Diagnosed with celiac disease? Here’s what to know about vitamins and supplements

Celiac disease is estimated to affect 1 in 100 people worldwide, with only about 30% of cases being properly diagnosed. Because additional studies show nutritional deficiencies affect around 20% to 38% of celiac disease patients,[2] it’s important to understand the role celiac disease can play in creating these deficiencies — and what to do about it.

So, why does it happen? “Micronutrient deficiencies can occur in undiagnosed or poorly controlled celiac disease, or in those following a strict gluten-free diet but lacking the proper nutrition,” said Nicole Lindel, a Registered Dietitian at Rocky Mountain Gastroenterology. “The small intestines have finger-like structures called ‘villi’ which help with nutrient absorption. If someone with celiac disease consumes gluten, the immune system attacks these finger-like structures and they flatten, preventing absorption of nutrients.”

Lindel says that for those with celiac disease who follow a strict gluten-free diet, micronutrient deficiencies may also occur as gluten-free alternatives are often nutritionally inferior. According to Lindel, only 5% of gluten-free breads contain all four mandatory fortification nutrients (calcium, iron, niacin, and thiamin).

Because a lack of essential nutrients can lead to issues of neurological complications, psychiatric symptoms, including anxiety or depression, and bone alterations, such as osteopenia or osteoporosis, Lindel stresses the importance of ensuring vitamin needs are being met.

RELATED: What to do after a celiac disease diagnosis: Two experts share their tips on long term management, shopping gluten-free, and more

For most people with celiac disease, following a strict gluten-free diet will allow the body to recover and repair the villi of the small intestines. However, in certain situations extra supplementation may be needed to ensure proper absorption.

“Some of the most common micronutrient deficiencies among those with celiac disease include iron, calcium, magnesium, as well as vitamin D, E, and B vitamins,”[3] said Lindel. To make the most out of supplementation, Lindel says it’s important to discuss supplementation with your healthcare provider as a first step.

Of course, Lindel says that diet also plays a factor. She suggests incorporating plant-based foods — such as fruits, vegetables, legumes, nuts — and naturally gluten-free whole grains — such as quinoa and amaranth — since they're all good sources of folate, riboflavin, vitamin C, and vitamin E.


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References:

1. What is celiac disease? Celiac Disease Foundation. URL . Accessed August 23, 2022.

2. Di Nardo G, Villa MP, Conti L, Ranucci G, Pacchiarotti C, Principessa L, Raucci U, Parisi P. Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet: A Systematic Review. Nutrients. 2019 Jul 13;11(7):1588. doi: 10.3390/nu11071588. PMID: 31337023; PMCID: PMC6683263.

3. Cardo A, Churruca I, Lasa A, Navarro V, Vázquez-Polo M, Perez-Junkera G, Larretxi I. Nutritional Imbalances in Adult Celiac Patients Following a Gluten-Free Diet. Nutrients. 2021 Aug 21;13(8):2877. doi: 10.3390/nu13082877. PMID: 34445038; PMCID: PMC8398893.

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