Micronutrient Considerations for Celiac Disease

While the benefit of a gluten-free diet to promote healing in individuals with celiac disease is clear, it is critical for providers to consider the micronutrient fluctuations that are associated with this condition and its dietary treatment. Nutritional deficiencies of micronutrients are frequently found in untreated or newly diagnosed celiac disease often as a byproduct of malabsorption. Deficiencies may persist even after strict adherence to a gluten-free diet related to lower nutrient profiles of gluten-free grains and gluten-free products and possibly concurrent dietary restrictions. Micronutrients of concern that may or may not require supplementation include vitamin D, calcium, vitamin B12, folate, and iron. A team approach, including a dietitian specializing in celiac disease, is necessary to ensure micronutrient needs are met on an ongoing basis. This review will summarize considerations for monitoring and supplementation of micronutrients of concern for those adherent to a gluten-free diet.