Patients with the celiac disease commonly have micronutrient deficiencies including B12 and D, as well as folate, iron, zinc, and copper, at the time of diagnosis, finds a recent study. 

Published in the 'Mayo Clinic Proceedings', the retrospective study of 309 adults newly diagnosed with celiac disease at Mayo Clinic from 2000 to 2014 also found that low body weight and weight loss, which are commonly associated with celiac disease, were less common. Weight loss was seen in only 25.2 per cent of patients, and the average body mass index was categorised as overweight. 

"It was somewhat surprising to see the frequency of micronutrient deficiencies in this group of newly diagnosed patients, given that they were presenting fewer symptoms of malabsorption," said Adam Bledsoe, a gastroenterology fellow at Mayo Clinic's Rochester campus. "Our study suggests that the presentation of celiac disease has changed from the classic weight loss, anemia, and diarrhea, with increasing numbers of patients diagnosed with nonclassical symptoms. Micronutrient deficiencies remain common in adults, however, and should be assessed," said Dr Bledsoe, the study's primary author.

Assessment should include vitamin D, iron, folic acid, vitamin B12, zinc, and copper. Zinc deficiency was observed most frequently at diagnosis, the study said, with 59.4 per cent of patients having a deficiency. Other deficiencies included iron, vitamin D, copper, vitamin B12 and folate. Celiac disease is an immune reaction to consuming gluten, a protein found in wheat, barley, and rye. 

Eating gluten triggers an immune response in the small intestine that over time damages the intestine's lining and prevents it from absorbing some nutrients, leading to diarrhea, fatigue, anemia, weight loss, and other complications. The nutritional deficiencies have potential health ramifications, though in this retrospective study the clinical implications remain unknown.

"Further studies are needed to better define the implications of the deficiencies, optimal replacement strategies, and follow-up," says Dr Bledsoe.