Date: 17 Oct 2013

Dietary Supplements in Celiac Disease

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Abstract

Celiac disease (CD) is an immune-mediated disorder that occurs in genetically predisposed individuals who ingest gluten. Gluten is a dietary protein found in wheat, barley, and rye. In the susceptible person, this gluten-containing diet can lead to the development of an autoimmune enteropathy, causing malabsorption of carbohydrates, proteins, fats, and critical vitamins and minerals. Deficiencies of key nutrients in celiac disease occur due to malabsorption, poor dietary intake, and lack of fortification of gluten-free foodstuff. This chapter reviews the data regarding common dietary supplements that may enhance a healthy gluten-free lifestyle, including iron, B-complex vitamins, fat-soluble vitamins, trace metals and minerals, fiber, and probiotics. Special attention is given to dietary supplements that promote bone health, pregnancy, and fertility, and alleviate symptoms in refractory celiac disease (RCD). Clinicians must maintain a high index of suspicion for these nutritional deficiencies, as they may present with a myriad of symptoms that closely mimic other disorders. If diagnosed early, the nutritional complications of long-standing celiac disease can be completely avoided by strict adherence to the gluten-free diet and appropriate dietary supplements.