Tests following a celiac diagnosis?

Melinda Dennis MS, RDN, LDN

Q: Can you review which tests are important to have following a celiac diagnosis?  Should my doctor be checking Vitamins K, D and any others?

Answer


The following applies to labs for adults with celiac disease treated at Beth Israel Deaconess Medical Center’s (BIDMC) Celiac Center.

There actually aren’t any universal guidelines in place for testing for nutritional deficiencies in celiac disease. A review of the research shows that testing for the newly diagnosed patient is very individualized across the world. At BIDMC’s Celiac Center, a common celiac panel for the newly diagnosed patient includes: vitamin D (25 OHD), B12, folate (depends on the doctor and the patient’s medical history), ferritin and/or iron, and a complete blood count (which includes hemoglobin and hematocrit). Zinc, a common deficiency among the trace elements, is often checked, especially if there are concerns about skin, hair, or nail integrity. At BIDMC, we check copper if zinc deficiency is not resolving. The other B vitamins (B1, B2, B3 and B6) may be requested, as needed.

Calcium and magnesium are included in a chemistry panel which is typically already available in the patient’s records. Other labs related to bone health, such as parathyroid hormone and vitamin K (as well as vit D above), may be requested, as needed. Liver enzymes, lipid panel, and thyroid panel are requested, as needed. A vitamin A test may be ordered when a person has signs and symptoms of night blindness. The fat soluble vitamins (vit A, D, E and K) are also checked in the case of steattorhea (fatty, frothy, foul smelling, hard to flush stool). Vitamin K may also be checked in case of excessive bleeding and easy bruising.

At BIDMC’s Celiac Center, we check celiac serology (TTG IgA, DGP IgA or DGP IgG) every few months until it is normal, and then yearly, or more frequently, as needed.

Reviewed October 3, 2022.

Note: This information is provided by NCA and Melinda Dennis, NCA's Senior Consulting Dietitian. This information is meant for educational purposes and is not intended to substitute for personalized medical advice or replace any medical advice provided directly to you by your health care provider. This information can be printed and used in consultation with your physician or dietitian. No liability is assumed by NCA, Ms. Dennis or her nutrition consulting service Delete the Wheat, LLC. by providing this information.

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About Melinda Dennis MS, RDN, LDN

Melinda Dennis, Senior Nutrition Consultant for NCA, is an expert celiac dietitian and and Nutrition Coordinator for the Celiac Center at Beth Israel Deaconess Medical Center in Boston, MA. Diagnosed with celiac disease in 1990, she specializes in the nutritional treatment of patients with celiac disease and gluten-related disorders.

Melinda lectures internationally and has written extensively on the nutritional management of celiac disease including the award-winning book Real Life with Celiac Disease. Melinda was the original founder of NCA in 1993 and so it is only fitting that she comes back to us in this capacity. We are truly honored to have her on our team.