- Celiac disease can cause nutritional deficiencies (low vitamin and mineral levels). Malabsorption (when nutrients do not get absorbed in the intestine) can be due to diarrhea, as well as damage to and inflammation of the small intestine.
- For people with diarrhea, malabsorption can also cause loss of protein, calories, and fats. Long term or severe malabsorption can lead to muscle and weight loss. 1
- Nutritional deficiencies can also be caused by the need to avoid certain food groups (such as gluten-containing grains) that provide necessary vitamins, minerals and other nutrients. To learn which gluten-free grains and foods supply these important nutrients and how to create a balanced and healthy diet, visit Healthy Eating.
- People with celiac disease have very different nutrient requirements based on their age, gender, medical history, and activity level. Be sure to speak to your doctor or dietitian about your particular nutrient and supplement needs.
Below is a list of the most common nutrient deficiencies in celiac disease at diagnosis. 2
- Vitamin D
- B vitamins
- B12 3,4
- Thiamine (B1)
- Riboflavin (B2)
- Niacin (B3)
- Vitamins A, E and K are commonly deficient in people with the more severe malabsorption sometimes seen in celiac disease. 4,5
- Zinc 4
- Calcium (a common deficiency of the gluten-free diet if a person is avoiding dairy due to lactose intolerance)
Other Common Deficiencies at Diagnosis Include:
In addition to standard blood tests, there are specific blood tests recommended for newly diagnosed or untreated celiac disease:
*Other labs, such as vitamin A, vitamin E and vitamin K, carnitine, zinc, copper or selenium, may be drawn based on your particular medical condition and symptoms.
Follow up with your doctor to review your blood test results and discuss the possible need to supplement your gluten-free diet.
TAKE HOME MESSAGES:
- Developing a nutritional deficiency is related to 4 factors:
- How long celiac disease was undiagnosed
- The amount of damage to the small intestine 6
- The location of the damage in the small intestine
- A person's nutrient needs based on age, growth, etc.
- It is important that you have routine health check-ups and lab work with your physician or health care provider. Ask for a referral to see a dietitian specializing in celiac disease to help you plan a balanced diet meeting all of your nutritional needs.
- Visit the Supplements section to learn more about which vitamins and minerals are generally recommended for people with celiac disease and which ones can be unhealthy or toxic in higher doses, such as iron and vitamin A.
- Kelly, C. Common and Uncommon Presentations of Celiac Disease. In Real Life with Celiac Disease: Troubleshooting and Thriving Gluten-Free . Eds. Dennis M, Leffler D. AGA Press. Bethesda, MD, 2010.
- Kupper, C. Dietary guidelines and implementation for celiac disease. Gastroenterology, 2005;128:S121-S127.
- U.S. Department of Health and Human Services/National Institutes of Health. NIH Consensus Development Conference on Celiac Disease. http://consensus.nih.gov/2004/2004CeliacDisease118html.htm. Accessed August 16, 2011.
- Barton SH, et al. Nutritional Deficiencies in Celiac Disease. Gastroenterol Clin N Am, 2007(36):93-108.
- See J, Murray JA. Gluten-free diet; the medical and nutritional management of celiac disease. Nutrition in Clinical Practice, 2006;21:1-15.
- Saturni L. The gluten-free diet: safety and nutritional quality. Nutrients, 2010; 2:16-34.
Revision Date: 10-8-13
Author: Melinda Dennis, MS, RD, LDN
Editors: Anne Lee, MSEd, RD, LD and Rupa Mukherjee, MD