Being newly diagnosed with celiac disease can feel overwhelming. The condition requires a complete change in how you approach food, nutrition, and even lifestyle habits. It's crucial to understand the full impact of the disease and how to manage it effectively. A valuable first step is to ask your healthcare provider the right questions to get clarity and direction for your treatment plan.

Understanding the Extent of Intestinal Damage

Your healthcare provider likely performed a biopsy of your small intestine to assess the damage caused by gluten. This damage is usually measured using a grading system that indicates how severely the villi—tiny finger-like projections in the intestine that absorb nutrients—have been affected. Severe damage might mean you have not been absorbing essential nutrients, even if you've been eating well. Knowing the extent of this damage can help determine whether additional screenings for other health complications are needed.

Testing for Nutritional Deficiencies

Due to the compromised absorption of nutrients caused by celiac disease, it's common for newly diagnosed patients to suffer from deficiencies. This can happen even if their diet seemed balanced before diagnosis. Essential nutrients like iron, folate, vitamin B12, calcium, magnesium, and vitamin D may be lacking. You should discuss with your doctor whether specific blood tests are needed to check for deficiencies and guide any supplementation or dietary adjustments.

Checking for Bone Density Loss

Because celiac disease can prevent the absorption of calcium and vitamin D—both crucial for bone health—it’s important to check for potential bone issues like osteopenia or osteoporosis. These conditions make bones weaker and more prone to fractures. Your doctor might suggest a bone density scan, especially if you’ve experienced symptoms like frequent fractures or persistent bone pain. Addressing bone health early can prevent long-term complications.

Discussing Nutritional Supplements

Your provider may suggest a daily multivitamin or additional supplements depending on your blood work. While it's tempting to self-prescribe, excessive intake of certain vitamins—like vitamin D—can have negative effects. Always consult with your healthcare provider before starting any supplements, as they will help create a plan tailored to your specific needs and current deficiencies.

Getting Support From a Dietitian Specializing in Celiac Disease

A dietitian with experience in gluten-free nutrition can be an invaluable resource. Learning to identify hidden sources of gluten and making healthy, balanced choices can be difficult on your own. A knowledgeable dietitian can help you build confidence in reading food labels, selecting safe food alternatives, and maintaining a varied, nutrient-rich gluten-free diet.

Determining If Dairy Should Be Avoided

Many people with celiac disease find they’re also temporarily intolerant to lactose, the sugar found in milk. This occurs because the enzyme that digests lactose, called lactase, is produced in the same villi that gluten damages. Without enough lactase, dairy can cause bloating, gas, and diarrhea. This lactose intolerance often improves over time as the intestines heal on a gluten-free diet, but your provider may recommend avoiding lactose at first or doing tests to confirm intolerance.

Planning Future Monitoring and Follow-Up Care

Celiac disease requires ongoing monitoring even after starting a gluten-free diet. Your provider might recommend periodic blood tests to check for gluten antibodies and track your compliance with the diet. In some cases, a repeat intestinal biopsy might be advised after six months to a year to ensure that healing is taking place. Regular follow-ups can help manage symptoms, track improvements, and identify any recurring issues early.

Testing Immediate Family Members

Since celiac disease has a genetic component, first-degree relatives of a diagnosed individual—parents, siblings, and children—are at a significantly increased risk. It's recommended that these family members undergo testing, even if they do not have symptoms. Moreover, one negative test does not rule out future risk, so repeated screenings over time may be necessary. Early diagnosis in relatives can help prevent complications and improve long-term health outcomes.

Conclusion

Being diagnosed with celiac disease is just the beginning of your journey toward better health. With the right questions and support, you can manage the condition effectively and reduce your risk of complications. Open communication with your healthcare provider, guided nutritional planning, and routine monitoring are key to adapting to a gluten-free lifestyle and maintaining overall wellness. Encouraging your family to get tested and working with experts ensures that you’re not facing the challenge alone—and that you’re taking proactive steps to protect your health for the future.