Due to intestinal mucosal damage, nutrient malabsorption is common in coeliac disease. Severe malabsorption and diarrhoea, may be associated with low sodium, potassium, magnesium and zinc levels. Iron absorption occurs in the proximal small bowel, therefore, iron-deﬁciency anaemia is one of the most common clinical presentations of coeliac disease. Anaemia, secondary to folate deﬁciency or vitamin B12 deﬁciency, can also be more prevalent.
The prevalence of anaemia varies greatly (depending on the type) and has been found in 12%-69% of newly diagnosed coeliac disease patients (12). Calcium absorption can also be affected in people with coeliac disease. Therefore, low calcium and vitamin D may lead to osteopenia or osteoporosis (13).
Coeliac disease is also associated with an increased risk of other autoimmune diseases (e.g. type 1 diabetes) and malignancies (4).