For those with celiac disease or gluten sensitivity, ingesting even the smallest amount of gluten can trigger a reaction, and it's no different when it comes to medication. Both over-the-counter and prescription drugs can be a hidden source of gluten. If you're following a gluten-free diet, that can spell trouble. Follow these tips to make sure your meds are gluten-free.

Learn the Ingredients

The first step is identifying whether or not a medication contains gluten. This can be tricky. Labeling gluten-containing ingredients in medication isn't legally required, and it's often the inactive ingredients (binders or fillers) that can be potential sources of gluten. Cross-contamination can also be an issue.

Just like with food, learning the ingredients and how to read the label is a must. Pay attention to the inactive ingredients—particularly anything with starch or dextrin, unless it states a gluten-free grain as the source.

Check the back of the box on over-the-counter medications for ingredients. Prescription ingredients can be found in the package insert or on the manufacturer's website. If in doubt, ask your pharmacist to call the manufacturer or call yourself to confirm if a medication is safe.

Consult Your Doctors

Another major step is to consult your doctors—all of them. This includes your dentist (think about what they might use to clean your teeth) and any specialists.

Get to Know Your Pharmacist

In addition to developing a relationship with your doctors, it's also important to work with your pharmacy to address your gluten-free needs. They are, after all, the ones filling your prescriptions, and the prescribing doctor might not necessarily know which medications have gluten in them or not. Make a point to fill your prescriptions at the same pharmacy and ask the pharmacist to make a note in your file that states your medication cannot contain gluten.

Investigate Brand vs. Generic

The difference between a brand-name product and generic can often lie in the inactive ingredients that are used, which is where gluten might show up. Simply put: check everything.

Tell Your Insurance

Informing your insurance from the get-go that you have celiac disease and are required to follow a gluten-free diet may help when it comes to approving brand-name medication over generic, if the generic medication contains gluten. However, it's not a guarantee.

Original article reviewed By Jill Kohn, MS, RDN, LDN 

What vitamin deficiency affects over half the population, rarely goes diagnosed, and has been linked to many cancers, high blood pressure, heart disease, diabetes, depression, fibromyalgia, chronic muscle pain, bone loss, and autoimmune diseases like multiple sclerosis?

If you answered vitamin D, you’re correct.

Vitamin D: It's the sunshine hormone.

Vitamin D isn’t actually a vitamin or nutrient; it is a hormone produced from a photolytic reaction with ultraviolet (UV) light.  Many of us live in more northern latitudes (pretty much anywhere north of Florida), where ample sunlight is not available year round. Even for those who do have access to it, many folks spend the majority of time indoors or slather on sunscreen when they do go out. That means you probably need to get vitamin D from your diet.

As a medical doctor, I prefer patients get nutrition from food whenever possible, but vitamin D presents some obstacles. Food sources are minimal, which is why dairy and other food products are fortified with vitamin D. Some plants contain small amounts of the non-biologically active form of vitamin D, such as fungi-yeast, molds, and mushrooms. The best animal sources are liver, especially from cod, herring, and sardines. Still, unless you’re eating 30 ounces of wild salmon a day or downing 10 tablespoons of cod liver oil a day (which you're probably not!), I recommend patients supplement with vitamin D to get optimal amounts.

Even if you get enough vitamin D, you may not be absorbing it.

Among the obstacles for your body to make sufficient vitamin D include age. The average 70-year-old creates significantly less vitamin D than a younger person.
Skin color makes a difference, too. People with dark skin produce less vitamin D, and I’ve seen very severe deficiencies in Orthodox Jews and Muslims who keep themselves covered all the time.
The government recommends 200 to 600 IUs of vitamin D a day. That’s the amount to prevent rickets, a disease caused by vitamin D deficiency. But the real question is: How much vitamin D do you need for optimal health, not just deficiencies?

How much vitamin D is the right amount?

Much more than you think. When my patients reach optimal levels, they frequently tell me how much better they feel. I see major improvements in their health. That’s why I put nearly every patient on vitamin D supplements, which are inexpensive and easy to take via softgels or liquid drops.
At the same time, more vitamin D is not always better, and very high levels can become toxic. Here are five ways to optimize your levels to get all of the benefits from this workhorse hormone:

1. Get tested.  Before starting to supplement with vitamin D, ask your doctor for a 25-hydroxy test. This will give you and your doctor an idea of how much you may need to supplement.

2. Take the right form.  Use D3, not D2. Vitamin D3 is derived from lanolin, so strict vegans should find a lichen-derived D3. To improve absorption, take vitamin D with food that contains some fat since it is a fat-soluble nutrient.

3. Take the right amount. If you have a deficiency, correct it with 5,000 to 10,000 IUs of vitamin D3 a day for three months—but only under a doctor’s supervision. (Higher doses should ideally be combined with vitamin K, and many better supplements combine these two vitamins.) For maintenance, take 2,000 to 4,000 IUs a day of vitamin D3. Some people may need higher doses, but please discuss this with your doctor.

4. Get rechecked every three months.  Since vitamin D is a hormone, it fluctuates for everyone differently, and obviously seasonal changes affect it too.  There are different "optimal ranges." Experts and organizations have different ranges. You want levels over 30ng/mL and not more than 80ng/mL.

5. Be patient.  It could take six to ten months to "fill up the tank" for vitamin D if you’re deficient. Once this occurs, you can lower the dose to the maintenance dose of 2,000 to 4,000 IUs a day.

As I mentioned earlier, please talk to your doctor about making any changes to your normal health routine, as every body has different needs.

Mark Hyman, M.D.Funtional Medicine Doctor