There are a variety of nutritional deficiencies associated with celiac disease, primarily caused by the inability of the damaged small intestine to properly absorb enough of the nutrients our bodies need. 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. Deficiencies in copper and vitamin B6 are also possible, but less common. A study from 2002 by Bona et. al. indicated that the delay in puberty in children with celiac disease may partially be 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 therefore do not require supplementation. For certain patients however, nutrient supplements may be beneficial.
The quality of gluten-free products on the market today also poses some challenges to thriving on the gluten-free diet. 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. Furthermore, studies show that patients on a gluten-free diet tend to consume 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; the FDA has only recently standardized the meaning of a “gluten-free” label, so it is important for anyone with a gluten-related disorder to talk to a registered dietitian as well as their physician about their nutritional needs. If you need help finding a registered dietitian or physician in your area with expertise in dealing with gluten-related disorders, try using Celiac Disease Foundation’s Healthcare Practitioner Directory.