Nutritional Assessment for the Newly Diagnosed
Included here are some sources that might be useful in determining appropriate testing for the newly diagnosed patient.
Gluten-Sensitive Enteropathy (Celiac Disease): More Common Than You Think (see table 5)
By Dr. Kenneth Fine
"Almost all CD-patients (87%) had at least one value below the lower
limit of reference. Specifically, for vitamin A, 7.5% of patients showed
deficient levels, for vitamin B6 14.5%, folic acid 20%, and vitamin B12
19%. Likewise, zinc deficiency was observed in 67% of the CD-patients,
46% had decreased iron storage, and 32% had anaemia. Overall, 17% were
malnourished (>10% undesired weight loss), 22% of the women were
underweight (Body Mass Index (BMI) < 18.5), and 29% of the patients
were overweight (BMI > 25). Vitamin deficiencies were barely seen in
healthy controls, with the exception of vitamin B12.
Vitamin/mineral deficiencies were counter-intuitively not associated
with a (higher) grade of histological intestinal damage or (impaired)
nutritional status. In conclusion, vitamin/mineral deficiencies are
still common in newly "early diagnosed" CD-patients, even though the
prevalence of obesity at initial diagnosis is rising. Extensive
nutritional assessments seem warranted to guide nutritional advices and
follow-up in CD treatment."
More than one in 10 of both newly-diagnosed and experienced women had
inadequate thiamin, folate, vitamin A, magnesium, calcium and iron
intakes. More than one in 10 newly-diagnosed men had inadequate thiamin,
folate, magnesium, calcium and zinc intakes.
Conclusions. Adults with longstanding coeliac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well-being, suggesting that B vitamins should be considered in people advised to follow a gluten-free diet.
Neurologic impairment due to vitamin E and copper deficiencies in celiac disease.
Metabolic and nutritional features in adult celiac patients.
Celiac disease with diffuse cutaneous vitamin K-deficiency bleeding.
Anemia in celiac disease is multifactorial in etiology.
Nutritional deficiencies in celiac disease.
Gluten-free diet: the medical and nutrition management of celiac disease.
Neurological manifestations in celiacs and vitamin E status.
Nutritional status in adolescents and young adults with screen-detected celiac disease.