There are a variety of nutritional deficiencies associated with celiac disease, primarily caused by the damaged small intestine not being able to properly absorb enough of the nutrients the human body needs. People recently diagnosed with celiac disease are commonly deficient in fiber, iron, calcium, magnesium, zinc, folate, niacin, riboflavin, vitamin B12, and vitamin D, as well as in calories and protein. Lower levels of other important things like copper and vitamin B6 are also possible, but are more rare. A study from 2002 by Bona et. al. shows that the delay in puberty in children with celiac disease is most likely at least partially due to low amounts of B vitamins, iron, and folate.
After treatment with a strict gluten-free diet, most patients’ small intestines recover and are able to properly absorb nutrients again, and don’t necessarily require any supplementation. For certain patients however, nutrient supplements may be helpful.
Issues with the gluten-free diet itself may also add to this problem of nutritional deficiency. Though the gluten-free market has grown immensely over recent years and is still growing, many gluten-free products are not enriched and have lower amounts of folate, iron, thiamin, niacin, fiber, and riboflavin. Gluten-free products may also be unbalanced in other ways. Patients on strict gluten-free diets were shown to have a higher amount of calories from fat and less from carbohydrates. Following a strict gluten-free diet while maintaining proper nutrition can be very challenging.
Vitamin and mineral therapy can be used in addition to the standard gluten-free diet to hasten a patient’s recovery from nutritional deficiency. However, certain ingredients in medications, typically the inactive ingredients, can contain gluten, so extra care must be taken to avoid any gluten exposure.
The gluten-free diet is very complex with research still being done on many types of grains and cereals and the FDA has only recently standardized the meaning of a “gluten-free” label, so it is important for anyone suffering from a gluten-related disorder like celiac disease to talk to a registered dietician about their diet as well as their physician. If you need help finding a registered dietician or physician with expertise in dealing with gluten-related disorders, try using Celiac Disease Foundation’s Healthcare Practioner directory at the following link.