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Dietary Supplement Use in Patients With Celiac Disease in the United States

Nazareth, Samantha MD*; Lebwohl, Benjamin MD, MSc*,†; Tennyson, Christina A. MD; Simpson, Suzanne RD*; Greenlee, Heather ND, PhD†,§; Green, Peter H. MD*

Journal of Clinical Gastroenterology: August 2015 - Volume 49 - Issue 7 - p 577–581
doi: 10.1097/MCG.0000000000000218
ALIMENTARY TRACT: Original Articles

Background: There has been increasing interest in the use of complementary and alternative medicine (CAM) in the general population. Little is known about CAM use in patients with celiac disease (CD).

Goals: We aimed to determine the demographics and clinical characteristics of patients with biopsy-proven CD who use dietary supplements to treat their symptoms.

Study: CD patients completed a questionnaire on demographics, types of dietary supplement use, attitudes toward CAM, and 3 validated scales: CD-related Quality Of Life (CD-QOL), the CD Symptoms Index (CSI), and the CD Adherence Test (CDAT).

Results: Of 423 patients, 100 (23.6%) used dietary supplements to treat CD symptoms. The most frequently used supplement was probiotics (n=59). Supplement users had a higher CD-QOL score (75.06 vs. 71.43, P=0.04) but had more symptoms based on CSI (35.64 vs. 32.05, P=0.0032). On multivariable analysis, adjusting for age, sex, education, symptom improvement following a gluten-free diet, and where the survey was completed, patients presenting with classic symptoms (OR, 2.56; 95% CI, 1.01-6.44) or nonclassic symptoms (OR, 2.75; 95% CI, 1.04-7.24) were significantly more likely to use supplements than those with asymptomatic/screen-detected CD.

Conclusions: Patients with biopsy-proven CD who have symptoms at diagnosis tend to use dietary supplements more than those that are screen detected. Those using supplements report persistent symptoms, but a higher quality of life. The contribution of the gluten-free diet and supplement use to quality of life in the symptomatic CD patient needs to be determined.

*Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons

Department of Epidemiology, Mailman School of Public Health, Columbia University

Mount Sinai School of Medicine

§Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY

The authors declare that they have nothing to disclose.

Reprints: Peter H. Green, MD, Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, 180 Fort Washington Ave, Room 936, New York, NY 10032 (e-mail:

Received March 25, 2014

Accepted August 2, 2014

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