Celiac Disease & Vitamin B12 Deficiency

Vitamin B12 is a water-soluble vitamin that your body needs for essential functions such as DNA synthesis, carbohydrate metabolism for energy, red blood cell production, and cellular and tissue repair. Your body uses what it needs of most water-soluble vitamins and excretes the rest in urine. B12, however, is different because your body can store it in the liver for up to five years. A B12 deficiency is rare in healthy people, but can occur in people who suffer from disorders such as celiac disease.

A man drops a water soluble vitamin B tablet into a glass of water. (Image: Tom Le Goff/DigitalVision/Getty Images)

B12 Deficiency

Your body does not create B12 so you must consume it through a balanced diet of foods rich in the vitamin such as eggs, meat, poultry and milk products. The body absorbs vitamin B12 in the small intestine. A lack of B12 can cause a condition where your body does not create enough red blood cells and can affect how the body metabolizes carbohydrates for energy. This can lead to symptoms such as pale skin, shortness of breath, weakness, fatigue and bleeding gums, according to the University of Maryland Medical Center, or UMMC.

Celiac Disease

Celiac disease is a disease of the digestive tract that causes damage to the small intestine. People with celiac disease have intolerance for a protein in wheat, rye and barley called gluten. Gluten is found in foods as well as some medicines, vitamins and lip balms. The National Institute of Diabetes and Digestive and Kidney Disease, or NIDDK, explains that when you have celiac disease, your body responds to gluten ingestion by initiating the immune system to attack the small finger-like protrusions lining the small intestine called villi. Symptoms of celiac disease can cause chronic diarrhea, pain, abdominal pain, vomiting, constipation, weight loss and pale, fatty foul-smelling stools.

Malabsorption

When the intestine is damaged, your body cannot absorb B12 properly, leading to a deficiency. Because celiac disease causes damage and, over time, the destruction of villi, people with this condition often suffer from malabsorption of essential vitamins, increasing the risk of vitamin deficiency anemia, fatigue, bone pain, arthritis and peripheral neuropathy of the hands and feet, reports the UMMC.

Diagnosis

Diagnosis of B12 deficiency often requires a simple blood test. However, diagnosing celiac disease often requires additional testing. If your physician suspects celiac disease, he will run blood tests to look for anti-tissue transglutaminase antibodies, or tTGA, and anti-endomysium antibodies, or EMA, which are often present with celiac disease, according to the NIDDK. If the tests are negative, but your physician still suspects celiac disease, he will take a small sample of your intestine to examine it for damage to the villi.

Treatments

Because of intestinal damage, traditional oral B12 supplements or dietary changes will not work. People with celiac disease will often require long-term or lifelong injections of B12 on a monthly basis. The UMMC explains that for severe B12 deficiencies, a physician will often put you on daily injections to start, tapering off to monthly injections as the condition improves.