Damage doesn’t always correlate with celiac symptoms but could correlate with nutritional deficiencies and other health risks. If your damage is severe, you and your healthcare provider may decide you need screening for other health problems.
Common deficiencies include iron, B vitamins such as folate and B12, calcium, magnesium, vitamin D and essential fatty acids. Your healthcare provider might consider testing to determine if you’re deficient in specific nutrients.
Bone density generally returns to normal within two years on a gluten-free diet, but a bone density scan can help diagnose thinned bones and determine whether you need supplements or even a drug such as Fosamax (alendronate) to build bone mass more quickly.
For example, the CSA warns that it’s possible to actually lose bone mineral density by taking too much vitamin D—which could happen if you’re trying to make up for having too little of the vitamin in your system by taking multiple supplements.
A nutritionist can help you learn to read food labels while teaching you which foods are naturally gluten-free. However, it’s important to choose a nutritionist who knows the detailed ins and outs of the gluten-free diet; hopefully, your healthcare provider can recommend someone.
Lactose intolerance symptoms include abdominal pain and bloating, diarrhea and gas. Testing can identify celiac patients who also are lactose-intolerant. Fortunately, lactose intolerance often reverses after you’ve been on the gluten-free diet for a while since the villi heal and begin to produce lactase again.
Your healthcare provider also might recommend a repeat endoscopy after six months or one year on the gluten-free diet to confirm that damage is healing properly.
A one-time test will not be sufficient to catch all celiac cases, either. For example, one study found that, of 171 family members who were negative when first screened, 3.5% tested positive on their second screening, even though most were asymptomatic. The study authors recommended periodic repeat testing of family members, regardless of symptoms.
