If the diarrhoea is severe it is accompanied by weight loss, abdominal bloating and much rumbling and wind. Many coeliacs are anaemic due to poor absorption of iron and folic acid. This may lead to lethargy, tiredness and a pale complexion. The same deficiencies may be responsible for recurrent mouth ulcers, a common complaint among coeliacs. Symptoms may be precipitated by antibiotics, operations, after pregnancy and at the menopause.
Anaemia is one of the common problems present before the diagnosis of coeliac disease is made.
If the blood is particularly deficient in iron or folic acid, it is advisable to take supplements of either or both of these when one first starts a gluten free diet. Your hospital doctor will have checked this out. After a couple of months on the gluten free diet the mucosa should be able to absorb sufficient iron and folic acid from the foods you ingest and you should no longer need any supplements. This is to ensure that you are remaining well on your gluten free diet. It is a good idea to have a blood test to determine if you are anaemic once a year.