“Increased stool frequency” in a 36-year-old woman revealed two major underlying shortcomings.
Vitamin D plays a critical role in skeletal and muscle health, while iron ensures oxygen transport in blood cells. Together, nutrients predominantly come from food, but if their absorption is impaired, deficiency can occur. Severe cases of celiac disease, which can lead to critical nutrient deficiencies, are sometimes indicated in patients with multiple deficiencies.
In 2022, EMJ Reviews reported the case of a 36-year-old man who moved to a country where food was fortified with vitamins and minerals.
Her report stated: “At that time, she noticed muscle aches, fatigue, migraine headaches, recurrent painful mouth ulcers, upper respiratory allergies, wheezing, and sleep disturbances.
“Soon her menstrual cycles became irregular, but there was no menorrhagia or clots.”
The female also noticed that her headaches became more frequent, her respiratory complaints intensified, she developed intolerance to dairy products with bloating, cramps and frequent stools.
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Balance problems persisted with eyes open and closed, making it difficult for her to get up from a chair.
With an adequate diet of fortified foods, the woman’s case was suggestive of gastrointestinal malabsorption.
Subsequent tests revealed the presence of iron and vitamin D deficiency.
This discovery, in addition to the patient’s multi-organ symptoms, led researchers to believe that the patient had celiac disease as an adult.
This is because the onset of symptoms in multiple body systems, especially outside the gastrointestinal tract, is often described as an atypical manifestation of celiac disease.
In particular, frequent stools are a common symptom of celiac disease, as are other gastrointestinal problems.
Diarrhea is also a common characteristic of celiac disease and is caused by the body’s inability to fully absorb nutrients.
This malabsorption of nutrients can also cause stools to contain unusually high levels of fat, which is mentally referred to as steatorrhea.
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Although this condition usually affects the upper part of the small intestine, the entire small intestine can be affected.
In fact, celiac disease causes iron deficiency anemia because the part of the intestine damaged by gluten is also responsible for iron absorption.
The patient report suggested that the presence of iron deficiency in the absence of blood loss, in combination with the presence of vitamin D deficiency despite eating foods rich in vitamin D, increased the likelihood of celiac disease.
Malabsorption of many nutrients, such as iron, vitamin D, and zinc, has been repeatedly shown to be common in patients with untreated celiac disease.
A study published in the journal Nutrients found that approximately 46 percent of celiac disease patients have reduced body iron stores, and 32 percent are iron deficient.
Iron deficiency has many causes, including a diet low in iron, trauma, or heavy menstrual bleeding.
When none of these problems is the cause, it may indicate the presence of celiac disease.
To correct the patient’s symptoms, the researchers advised her to follow a gluten-free diet, to which she agreed.
After four weeks of oral iron, vitamin D, and oral calcium supplements, her symptoms improved.
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