Micronutrient deficiencies: Researchers discover change in celiac disease symptoms
Mayo Clinic researchers carried out the retrospective study of 309 adults newly diagnosed with celiac disease from 2000 to 2014 and found that low body weight and weight loss - usually associated with celiac disease - were less common than expected.
The study, to be published in the July issue of Mayo Clinic Proceedings, found that weight loss was seen in only 25.2% of patients, and the average body mass index was actually categorised as overweight.
Zinc deficiency was observed most frequently at diagnosis, the study says, with 59.4% of patients having a deficiency. Other deficiencies included iron, vitamin D, copper, vitamin B12 and folate.
"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," says Adam Bledsoe, M.D., 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, anaemia and diarrhoea, with increasing numbers of patients diagnosed with nonclassical symptoms.
"Micronutrient deficiencies remain common in adults, however, and should be assessed."
The researchers argue that assessment should include vitamin D, iron, folic acid, vitamin B12, zinc and copper.
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," adds Dr. Bledsoe.
immune reaction
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 diarrhoea, fatigue, anaemia, weight loss and other complications.
