Iron deficiency commonly occurs in patients with undiagnosed celiac disease (CD) or patients with CD consuming gluten, because iron is absorbed at the place that is most severely affected by CD. Celiac disease should be considered in the differential diagnosis of unexplained anemia, given that iron deficiency can be the sole manifestation of CD. In fact, certain authors consider it to be the most usual clinical presentation; 49 percent of patients diagnosed with CD previously suffered from anemia. If an atypical patient presents with anemia, such as a young healthy male, or pre-pubertal female, it would be wise to consider CD as a possible cause.
Once gluten is excluded from the diet, low iron can persist until the intestine has healed and iron stores have been replenished. Foods rich in iron can be prescribed as well as an iron supplement. If iron supplements are required, it would be advisable to continue for six months after beginning the gluten free diet. This is the minimum period to normalize the intestinal anatomy
The RDA for iron is 10 mg daily for males and 15 mg daily for females. The RDA for children is 10-12 mg daily. In the case of iron deficiency, the recommended dosage is 30 mg twice daily between meals. If this results in abdominal discomfort, it can be dosed 30 mg 3 times daily with meals. Iron supplements can be given with vitamin C supplements or foods rich in vitamin C to optimize the absorption of the iron. Some products contain both iron and vitamin C combined into one dosage form to facilitate the absorption of the iron.
In good health,