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Deficiencies


newceliac

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newceliac Enthusiast

I had an appt. today for a re-check with the endocrinologist. I was referred to an endocrinologist several months ago by the orthopedic I went to for back and joint pain. He did bone density scan and checked several things by blood test. In addition to my back problems, he said I had osteoporosis and a severe vitamin d deficiency. My vitamin d level was 8.2. During my first visit with the endocrinologist, he put me on 50,0000 iu of vitamin d 2x weekly for six weeks. This was all before I was diagnosed with celiac.

In the meantime, I have now been diagnosed with celiac disease. I recently had the blood work done for my revisit with the endocrinologist. My vitamin d had increased some but he said it was still what he considered a little low. He put me back on 50,000 iu of vitamin d but this time it is only 1x weekly for 6 weeks. He also prescribed Actonel for me to begin taking.

My ionized calcium level was just a bit high but he thought it was a mistake because the PTH levels were normal and the other calcium levels were normal. However, he is checking it again in 4 months. Has anyone had this problem?

Also, I discussed with him the fatigue and bone pain I experienced before diagnosis with celiac disease and still experience periodically. He said that could be some form of iron deficiency. I asked about Vitamin B levels and he said that could also be a reason. He did not order Vitamin B though and he said that my PCP could order those. Also, my RDW level was a little bit low but the RBC was normal. He did give me some samples of a prescription called Metanx, which he said is for Vitamin B levels. Has anyone taken this or does anyone know anything about it?

He was very honest and said that he didn't know that much about celiac disease. So, he is basically is only treating me for the osteoporosis and vitamin d problem.

My question is also this....should I have my Vitamin B levels checked.? Also, should I see a rheumologist? Some people have suggested that I see a rheumotologist. I am not quite sure what exactly they would do or if they could help with anything to do with celiac disease.

It has been about 3 1/2 weeks ago that I was diagnosed.

I appreciate the responses and assistance for all the guidance this board provides. Thanking you in advance!


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gfpaperdoll Rookie

You need to do some serious research on celiac and osteoporosis. Celiac is the leading cause of osteo - & most doctors know that. There is some controversy about taking drugs for osteo in the first year or so gluten free... you might need a new doctor because if this one is treating your osteo & knows nothing about celiac - he is just stabbing in the dark while writing a prescription - pretty dangerous combination, I think.

you should definitely take a B12 everyday.

DEE BAERTSCH Newbie
I had an appt. today for a re-check with the endocrinologist. I was referred to an endocrinologist several months ago by the orthopedic I went to for back and joint pain. He did bone density scan and checked several things by blood test. In addition to my back problems, he said I had osteoporosis and a severe vitamin d deficiency. My vitamin d level was 8.2. During my first visit with the endocrinologist, he put me on 50,0000 iu of vitamin d 2x weekly for six weeks. This was all before I was diagnosed with celiac.

In the meantime, I have now been diagnosed with celiac disease. I recently had the blood work done for my revisit with the endocrinologist. My vitamin d had increased some but he said it was still what he considered a little low. He put me back on 50,000 iu of vitamin d but this time it is only 1x weekly for 6 weeks. He also prescribed Actonel for me to begin taking.

My ionized calcium level was just a bit high but he thought it was a mistake because the PTH levels were normal and the other calcium levels were normal. However, he is checking it again in 4 months. Has anyone had this problem?

Also, I discussed with him the fatigue and bone pain I experienced before diagnosis with celiac disease and still experience periodically. He said that could be some form of iron deficiency. I asked about Vitamin B levels and he said that could also be a reason. He did not order Vitamin B though and he said that my PCP could order those. Also, my RDW level was a little bit low but the RBC was normal. He did give me some samples of a prescription called Metanx, which he said is for Vitamin B levels. Has anyone taken this or does anyone know anything about it?

He was very honest and said that he didn't know that much about celiac disease. So, he is basically is only treating me for the osteoporosis and vitamin d problem.

My question is also this....should I have my Vitamin B levels checked.? Also, should I see a rheumologist? Some people have suggested that I see a rheumotologist. I am not quite sure what exactly they would do or if they could help with anything to do with celiac disease.

It has been about 3 1/2 weeks ago that I was diagnosed.

I appreciate the responses and assistance for all the guidance this board provides. Thanking you in advance!

DEE BAERTSCH Newbie

Once I became gluten free & got up to speed on my Vitamin D my joint & muscle aches went away; it was amazing; I thought I would just have to live my life with them! I agree you need to find a Dr. who is knowledgeable about Celiac; that and keep inquiring here & on the web. There's no better advice than from people who have gone thru what you are. You're starting to read alot more about the reasons not to take Actonel, etc. For me & alot of celiacs you are also lactose intolerant; all of the pills for osteoporosis contain lactose. The other concern is that they stop the old bone tissue from leaving your bones but also prevent new bone from growing. I think the most important thing is making sure you're getting enough of all of the essential vitamins and exercising religously. Most celiacs are deficient in certain vitamins & minerals; I think that is the key along with weight bearing exercise. There is a really good website called Woman to Woman; even if you're a man the article on osteoporosis talks about this issue in more detail. Good luck; you're almost there!

Dee

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    • trents
      You might consider asking for a referral to a RD (Registered Dietician) to help with food choices and planning a diet. Even apart from any gluten issues, you will likely find there are some foods you need to avoid because of the shorter bowel but you may also find that your system may make adjustments over time and that symptoms may improve.
    • Ello
      I wish Dr’s would have these discussions with their patients. So frustrating but will continue to do research. Absolutely love this website. I will post any updates on my testing and results.  Thank you
    • trents
      Losing 12" of your small bowel is going to present challenges for you in nutritional uptake because you are losing a significant amount of nutritional absorption surface area. You will need to focus on consuming foods that are nutritionally dense and also probably look at some good supplements. If indeed you are having issues with gluten you will need to educate yourself as to how gluten is hidden in the food supply. There's more to it than just avoiding the major sources of gluten like bread and pasta. It is hidden in so many things you would never expect to find it in like canned tomato soup and soy sauce just to name a few. It can be in pills and medications.  Also, your "yellow diarrhea, constipation and bloating" though these are classic signs of a gluten disorder, could also be related to the post surgical shorter length of your small bowel causing incomplete processing/digestion of food.
    • Ello
      Yes this information helps. I will continue to be pro active with this issues I am having. More testing to be done. Thank you so much for your response. 
    • trents
      There are two gluten-related disorders that share many of the same symptoms but differ in nature from each other. One is known as celiac disease or "gluten intolerance". By nature, it is an autoimmune disorder, meaning the ingestion of gluten triggers the body to attack it's own tissues, specifically the lining of the small bowel. This attack causes inflammation and produces antibodies that can be detected in the blood by specific tests like the TTG-IGA test you had. Over time, if gluten is not withheld, this inflammation can cause severe damage to the lining of the small bowel and even result in nutrient deficiency related health issues since the small bowel lining is organ where all the nutrition found in our food is absorbed.  The other is NCGS (Non Celiac Gluten Sensitivity or just "gluten sensitivity") which we know less about and are unsure of the exact mechanism of action. It is not an autoimmune disorder and unlike celiac disease it does not damage the lining of the small bowel, though, like celiac disease, it can cause GI distress and it can also do other kinds of damage to the body. It is thought to be more common than celiac disease. Currently, we cannot test for NCGS. Celiac disease must first be ruled out to arrive at a diagnosis of NCGS. Both disorders require elimination of gluten from the diet.  Either of these disorders can find their onset at any stage of life. We know that celiac disease has a genetic component but the genes are inactive until awakened by some stress event. About 40% of the general population has the genetic potential to develop celiac disease but only about 1% develop active celiac disease. The incidence of NCGS is thought to be considerably higher. I hope this helps.
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