Celiac Disease and Osteoporosis

By November 28, 2017The Bone Bandits

What is Celiac Disease?

Celiac disease is an autoimmune disorder which causes your body’s immune system to produce antibodies to gluten found in certain grains and starches in your diet. This leads to inflammation and damage of the small intestine where the majority of important vitamins and nutrients are absorbed. Celiac disease is relatively uncommon, impacting only 0.2% of the general population. However, 3.4% of people with osteoporosis have the disease, making it an important bone health consideration.

How is Celiac Disease Diagnosed?

If you have celiac disease, you may experience a variety of gastrointestinal symptoms. More mild forms of the disease often do not cause any symptoms, whereas more severe cases of celiac disease can lead to abdominal pain, bloating, chronic diarrhea, and unexplained weight loss.

The most accurate lab tests used to detect celiac disease are blood tests known as the IgA tissue transglutaminase antibody and IgA endomysial antibody. The diagnosis of celiac disease is confirmed by having a biopsy taken of your small intestine.

  • Tissue Transglutaminase Antibody (tTG-IgA). This lab is the primary screening tool for celiac disease. Elevated levels indicate that your body is producing antibodies to gluten which can damage your small intestine. This test is frequently combined with a second lab, known as the total serum IgA to ensure accuracy of the results.
  • IgA Endomysial Antibody (IgA EMA). This lab measures another type of antibody that your body can form in response to gluten if you have celiac disease. It is not as commonly used as tTG-IgA because it is more expensive. A positive result indicates that you likely have celiac disease.
  • Small Intestine Biopsy. This medical procedure involves taking a small biopsy of the inner lining of your small intestine. It is then evaluated under a microscope for damage and inflammation caused by celiac disease. This is certainly the most invasive way to diagnose the disease, but it is also the most accurate and is required in some people to accurately diagnose the disease.

How Does Celiac Disease Impact Your Bones?

Celiac disease is an under-recognized medical disease, impacting 1 in 500 people… but 83% of those with celiac disease are unaware they have it! Over time, celiac disease leads to chronic inflammation and destruction of the portion of your small intestine necessary for absorbing key bone building nutrients. With less calcium, vitamin D, magnesium, etc. being absorbed, your body will need to find calcium from other sources for normal day to day function— including your bones! This ultimately leads to weaker bones and an increased risk of fractures.

Studies have also demonstrated that celiac disease can lead to inflammation throughout your entire body as well. When these inflammatory substances known as cytokines reach your bones, they stimulate bone-breakdown osteoclast cells to weaken your bones!

How Can Those With Celiac Disease Improve Their Bone Health?

The current treatment for celiac disease is adhering to a strict gluten free diet. The emphasis is on STRICT (which requires careful meal planning and label checking!). In doing so, your body will no longer form antibodies against gluten and your small intestine is able to heal. Researchers have shown that if you have osteoporosis caused by celiac disease, you can SIGNIFICANTLY IMPROVE your bone density simply by eliminating gluten from your diet. However, your bone density may not return to normal levels by dietary changes alone. This means that a gluten free diet may be the only treatment needed for those with a low fracture risk, but if your fracture risk is high, other osteoporosis treatments may still be necessary.