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Iron supplementation for Coeliac disease

Coeliac disease and iron deficiency (ID) often occur together. 1

Having coeliac disease increases your chances of also being iron deficient,1 and it’s even possible that your doctor found you to be iron deficient before they diagnosed you with coeliac disease. 2

Coeliac disease is a condition where your immune system attacks your intestines when you eat gluten, which is found in wheat, barley and rye.

This causes the lining of your small intestine to become inflamed and sometimes damaged. 2,3

If you have inflamed or damaged intestines because of coeliac disease, it is likely that nutrients such as iron, folic acid and vitamin B12 are not absorbed well from your food into your bloodstream. 1 In the case of iron, this can lead to ID and iron deficiency anaemia (IDA). 1 As well as the reduced uptake of iron from your diet, coeliac disease can cause internal bleeding in your gastrointestinal tract. 1 This loss of blood means that more iron is lost from your body than normal, which could also lead to ID.

You are also at greater risk of ID if you have coeliac disease and you are: 4

  • Pregnant, as pregnancy increases the iron demands on your body
  • Premenopausal women, as your “period” increases the amount of iron lost from your body
  • An athlete

Once you are following a gluten free diet it is likely that your iron levels will improve but you may also need to be treated with extra iron to replenish the iron levels in your body. 1

Talk to your doctor  if you are concerned about your health or you are experiencing any of the signs of ID . Fatigue is a well-known symptom of coeliac disease,3 as well as restless-legs syndrome 5 and hair loss.3 It is important that you discuss all your symptoms with your doctor at your next appointment.


  1. Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifestations of celiac disease. Blood 2007;109(2):412-421.
  2. Presutti RJ, Cangemi JR, Cassidy HD, Hill DA. Celiac disease. Am Fam Physician 2007;76(12):1795-1802.
  3. Nelsen D. Gluten-sensitive enteropathy (celiac disease): more common than you think. Am Fam Physician 2002;66(12):2259-2266.
  4. Freeman HJ. Iron deficiency anemia in celiac disease. World J Gastroenterol 2015;21(31):9233-9238.
  5. Moccia M, Pellecchia MT, Erro R, Zingone F, Marelli S, Barone DG, et al. Restless legs syndrome is a common feature of adult celiac disease. Mov Disord 2010;25(7):877-881.
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