What vitamins should I be taking if I have celiac? An essential guide

October 8, 2025 •

5 min read

Recent studies indicate that a large percentage of newly diagnosed celiac patients experience nutrient deficiencies due to intestinal damage that impairs absorption. If you have celiac disease, understanding what vitamins should I be taking if I have celiac? is a critical step toward restoring your health alongside a strict, gluten-free diet.

Quick Summary

Individuals with celiac disease often need supplements for vitamins D and B12, folate, iron, calcium, magnesium, and zinc due to malabsorption. Medical guidance is essential for identifying and correcting deficiencies.

Key Points

Initial Assessment is Key: Upon diagnosis, work with a healthcare provider to test your nutrient levels and identify specific deficiencies, as malabsorption is common.
Focus on Common Deficiencies: The most frequently needed supplements include iron, vitamins D and B12, calcium, folate, magnesium, and zinc.
Choose Certified Gluten-Free Supplements: Always verify that your vitamins and minerals are certified gluten-free to avoid triggering symptoms and intestinal damage from cross-contamination.
Prioritize a Nutrient-Dense Diet: While supplements are often necessary, a balanced, whole-foods, gluten-free diet provides the best foundation for long-term health and healing.
Monitor and Adjust Over Time: As your small intestine heals on a GFD, your body's ability to absorb nutrients improves. Regular follow-ups and blood tests are vital to adjust supplementation as your needs change.
Be Mindful of Absorption: Some supplements absorb better under specific conditions, like taking fat-soluble vitamins (A, D, E, K) with food or iron with vitamin C.

Understanding Nutrient Deficiencies in Celiac Disease

Celiac disease is an autoimmune condition where gluten consumption triggers damage to the small intestine's lining. This damage, known as villous atrophy, reduces the surface area available for nutrient absorption, leading to common deficiencies, especially in newly diagnosed or poorly managed cases. Even with a strict gluten-free diet (GFD), some deficiencies may persist, requiring targeted supplementation. Furthermore, many gluten-free products are not fortified with the same vitamins and minerals as their gluten-containing counterparts, which can exacerbate the problem over time.

The Most Common Deficiencies in Celiac Patients

The most frequent nutrient deficiencies in people with celiac disease involve iron, vitamin B12, folate, vitamin D, calcium, magnesium, and zinc. A healthcare provider will typically test your nutrient levels upon diagnosis to create a personalized plan.

Iron

Iron deficiency anemia is the most common extra-intestinal manifestation of celiac disease, affecting a significant portion of patients at diagnosis. The absorption of iron primarily occurs in the duodenum, the first part of the small intestine, which is often the most severely damaged area in celiac disease. While a GFD can help, it may take a long time to replenish iron stores, and oral iron supplements can cause side effects like constipation.

Vitamin D and Calcium

Proper absorption of vitamin D and calcium is crucial for maintaining bone mineral density, as people with celiac disease are at an increased risk for osteopenia and osteoporosis. Both nutrients are often deficient, and supplementation is frequently needed, sometimes even after intestinal healing has occurred with a strict GFD. Vitamin D levels can be difficult to maintain through diet alone and are influenced by sun exposure.

Vitamin B12 and Folate

Deficiencies in B vitamins, particularly B12 and folate (B9), are common in celiac patients. Vitamin B12 is absorbed in the lower small intestine, and while deficiencies are often seen in severe disease, they can persist even on a GFD. Both are essential for red blood cell formation, energy, and neurological function. Supplementation has been shown to improve mood and reduce anxiety in some patients.

Zinc and Magnesium

Zinc and magnesium are vital minerals that are frequently low in celiac patients due to malabsorption. Zinc supports immune function and wound healing, while magnesium plays a role in over 300 biochemical reactions in the body, including muscle and nerve function. Magnesium deficiency can also be an issue because gluten-free grains often contain lower levels of this mineral.

The Importance of Certified Gluten-Free Supplements

Just as with food, it is critical to ensure that any supplements you take are certified gluten-free. Gluten can be used as a binder or filler in supplements, and accidental ingestion can trigger symptoms and damage the intestines, hindering recovery. The FDA requires that any product labeled “gluten-free” must contain less than 20 parts per million (ppm) of gluten. Always check the label or contact the manufacturer if you are unsure.

Optimizing Absorption and Nutrient Intake

To improve nutrient absorption and overall health, focus on a balanced, naturally gluten-free diet rich in whole foods.

Prioritize Nutrient-Dense Foods: Include plenty of naturally gluten-free foods like vegetables, fruits, legumes, lean proteins, nuts, and seeds. Quinoa and amaranth are examples of gluten-free grains rich in micronutrients.
Combine for Better Absorption: Pair iron-rich foods with sources of vitamin C (e.g., leafy greens with citrus fruits) to enhance absorption. Taking fat-soluble vitamins (A, D, E, K) with a meal containing some fat also improves their uptake.
Consider Lactose Intolerance: Many newly diagnosed celiac patients also have temporary lactose intolerance. Opt for lactose-free dairy alternatives or other calcium sources until your intestine heals.

How to Approach Supplementation

Initial vs. Long-Term Supplementation

At the time of diagnosis, a doctor or registered dietitian may recommend a high-potency, gluten-free multivitamin/mineral (MVM) along with specific, higher-dose supplements to address severe deficiencies. As your intestinal lining heals on a GFD, your ability to absorb nutrients improves, and the need for high-dose supplements may decrease over time.

Medical Supervision and Testing

Regular monitoring of your nutrient levels through blood tests is essential. This helps your healthcare team track your progress and adjust your supplement regimen as needed. Self-prescribing high-dose supplements, especially for iron or B6, can be harmful.

Conclusion

For individuals with celiac disease, proactive nutritional management is key to recovery and long-term health. Due to initial intestinal damage and the nutritional profile of many gluten-free products, deficiencies in key vitamins and minerals like iron, vitamin D, calcium, B12, folate, magnesium, and zinc are common. By working with your healthcare team to test your levels, choosing certified gluten-free supplements, and prioritizing a nutrient-dense diet, you can effectively correct these imbalances and support your body's healing process. Always remember to check labels for gluten and follow your doctor's guidance on supplement use.

For more information on managing celiac disease, you can visit the Celiac Disease Foundation website.

Common Deficiencies and Supplementation Strategies in Celiac Disease


Nutrient	Common Deficiency Signs	Supplementation Approach	Notes
Iron	Fatigue, paleness, shortness of breath, headaches	Oral iron (ferrous bisglycinate chelate is a well-tolerated option), potentially intravenous if non-responsive	Take with Vitamin C; can cause GI upset
Vitamin D	Poor bone mineral density, osteopenia/osteoporosis risk	Daily supplementation, dosage based on blood tests and medical advice	Take with a fat-containing meal for better absorption
Calcium	Reduced bone mineral density, potential for secondary lactose intolerance	Supplementation depending on age and intake levels as advised by a healthcare provider	Consider combining with magnesium to prevent constipation
Vitamin B12	Anemia, fatigue, neurological issues (memory, vision)	Oral or intramuscular, especially if malabsorption is severe and as recommended by a doctor	Check for active (methylcobalamin) forms; monitoring is crucial
Folate (B9)	Anemia, fatigue, potential mood issues	Included in MVM; higher dose might be needed under medical guidance, especially pre-conception	Standard multivitamin often provides sufficient amounts after healing
Magnesium	Often low due to malabsorption and GFD content	Supplemental magnesium (e.g., magnesium glycinate) if diet is insufficient, under medical advice	Look for gluten-free options; individual needs vary
Zinc	Impaired immune function, poor wound healing, growth issues	Often included in MVM; separate supplement under medical guidance	Balance with copper; check for certified gluten-free status

Frequently Asked Questions

People with celiac disease often need supplements because the damage to their small intestine from gluten exposure impairs the absorption of many vitamins and minerals. This malabsorption can lead to deficiencies in key nutrients like iron, Vitamin D, and B12, even with a strict gluten-free diet.

A standard multivitamin may not be enough, especially at the time of diagnosis or if deficiencies are severe. A healthcare provider might recommend a potent, certified gluten-free multivitamin plus targeted, higher-dose supplements for specific deficiencies based on your lab results.

The duration of supplementation varies by individual. While some nutrient levels normalize as the intestine heals on a GFD, some deficiencies, like Vitamin B12 or Vitamin D, can persist. Regular blood tests are necessary to determine the long-term need for supplements under a doctor's guidance.

A nutrient-dense, naturally gluten-free diet is the best long-term strategy for obtaining vitamins and minerals. However, supplements are often necessary, especially in the initial stages of healing, to correct existing deficiencies and replenish stores faster than diet alone can.

Oral iron supplements like ferrous bisglycinate chelate are often better tolerated and may be better absorbed than traditional ferrous sulphate, especially in the initial stages of intestinal healing. In severe cases, or if oral supplements fail, intravenous iron might be necessary.

To ensure your supplements are gluten-free, look for products that are explicitly labeled “gluten-free” on the packaging. The FDA mandates that these products contain less than 20 ppm of gluten. If you are unsure, contact the manufacturer directly to inquire about their gluten-free status.

Vitamin D is crucial for celiacs because it is necessary for calcium absorption and maintaining bone health. Celiac disease can increase the risk of osteopenia and osteoporosis, so ensuring adequate Vitamin D and calcium intake is particularly important.