Can coeliac disease cause vitamin B12 deficiency?

Coeliac disease damages the lining of the small intestine after gluten exposure. That change can affect absorption of vitamin B12 and other nutrients, especially if the condition has not yet been diagnosed or is not well controlled. Vitamin B12 deficiency may cause tiredness, a sore or smooth tongue, pale skin, pins and needles, numbness, balance problems or changes in memory and concentration. These symptoms have several possible causes, so they do not confirm either condition by themselves.

A clinician may review your symptoms, diet, blood count and vitamin B12 level. Further tests can help clarify whether low B12 relates to absorption, dietary intake or another cause.

Arrange a medical review if you have coeliac disease and symptoms that could fit vitamin B12 deficiency. Do not start a gluten-free diet before coeliac testing unless a clinician advises it, because removing gluten can affect test results. If coeliac disease is already confirmed, follow the recommended gluten-free plan and attend blood-test reviews.

Treatment may involve vitamin B12 tablets or injections, depending on the level, symptoms and suspected absorption problem. A clinician can also check for related nutrient deficiencies and review medicines or diet that may affect B12.

Seek prompt medical advice for new numbness, worsening balance, marked weakness, confusion or breathlessness. Get urgent help for sudden one-sided weakness, trouble speaking, fainting or severe breathing difficulty. These symptoms need assessment because they can have causes unrelated to coeliac disease or vitamin B12 deficiency.

Ask whether you need a blood count, vitamin B12 testing and tests for other nutrient deficiencies. You can also ask whether your results suggest an absorption problem, which form of B12 treatment is suitable, and when your levels and symptoms should be reviewed.