Celiac disease is an autoimmune condition that develops in individuals with a genetic predisposition when they consume gluten. This ingestion leads to an immune response that damages the small intestine. A “low blood count,” medically referred to as cytopenia, occurs when the bone marrow does not produce enough of one or more types of blood cells, such as red blood cells, white blood cells, or platelets.
How Celiac Disease Affects Nutrient Absorption
When individuals with celiac disease consume gluten, their immune system mistakenly attacks the lining of the small intestine, damaging tiny, finger-like projections called villi. These villi significantly increase the surface area for nutrient absorption.
The damage to these villi is known as villous atrophy, which means the villi become flattened or even disappear. This erosion of the intestinal surface reduces the body’s capacity to absorb essential vitamins, minerals, and other nutrients. Even if a person with celiac disease consumes a nutrient-rich diet, their compromised intestine may not effectively take in these vital components. This impaired absorption, or malabsorption, directly impacts the availability of nutrients needed for healthy blood cell production.
Types of Low Blood Count Linked to Celiac Disease
One common type of low blood count associated with celiac disease is iron-deficiency anemia. Iron absorption primarily occurs in the duodenum, the upper small intestine, often severely affected by celiac disease. When the villi in this region are damaged, the body cannot absorb enough iron, which is necessary for producing hemoglobin, which carries oxygen in red blood cells.
Vitamin B12 deficiency is another type of low blood count. While vitamin B12 is absorbed in the terminal ileum, the lower part of the small intestine, damage can sometimes extend to this area. Vitamin B12 is involved in the formation and maturation of red blood cells, and its deficiency can lead to megaloblastic anemia, characterized by abnormally large red blood cells.
Folate, or vitamin B9, is absorbed mainly in the jejunum, another section of the small intestine often impacted by the disease. This vitamin also plays a part in the production of red blood cells, and a shortage can contribute to anemia. These nutrient deficiencies underscore the systemic impact of intestinal damage in celiac disease.
Identification and Management
Diagnosing celiac disease and its associated low blood counts begins with blood tests. Serology tests look for specific antibodies, such as tissue transglutaminase (tTG-IgA) antibodies, which indicate an immune reaction to gluten. It is important for individuals to continue consuming gluten before these tests to ensure accurate results.
If blood tests suggest celiac disease, an intestinal biopsy confirms the diagnosis. This involves taking a tissue sample from the small intestine to examine it for villous atrophy. A complete blood count (CBC) assesses red blood cells, white blood cells, and platelets, identifying low blood counts.
The primary treatment for celiac disease is a strict, lifelong gluten-free diet. Adhering to this diet allows the small intestine to heal, gradually restoring its ability to absorb nutrients. To address deficiencies, nutrient supplementation (iron, vitamin B12, folate) may be recommended under medical supervision. Regular follow-up with a healthcare team monitors healing and nutritional status.