• Problem: Lactose intolerance Common in newly diagnosed celiac disease patients; a temporary lactose-free diet, in addition to a lifelong gluten-free diet, may be necessary to heal intestinal villi, microscopic fingerlike projections that absorb nutrients in the small intestine.
• Solution: Lactase enzyme drops or tablets, lactose-reduced dairy products, or nondairy milks.
• Problem: Vitamin B12 deficiency
  Common in cases of extreme B12 malabsorption.
• Solution A multivitamin with vitamin B12, or B12 injections (in some cases).
• Problem: Bacterial overgrowth
  Typically associated with celiac disease due to intestinal villi damage.
• Solution Probiotic therapy, which recolonizes the intestine with good bacteria. Cynthia Rudert, MD, an Atlanta-based gastroenterologist and CD expert, recommends probiotics found in supplements and yogurt (which contains very little lactose).
• Problem: Osteopenia or osteoporosis
  Conditions common in both children and adults due to nutrient malabsorption.
• Solution Calcium and vitamin D supplements, taken together in more than one dose. Calcium citrate is the best-absorbed form; calcium carbonate is more economical and needs to be taken with food.
• Problem: Iron deficiency
  Common symptom of celiac disease.
• Solution Anemia usually disappears upon adopting a gluten-free diet. However, short-term iron supplementation may be necessary, taken in lower doses or in a gluten-free multivitamin with iron. Take with vitamin C for highest absorbency.
• Problem: Folate deficiency
  May occur in cases of folic acid malabsorption.
• Solution: A multivitamin with folic acid.

—J.R.L.

Sources: Shelley Case, RD; Cynthia Rudert, MD.

Note: Consult your physician before taking any supplements.