title: Dietary Supplement Use in Patients With Celiac Disease in the United States.
abstract: 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).
  
  
  OBJECTIVE
  We aimed to determine the demographics and clinical characteristics of patients with biopsy-proven CD who use dietary supplements to treat their symptoms.
  
  
  METHODS
  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.
authors.affiliation: *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.
authors.forename: Samantha
authors.initials: S
authors.lastname: Nazareth
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lebwohl
authors.forename: Christina A
authors.initials: CA
authors.lastname: Tennyson
authors.forename: Suzanne
authors.initials: S
authors.lastname: Simpson
authors.forename: Heather
authors.initials: H
authors.lastname: Greenlee
authors.forename: Peter H
authors.initials: PH
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002446:Celiac Disease / Q000178:diet therapy* / Q000473:pathology / Q000523:psychology; D000529:Complementary Therapies / Q000523:psychology; D055050:Diet, Gluten-Free; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult