Celiac disease, an autoimmune reaction to gluten-containing grains, leads to intestinal malabsorption. Malabsorption can result in vitamin and mineral deficiencies. Vitamin D deficiency explains the association between celiac disease and osteoporosis, and vitamin K deficiency explains the association with hemostasis disorders. Routine testing and management of fat-soluble vitamin levels are recommended in adult patients with celiac disease, but there is no consensus on this issue in children.  

A case-control study, published in BMC Pediatrics in 2018, aimed to evaluate fat-soluble vitamin deficiencies in children recently diagnosed with celiac disease and to determine whether testing of fat-soluble vitamins should be routine in this population. A total of 52 patients (aged 0-18) with celiac disease were matched with 50 healthy controls. Patients and controls were tested for serum vitamin D, vitamin E, vitamin K1, and vitamin A.  

 Vitamin D insufficiency was present in 92% (48) of celiac patients and 18% (9) of controls. Vitamin D deficiency was present in 62% (32) of celiac patients and 4% (2) of controls. Vitamin A deficiency was present in 33% (17) of celiac patients and none of the controls. Vitamin E deficiency and vitamin K deficiency were not present in any of the celiac patients or controls. The rates of vitamin D and vitamin A deficiencies were significantly higher in the patients with celiac disease than in controls.  

The results of this study provide sound evidence in support of screening children who have been recently diagnosed with celiac disease for deficiencies of vitamins D and A. Correction of these deficiencies could reduce the risk of developing additional symptoms or conditions associated with vitamin deficiency.  

By TAP Integrative



Tokgöz Y, Terlemez S, Karul A. Fat soluble vitamin levels in children with newly diagnosed celiac disease, a case control study. BMC Pediatr. 2018; 18: 130. 

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