Food to boost dds energy and iron levels - gluten free

[Tirednest]

She's 16, anaemic and being tested for coeliac disease. We've gone gluten free while waiting for results and this is definitely helping with her tummy issues. She's been taking ferrous sulphate from the gp for a few weeks now and feels more tired than ever 😢

We eat healthily but with not much red meat which dh and I think we may need to change. Her typical diet is
Porridge and fruit for breakfast sometimes Greek yogurt
School lunch - she gets a cooked lunch which can be hit and miss, ie yesterday was a roast which was great, but Monday was chicken katsu curry so she was given rice only as the chicken was in breadcrumbs 😐
Dinner - this week she's had a vegan beyond meat burger (using up what was in freezer) with gf bun and salad and a few chips
Gf pasta with sausage peas and cream
Homemsde Chicken curry with rice

Any advice for food or snacks to boost her iron and energy levels? She just looks tireder and paler than ever. She does a lot of sport and is very active but I'm secretly hoping she'll give that a rest in half term.

Thank you.

I've been GF for 10 years as a result of IBS and I find certain foods contribute to digestive issues, and iron supplements are a disaster!

Fortunately, there are GF equivalents of almost all foods nowadays and I suggest you and your DD get familiar with the various brands and which shops sell which, and give them all a try. I like Schär and Genius breads - particularly Genius pita breads which are delicious!

But yes to protein for energy and if all she's getting for lunch is rice and there is not GF option, that's not acceptable and no wonder your poor DD is exhausted and anaemic! I'd be making her (or getting her to make) a packed lunch with a GF sandwich with a protein and salad in it, a smoothie, a GF cereal bar, an apple/orange/whatever, plus I'd give her some GF snacks to eat at break or before/after games if she's very active.

My 15-year-old sporty DS eats breakfast, snack, lunch, snack, dinner and protein shake every day. His protein shake is a banana, a scoop of protein powder, a large teaspoon of peanut butter and enough skimmed milk to make up a pint-sized shake. I appreciate that girls don't want to bulk up like many boys do, but she should definitely be getting three balanced meals a day, as a minimum.

Floradix is NOT gluten free

If she is coeliac then she probably has damage in her bowels that will need to heal and help her absorb vitamins etc better.
I have no dietary advice as DD is coeliac and ND and has a limited diet anyway. So we just take supplements from the doctor.

My butcher recommend adding black pudding to things like beef stew for iron, make a fab gravy and no signs of it in the stew at all.

I found liquid iron drinks much more palatable.

If there any fortified cereal she would eat? Also, have something that aids absorption with meals, not tea.

It might not just be the anaemia that’s contributing to her tiredness and fatigue. My husband is coeliac and he was by the time he was finally diagnosed, he was severely deficient in absolutely everything. He had a course of six B12 injections over a two week period at our GP surgery immediately after diagnosis, and he felt much better afterwards. Magnesium deficiency can contribute to tiredness too, you can get magnesium supplements for a couple of quid in places like home bargains.

if she is coeliac she likely needs to aboid oats too.

yes to her b12 needing to be checked. very common in cases of mal absorbtion to be affected.

with regards to iron tablets - there are many different forms. I personally didn't get on with liquid iron but was tgen prescribed tablets that only dissolve in the intestines. also taking it every other day instead of daily seems to increase absorbtion and decrease side effects.

ALDIs version of marmite is possibly gluten free.

This image has vegetarian on the label, but the one I have on my desk says vegan.

When I was anaemic in my teens I was prescribed marmite from the doctor (you wouldn’t see that these days!) and marmite on toast and a clementine was a staple breakfast. You might need gluten free bread or rice cakes though.

This is all really interesting thank you. I will look into the vitamin b12

Dried apricots are high in iron and gluten free.

Could she take a packed lunch instead? She’s more likely to have something that’s balanced and helps with her energy eg gluten free sandwiches or pasta salads with a source of protein. Then a couple of snacks. Does she have snacks throughout the day? What you mention isn’t a lot of food so no wonder she’s tired.

Red meat has many times more iron than leafy green veg, but these are the only things that are moving my iron levels back up from a stupidly low base. Bacon has plenty too! I do take ferroglobin when I can, as well, though I can’t always tolerate it (digestive issues). I can’t have citrus, so I have to make sure I am getting enough Vitamin C to allow my body to take in the iron.

It’s hard to get the balance right, but I think some more red meat would be a good step towards recovering, especially given her other restrictions.

I would wait until the coeliac test comes back at this point. Supplement Vit D specifically, not just with a multivitamin.

Coeliac/gluten intolerance can caused lactose intolerance over time, so some people need to give up both gluten and lactose for a while until their gut recovers. Hard cheese and some yoghurt is very low in lactose so this isn't as awful as it sounds. But I felt much better when I stopped having porridge with milk for breakfast, and switched to scrambled eggs and gluten free wraps. Often something else alongside - just one of baked beans, cheese, mushrooms, bacon, chorizo, tomatoes. You could also think of it as splitting breakfast in 2, giving her something protein based at home and then she takes a GF muffin in to eat at school.

Iron tablets are a real challenge. I take them at bedtime. If I eat them with food, my body reacts like I'm eating gluten.

It sounds like school dinners are compulsory? You need to arrange with them an acceptable protein source that she can just be served whenever the main meal is not suitable for her. Just something that will sit in the freezer and they can bung in the oven - plain chicken breast, or GF fish portion or whatever. I would prefer her on packed lunches while you're figuring out what works.

Lambs liver in Bolognese is a great tip.

Thank you. She has almond milk in her porridge. Yes school lunches as compulsory so I'm just concentrating on a good nourishing supper ATM. I've bought a steak for Friday night and I'll make a big cottage pie at the weekend

What stage are you at in the testing process for celiac disease?

Waiting for bloods.

But initial tests show anaemia and very low in vitamin d

I'm sorry to say, but your daughter needs to be having gluten, and every day, to get a dx of coeliac disease. It's a common mistake (even advised by some drs!) to stop it to see if it helps, which then causes a misdiagnosis in the blood results. She needs to be having gluten daily, to have an accurate blood test result.

Also, be aware that gluten is in all sorts of things that you wouldn't think of, if she does get a dx. Also again, some people still react to foods labelled gluten free. I myself can't tolerate the bisto gf gravy. I also don't touch "may contain" foods.

She was eating gluten at the time of the blood test, but yes I have heard this

The very low Vitamin D will cause low energy. What did the GP recommend? In lieu of any other advice get her the Better You D3000 vitamin D spray from Amazon. If she's low iron & Vit D there's a very high chance she's also low B12 too. You can't take too much B12 so until injections are offered get her to take masses (DD will take 10,000 a day when her low B12 symptoms hit) - any not needed comes out in urine so you can't take too much. Coeliacs stops the body absorbing vitamins & nutrients so if it is that once GF diet is under control everything else will hopefully fall in line (with a bit of help via supplements particularly in the beginning to get back to normal levels).

Please don't go gluten free yet!!

It's vital she's eating gluten in case she needs an endoscopy to confirm coeliac, if she's not eating lots of gluten then that won't be reliable. DD is coeliac and we went through this when she was 4. GPs often say to go gluten free but you mustn't until you see the consultant. Sometimes, if the blood test TTG levels are high enough, they diagnose without an endoscopy but you won't know yet.

Coeliac.org is a brilliant place for advice on this, with what to do whilst waiting for test results and what the different tests are about.

Yes school lunches as compulsory

@Tirednest your Dd isn’t consuming enough food. You don’t mention snacks throughout the day which would boost her energy. You need to have a word with the school about the lack of balanced meals your Dd is given and that this is having a negative effect on her energy and concentration levels. A portion of rice isn’t enough and I doubt she eats it all if it’s just plain rice.

Your Dd needs more protein in at breakfast and lunch. Snacks (eggs, veg or rice cakes with houmous or peanut butter, gluten free friend and nut bars, dried fruit etc) or protein smoothies:

e.g www.puregym.com/amp/blog/3-tasty-high-protein-smoothie-recipes/

Ah, it's good she's had the blood tests already. I thought you meant you were waiting for them. Be aware, you can get a false negative result. Good luck!

I forgot to say, I still wouldn't eliminate gluten as she may also need an endoscopy. I wouldn't stop until you have a confirmed diagnosis.