Basic pillars of nutritional health and lab parameters can resolve the symptoms of fatigue that many celiacs experience.
- Selena De Vries is dedicated to helping individuals who are struggling with digestive issues find food freedom. Selena understands that celiac disease not only effects one’s physical health but also effects one’s emotional health. Using an integrative approach in the management of digestive health conditions, she provides support for those with celiac disease/gluten sensitivity and nutrition coaching for other digestive health conditions.
Fatigue is probably the most common complaint I get when seeing clients with celiac disease. Often, individuals jump to thinking they need some complex supplement, an exclusion diet trial to discover food sensitivities, or specialized lab testing. But, it often comes down to a few basic pillars of nutritional health and lab parameters. Let’s discuss them below.
1. Lack of fiber and protein in the diet
This is by far, very common in not only individuals with celiac disease, but the general population. Protein and fiber helps to hold blood sugars stable, which is one thing that contributes to energy levels. Stable blood sugar = stable and consistent energy levels.
Often times, many people forget to include protein at breakfast and lunch and load up with a giant steak or chicken breast at dinner. Without adequate protein earlier in the day, energy levels will falter and you’ll be finding yourself wanting to take a snooze instead of being productive!
In terms of fiber, many people also don’t get enough. The average Canadian gets ~10-15g of fiber per day. The recommended amount is 25-38g per day. In individuals with celiac disease, a low fiber diet is even more common as celiacs tend to eat a lot of white rice products (low fiber) and other grains and products made with low fiber grains and starchs such as cereals, breads, pastas and bars.
Without consistent fiber intake at meals and snacks, blood sugars will be more likely to up and down vs stable which will contribute to uneven energy levels.
2. Skipping meals and/or meals that are not nutritionally balanced
Most people need 3 meals/day and, perhaps, 1 snack especially if you are someone that goes more than 5 hours between meals. Going without food for a long period of time may also contribute to uneven blood sugars which will have a negative effect on energy levels. Sometimes, people go so long without eating and mention to me that they have no problems going so long without food. But then once they eat, they find themselves gorging on food because they all of a sudden are STARVING and seem constantly hungry. This is your hunger hormone, ghrelin, at work. The longer your stomach is empty (ie- the longer you go without eating), the more of this hormone is secreted by your stomach. The higher your levels, the hungrier you get and it will be a, purely, biological drive to eat to satisfy that hunger. As you can imagine, eating a large amount of food in one sitting is most definitely going to make you feel lethargic.
In addition, if your meals aren’t balanced, it may also make it difficult to stabilize your energy levels. This has a lot to do with consistent and adequate fiber and protein at meals, which is discussed above.
3. Low lab parameters
Individuals with celiac disease are at higher risk for nutritional deficiencies as well as other autoimmune conditions that can contribute to fatigue. So, as a rule of thumb it is good to rule these out:
- Hashimotos (or autoimmune thyroid disease). You can test for this condition with your doctor by looking at TSH, thyroid antibodies and additional parameters such as T3 and T4.
- Iron deficiency anemia or low iron. Your doctor can order this test by ordering a CBC and ferritin level.
- Low B12 levels. This is another type of anemia and your doctor can order this test by ordering a B12 level.
- Low copper. This should be tested when iron levels are unresponsive to iron supplementation. Your doctor would order a copper level.
What to Eat for Improved Energy Levels:
- Aim for 3 meals per day and snacks so that you are going no longer than about 5 hours without eating.
- Aim for 7-10g of fiber at each meal. In order to achieve this, aim to make half your plate vegetables, 1/4 plate whole grains or fruit and 1/4 plate protein (choosing beans/legumes or nuts/seeds often for your protein choice).
- Include ~15g of protein at breakfast, and 20-30g of protein at lunch and dinner.
- Address low lab parameters individually with your medical doctor or dietitian.
Good Sources of Fiber:
- Fruit, especially oranges, berries, apples, and pears
- Vegetables, especially leafy greens, avocado, green beans, carrots and cruciferous veggies
- Whole grains including GF oats, brown rice, teff, millet, quinoa and buckwheat
- Beans and legumes including lentils, chickpeas, black beans, white beans, edamame beans, tofu, tempeh, ‘noodles’ or ‘rice’ made from beans etc.
- Ground flax, psyllium husk and chia seeds
Good Sources of Protein:
- Hemp hearts, almonds, cashews, sunflower seeds and other nuts and seeds
- Beans and legumes including lentils, chickpeas, black beans, white beans, edamame beans, tofu, tempeh, ‘noodles’ or ‘rice’ made from beans etc.
- Yogurt, cheese, cottage cheese, cows milk, soy milk
- Eggs, chicken, turkey, salmon, beef, moose, duck etc.
Sample Day of a Energy Boosting Diet:
- 7am: 1/2 cup GF large flakes oats, cooked, topped with 1/4 cup walnuts, 1 TBP ground flax, a handful of blueberries, topped with some yogurt/cream (optional) and a drizzle of maple syrup and shake of cinnamon.
- Fiber = 11g; Protein = 13g
- 12pm: 3/4 cup cooked quinoa, tossed with 1/2 cup cooked edamame, 1/4 cup chopped cucumber, 1/4 cup chopped cherry tomatoes, 3 TBP feta cheese, 1 cup spinach, tossed with your favourite salad dressing.
- Fiber = 13g; Protein 22g
- 4pm: apple
- Fiber = 4g
- 6:30pm: 4-5oz salmon with maple seasoning, 1/2 cup roasted sweet potato, 1 cup roasted broccoli, 1 sliced orange
- Fiber 10g; Protein = 28g
Total Fiber for the day 38g; Protein 63g
Selena De Vries is a Registered Dietitian living with celiac disease who specializes in the dietary management of that condition. She will be hosting a ‘virtual office hour’ on the Canadian Celiac Association Facebook Group every THIRD Friday from 12 – 1pm Pacific Standard Time (3pm – 4pm Eastern Standard Time). Selena will post at 12pm stating she is online. Ask your nutrition related questions in the comment section within her post. Arrive early and post your question!
Selena is licensed to practice as a dietitian in British Columbia. Her services are available to anyone in Canada.
Living in the Okanagan or anywhere in British Columbia? View Selena’s services or book an appointment!
Celiac Total Health Package – 5 sessions
- Includes one initial assessment, 3 follow ups and a meal planning assessment along with a one week meal plan. Selena will recommend labs/procedure to identify any underlying nutrient deficiencies, will provide you with all the education you need to feel confident going gluten free and get you feeling better throughout our appointments, and most importantly, help you prepare and choose healthy GF products and get healthy GF meals on the table that the whole family can enjoy. Book your appointment or contact Selena with questions.
Eating Out With Confidence – 3 sessions
- Are you avoiding eating out due to the fear of being ‘glutened?” If so, this package is for you. Selena will provide you with education and resources that will improve your confidence in eating out safely. You will also get access to her on the go! For example, if you are eating out at a restaurant and need help in ordering your meal to reduce risk of being contaminated, she will walk you through what you need to ask to ensure your meal is at low risk of being contaminated. Book your appointment or contact Selena with questions.
Meal Planning Initial Assessment – 1 hour In-person – Online, video chat or by phone
- If you are struggling with getting healthy meals on the table that everyone can eat, this is for you. Selena will conduct a meal planning assessment and based on your input, she will put together a sample one week meal plan along with brand name food recommendations. You will get recommendations that makes healthy eating (with food restrictions), convenient, healthy and delicious. Book your appointment or contact Selena with questions.
Celiac Initial Consultation – 1 hour 30 minutes In-person, online, video chat or by phone
- Please book if you have been newly diagnosed with celiac disease or if you have celiac disease but are still struggling with symptoms. Selena will conduct a nutrition assessment & will provide an emailed lifestyle plan within 24 hours detailing the nutrition plan going forward. Supplements and lab tests will be recommended on an individual basis and the lifestyle plan will also include educational handouts, recipe ideas, and brand name food recommendations. Allow a minimum of 3 days advance booking as a 3 day food journal is required prior to the appointment. Book your appointment or contact Selena with questions.
Celiac Dietitian on Demand – 30 minutes – Online, video chat or by phone
- This is not for newly diagnosed celiacs or those who are struggling with digestive symptoms. If this is you, please book the initial consult (either celiac or digestive health). This is for you if your symptoms are fairly under control and you have brief questions. For example, a question on supplement use, the inclusion of GF oats in the diet, if you are grocery shopping and want to confirm if a brand name product is gluten free and safe to consume, if you are at a restaurant and want to know how to order an item that will be at low risk for being contaminated, or if you have questions on GF travel. Book your appointment or contact Selena with questions.
Initial Digestive Health Consult – 1 hour 15 minutes – In-person, online, video chat or by phone
- Please book if you are struggling with digestive health concerns or have been diagnosed with a digestive health condition (if you have been diagnosed with celiac, please book the celiac specific consult). Selena will conduct a nutrition assessment & will provide an emailed lifestyle plan within 24 hours detailing the nutrition plan going forward. Supplement, lab tests and lifestyle recommendations will be recommended on an individual basis and the lifestyle plan will also include educational handouts, recipe ideas, and brand name food recommendations. Allow a minimum of 3 days advance booking as a 3 day food journal is required prior to the appointment. Book your appointment or contact Selena with questions.
45 Minute Follow Up Appointment – In-person, online, video chat or by phone
This service can only be booked after an initial consultation has been completed. We will identify how the individual is doing on goals, barriers they may be facing, and steps to take going forward. Book your appointment or contact Selena with questions.
- “I contacted Selena when I still wasn’t feeling well a year after my celiac diagnosis. I’d read so much on the Internet I thought I knew everything I needed to know. I was wrong.
- Selena has important advice on how to do GF properly (it’s not as straightforward as I thought) and for regaining your health. She is organized, punctual, and professional. And she has celiac disease herself , so she gets it.
- I think a lot of us, by the time we’re diagnosed, have had more than our share of health care practitioners and may not want to bother with a dietitian.
- Selena played a crucial role in my recovery, and I would highly recommend her, whether you’re newly diagnosed or just trying to feel better.”
- ~ Charlene (long-distance celiac disease client)
- HEALTHBEAN NUTRITION specializes in digestive health. We deliver easy to digest, bite-size pieces of information so our clients can, finally, achieve the healthy & happy digestive system they’ve been striving for. Learn more ...
- HEALTHBEAN PHILOSOPHY– Selena employs elimination diets and/or a specific diets in accordance with her clients’ conditions, and only when deemed necessary. She reserves advice about the gluten-free diet for those who require it – not those choosing to follow the diet as a lifestyle choice. Expect clear, concise instructions on the appropriate diet for you and, maybe even some myth busting! Learn more …
Selena knows first-hand how her undiagnosed celiac disease affected her physical and emotional health. After telling her that, “Well, you have celiac disease,” her MD suggested she, “google the diet,” and out the door she went. Sound familiar?
That’s why Selena established Healthbean Nutrition. She is dedicating her education, personal insights and her own recovery to helping her fellow celiacs make this enormous lifestyle transition – and find joy in eating again! Learn more …
Selena’s Road to Diagnosis
- “When I was going through university, I was exhausted, ALL the time. I had to drag myself out to hang out with friends, and if I had it my way I would have spent most days in bed sleeping. It was not unknown for me to sleep 12-16 hours a day. Call me crazy, but I related it all to the busy-ness of school. I was even checked for anemia at one point (common with celiacs) and I was ‘fine.’
- The symptoms continued through school and the brain fog was undeniable. I distinctly remember during my dietetic internship (like a medical residency except everything is nutrition based) at Kelowna General Hospital sitting in the office, charting on a patient and, literally, feeling like my brain was so fuzzy that I could barely keep my eyes from nodding off. It was awful.
- Another thing I didn’t pay much attention to, was bowels. I was always constipated. Never the other way around. Never. And, I also remember mentioning this to my gastroenterologist just before the endoscopy and he said ‘oh, well with your very low antibody levels and constipation, there is a very low chance that you are actually celiac but we will proceed with the endoscopy since you’re prepped and ready to go.’
- The piece of paper I received after the endoscopy said to follow up with my GP. I did follow up with my GP and the report came back positive for celiac disease. My GP said “well, you’re celiac. But, you’re a dietitian, right, so this should be easy for you!”
- Perhaps I had a leg up in the nutrition part of it, but I think we all know that the gluten free diet is not a walk in the park. And, although, I am so appreciative of the medical care I received, it did open my eyes to the lack of knowledge within the medical community when it came to celiac disease and the lack of support offered to individuals with celiac disease.
That’s how Healthbean Nutrition was born!
- *Information and perspectives posted on The Celiac Scene are intended to provide general information, without independent verification on the part of The Celiac Scene for the accuracy of the information provided to it. The information is specifically not intended to be a substitute for medical diagnosis or treatment by your physician or other health care professional. Always consult your own physician or other health care professionals about any medical questions, diagnosis, or treatment, especially before trying any diet. Healthbean Nutrition does not accept any liability for any injury, loss or damage incurred by use of or reliance on any content contained herein.