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Understanding the Link between Osteoporosis and Celiac Disease

Posted Feb 27 2011 10:57pm

     Medical researchers have noted for quite some time that osteoporosis and celiac disease commonly appear together. In my celiac advocacy work, I have come across several celiac patients who didn’t know they had the disease until they were diagnosed with osteoporosis, and vice-versa. If you have either condition, it’s important to understand this link and to know what symptoms to look for. Being informed on this subject can have priceless health benefits.

      Osteoporosis is a disease that causes the bones to be less dense than they should be, making them more fragile and more likely to break.  Many people with osteoporosis don’t realize they have the condition until they break a bone. Sometimes the fractures are major breaks, or there can be dozens or hundreds of tiny fractures. Loss of height with aging and a severely rounded upper back called the dowager's hump are usually the result of many small osteoporotic fractures that have weakened the spine.

     It is fortunate that osteoporosis is preventable. There are many risk factors for developing the disease, and the first step is to recognize which factors may apply to you and to take the appropriate steps to handle them. Risk factors include insufficient calcium intake, insufficient vitamin D intake, being thin or having a small frame, a family history of osteoporosis, taking certain medications, insufficient weight-bearing exercise, smoking, too much alcohol consumption, and in women, being postmenopausal, having an early menopause, or not having menstrual periods. The reason why people with celiac disease are at high risk for osteoporosis has to do with the first two of these risk factors—insufficient intake of calcium and vitamin D.

     When people with celiac disease eat foods that contain gluten, the villi that line the small intestine become damaged. Malabsorption—improper uptake of nutrients by the body—results, particularly of the nutrients calcium, vitamin D, and vitamin K, all of which are essential for healthy bones. Consequently, low bone density is common in celiac children and adults. Because they have gone longer without proper nutrient intake, celiac patients who weren’t diagnosed until adulthood have an increased risk of osteoporosis. In fact, the link between celiac disease and osteoporosis is so strong that researchers advise all patients who develop osteoporosis at a young age to get tested for celiac disease, to find out whether their low bone density is related to malabsorption. Researchers recommend that elderly patients with osteoporosis that doesn't seem to respond to medication should also be tested for celiac disease. If you have either condition, it is important that you schedule the appropriate testing with your doctor.

     The American Gastroenterological Association recommends that all patients with celiac disease undergo bone density tests, often called bone density scans, bone mineral density (BMD) tests, or bone densitometry, to determine whether they have osteoporosis. These tests are quick, easy, and painless. Your doctor will need to give you a prescription for a bone density test.

     So how do you treat osteoporosis? When celiac patients adopt a gluten-free diet, their bone density usually improves. In addition to avoiding gluten and having your bone density measured, it is essential that you get enough calcium and vitamin D through diet and supplements. You can also stimulate vitamin D production from exposure to sunlight. Exercise is important because, just as your muscles get stronger from working out, so do your bones. It also strengthens the muscles that support the bones and improves balance and flexibility, reducing the risk of falling and breaking a bone. Choose exercises that force you to lift weight against gravity, such as walking, stair climbing, and dancing, as well as weight training. Finally, avoid smoking and excessive alcohol. Just as smoking is harmful for your heart and lungs, it is also bad for your bones, and heavy alcohol consumption is linked to low bone density.

     If you’ve been diagnosed with osteoporosis or celiac disease, I urge you to consult with your doctor about getting tested for the associated condition. The sooner you are diagnosed, the easier treatment will be. You’ve already taken the first step by informing yourself about this documented link and the symptoms to look for.

Tina Turbin

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