten free diet.

Celiac disease can potentially cause serious liver harm. It is very common for celiacs to have elevated liver enzymes when first diagnosed. Following a gluten free diet is necessary of course, but it is often not sufficient to improve liver health and normalize liver enzymes.

Celiac disease is an autoimmune disease. That means when people with the condition consume gluten, their immune system attacks their small intestine. The chronic inflammation to the gut lining can impair nutrient absorption and lead to many nutritional deficiencies. The most common ones are iron, calcium, selenium, vitamin D and other fat soluble vitamins (A, E and K), and essential fatty acids.

The excessively permeable gut lining allows a large volume of waste products to diffuse into the bloodstream. They quickly make their way to the liver, where they can cause damage to liver cells and consequent raised liver enzymes. Bacteria, bacterial toxins, fungi, undigested food and waste products can cause significant harm to the liver if they are present in large quantities. This is common in people with celiac disease that has not been diagnosed, or if a person is not adhering to a gluten free diet. It can also occur when the harm to the gut caused by gluten does not heal properly just by removing gluten from the diet.

My recommendations for my patient

Believe it or not, Gina was taking a multi vitamin tablet that contains gluten! It’s critical to avoid all gluten all the time. Even trace amounts. The inflammatory chemicals the immune system produces when a celiac consumes gluten can cause serious tissue damage to their small intestine and liver.
A good liver tonic to help repair her liver and support bile production. The herbs and taurine in Livatone help to repair liver cells and increase the liver’s production of bile. This aids digestion and has a detoxifying effect in the body.
Selenium is immensely beneficial for anyone with an inflamed liver because it is required for the production of glutathione. This is your body’s own powerful antioxidant and detoxifier. Selenium levels are low in the soils of much of the world, therefore foods tend to be deficient. Anyone with poor digestive health will not absorb selenium well enough from food, therefore supplementation is usually necessary.
Gina still experienced abdominal bloating and gas, therefore I suspected she had small intestinal bacterial overgrowth (SIBO). I gave her BactoClear capsules to help address this. Ultimate Gut Health powder and bone broth are both wonderful for soothing an inflamed gut and enabling faster tissue repair. They help to reduce the toxin load that arrives at the liver from the intestines.
People with celiac disease have a higher requirement for probiotics than the average person. Fermented foods like sauerkraut, kim chi and apple cider vinegar are all good sources, as is a probiotic in supplement form.