Often, when a patient is following a long-term gluten-free diet with good compliance, micronutrient deficiencies cannot be detected. This review – published in the scientific journal Medicina – evaluates the most recent literature on micronutrient deficiencies in patients following a long-term gluten-free diet in order to provide dietary supplementation advice. The study concludes that in patients with micronutrient deficiencies caused by celiac disease, vitamin supplements may be necessary.

Micronutrient deficiencies (in particular, iron, folic acid, vitamins B6 and B12, vitamin D, copper, and zinc) are common in celiac patients. If untreated, these micronutrient deficiencies can contribute to neurological complications, psychiatric symptoms, and bone alterations. The American College of Gastroenterology guidelines reported that micronutrient deficiencies are frequent in celiac patients at the time of diagnosis. Therefore, treating physicians/dieticians should test newly diagnosed celiac disease patients for these deficiencies and integrate supplements if needed.

In patients following a long-term gluten-free diet, micronutrient deficiencies may persist due to an inadequate recovery of the mucous membrane.  This review included 73 studies. The studies on micronutrient levels in patients following a long-term gluten-free diet demonstrated a deficiency present in up to 30% of subjects for vitamin B12, 40% for iron, 20% for folic acid, 25% for vitamin D, and 40% for zinc in adults. Up to 3.6% of children were calcium deficient and 20% were magnesium deficient.

This study concludes that after an initial blood test to determine a person’s deficiencies, supplementation may be needed if patients are not getting enough micronutrients from their normal diet.

Gluten Free Foods that are naturally high in essential vitamins include: fruits, vegetables, protein, legumes, quinoa, and gluten-free whole grains, like buckwheat and millet. Check in with your healthcare provider to make sure you’re getting all of the necessary nutrients and vitamins from your diet.


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Dietary Supplementation Advice for Celiac Patients on a Long-Term Gluten-Free Diet