Laboratory/ Diagnostic Testing

  • Serology (Tissue transglutaminase, deamidated gliadin peptide can be used for monitoring CD)
  • Vitamins & Minerals- A, D, E, B12, folic acid, copper, zinc, ferritin, iron, calcium (if previously abnormal)
  • CBC- if previously abnormal
  • LFTs- if previously abnormal

Medication Management (including vitamins & minerals)

  • Vitamin B complex if appropriate
  • Supplemental vitamin D based on vitamin D level
  • Calcium intake at least 1000mg per day
  • Fiber supplement if appropriate

Screening/ Heath Promotion Activities (including vaccination recommendations)

  • According to CDC recommendations for adults

Anticipated Diet Education Needs

  • Consider reintroduction of lactose containing dairy products
  • Consider reintroduction of gluten-free oats
  • Encourage high-iron and high-folate foods

Quick Text

Greater than 40 minutes of face-to-face time was spent with this patient today with over half this time involving: Gluten free diet education, rx medication management, counseling, and co-ordination of care. Many questions were answered  to pt satisfaction.
PLAN: Labs- including cbc, cmp, celiac serology, and vitamin/minerals.  Comprehensive Gluten free diet discussed and handouts given.   Pt understands need for Gluten free diet is a life-long commitment to reduce risks of complications associated with malabsorption and  chronic inflammation-  including  Lymphoma. 100% Gluten free diet is recommended. Continue super B complex (plus folic acid, vitamin d, and iron if indicated). Bone density scan (baseline within one year of diagnosis).