Common Micronutrient Deficiencies in Celiac Disease
For those with celiac disease, the ingestion of gluten triggers an autoimmune response that results in damage to the cells that line the small intestine. Because the small intestine is responsible for the majority of digestion and absorption, nutritional deficiencies are common at the time of celiac diagnosis.
Blood tests may be used to evaluate and monitor for deficiencies including vitamins, copper, zinc, folic acid, ferritin, and iron. Some commonly diagnosed deficiencies in Celiac disease include:
Iron
Iron is an essential micronutrient that plays an important role in the creation of red blood cells, metabolism, and immunity. In celiac disease, damage to the area of the small intestine where iron is predominantly absorbed is common. Furthermore, chronic inflammation in the intestine can also reduce the lifespan of red blood cells, increasing iron requirements. The treatment options include a diet rich in iron and/or iron supplements.
Zinc
Zinc deficiency is common for those with celiac disease with reports of up to 59% of those with celiac having low zinc as compared to controls. Because the human body does not store zinc efficiently, deficiencies can arise quickly when inadequate dietary intake is coupled with malabsorption. For certain individuals, zinc supplements may be recommended though it is important to work with a trained healthcare professional to determine supplemental zinc needs as excessive zinc intake also poses health risks.
Folate
Folate is a water-soluble B vitamin that must be consumed through food. Many gluten-free products on the market contain lower amounts of folate than their gluten-containing counterparts placing those with celiac disease at ongoing risk of folate deficiency.
Calcium
Low calcium levels may be the result of low dairy intake for patients with celiac disease. Lactose intolerance is common at the time of diagnosis of celiac disease as mucosal damage leads to less lactase production and therefore decreased ability to break down lactose.
Magnesium
Magnesium is one of the more notable deficiencies in celiac disease though accurate assessment of magnesium levels is challenging as most magnesium in the body is stored in the cells or bones. Inadequate magnesium intake is common in the general population with almost half of adults in the US not hitting the recommended daily allowance target.
Vitamin D
Vitamin D is a common vitamin deficiency in the general population and studies are mixed as to whether there is a significant difference in the prevalence of Vitamin D deficiency in those with celiac disease versus controls. Vitamin D is an essential vitamin for bone health as it helps the body absorb calcium. In cases of deficiency, Vitamin D supplements are necessary.
While there is a definitive role for targeted supplementation for diagnosed nutrient deficiencies, consuming a wide variety of nutrient-dense foods can help prevent the development of deficiencies when measured levels are normal. Frequent consumption of nutrient-dense plant foods has the added benefit of lowering inflammation and reducing the risk of other chronic diseases.