Osteoporosis in Patients with Celiac Disease

At any given moment, there are at least 3 million people in the United States who are living with celiac disease. This number translates into roughly 1% of the population. Therefore, it is somewhat safe to say that the condition is not very common. That being said, the vast majority of people with celiac disease do not even know that they have it. In fact, as many as 97% of people living with the condition have yet to be diagnosed.

This is especially concerning considering the nature of the disease. Specifically, celiac disease causes damage to the lining of the small intestine whenever gluten is consumed. And, of course, gluten is found in many of the foods that we eat daily. This includes everything from pasta and bread to certain spices or sauces. Therefore, those who have undiagnosed celiac disease are likely consuming gluten and making their stomach issues even worse. Unfortunately, when gluten intake damages the lining of the small intestine, it prevents the organ from properly absorbing vital nutrients.

As you may very well imagine, malabsorption on this scale can potentially lead to a slew of complications. When the body is deprived of nutrients, it can lead to diarrhea, fatigue, anemia, or even osteoporosis. Much like celiac disease, many patients may not realize that they have osteoporosis until something goes wrong. (For example, until they break or fracture a bone.) So, it is entirely possible for a patient to have both conditions without realizing it for months or even years. Luckily, you can combat these problems by following a strict dietary regimen and making certain lifestyle changes. With the right multi-faceted approach, you will be able to live your life with minimal disruption.

How Do I Know if I Have Celiac Disease?

When you first experience the symptoms of celiac disease, it’s not extremely obvious what’s causing the problem. For example, you may chalk up your symptoms to some kind of thyroid deficiency, irritable bowel syndrome, or a different food allergy entirely. It’s natural to think these kinds of thoughts. After all, the symptoms mostly consist of generic problems, like diarrhea, fatigue, weight loss, and abdominal pain. That being said, ask yourself, “Has my digestive discomfort last for longer than two weeks?” If the answer is yes, then it’s time to see a doctor.

Due to the nature of malabsorption, you may also experience additional symptoms that seem entirely unrelated to the digestive tract. Of course, your mileage may vary. But, some patients report the following problems:

• Anemia
• Loss of bone density (potentially leading to osteopenia or osteoporosis)
• Oral ulcers
• Headaches
• Balance problems
• Joint pain
• Hyposplenism
• Growth problems
• Tooth enamel damage
• …and more.

If your doctor suspects that you have celiac disease, then he or she may perform several tests in order to confirm the diagnosis. For one, your doctor may order a serology test to screen for elevated levels of antibody proteins in the blood. High levels of certain antibodies in the bloodstream, for instance, may indicate gluten intolerance. Because celiac disease is hereditary, your doctor may also perform genetic testing for markers HLA-DQ2 and HLA-DQ8. Usually, doctors use this test to rule out a celiac disease diagnosis. In the event that you do have the condition, your doctor will recommend you to a dietician. This trained professional will put together a set of dietary rules that you will need to follow for the rest of your life.

The Relationship Between Osteoporosis & Celiac Disease

Osteoporosis is a condition that leads to bone weakness and brittleness. In the most severe cases, even mild stressors, such as coughing or bending over, may cause instantaneous bone fracturing. Unfortunately, there are typically no symptoms in the early stages of osteoporosis. As such, many patients do not realize that they have the condition until a bone is broken. Fractures from osteoporosis most commonly affect the hip, wrist, and spine.

As we have discussed, celiac disease causes damage to the small intestinal lining. Specifically, gluten consumption causes the destruction of intestinal villi, which leads to future problems with nutritional malabsorption.

Among these vital nutrients that the body craves is calcium, which is responsible for bone growth and general bone stability. People who are newly diagnosed with celiac disease are more likely to be deficient in this nutrient, among others. When the body does not get the calcium that it needs, it leads to low bone density—the hallmark of osteoporosis. Unless your doctor performs additional testing to screen for complications of celiac disease, it is likely that your osteoporosis will go unnoticed for quite some time. If left untreated, osteoporosis will not go away on its own. Instead, the condition will become progressively worse over time—until eventually—fractures occur.

To determine if you have osteoporosis, your doctor may use a special machine. This diagnostic device produces low levels of x-rays, which reveal the proportion of certain minerals in your bones. You’ll be happy to know that this test is completely pain-free as well as highly accurate. Generally, your doctor will only assess high-risk areas for fractures, such as the hip, wrist, and spine. Unlike celiac disease, you will have a lot of treatment options when it comes to osteoporosis.

Osteoporosis & Celiac Disease Treatment Options

Unfortunately, there aren’t many treatment options available for patients with celiac disease. Currently, the only real course of action is to follow a strict (and lifelong) gluten-free diet. Of course, gluten is present in a lot more foods than you might expect. Therefore, your best bet is to buddy up with a dietician who works with celiac disease patients. He or she will give you a list of specific foods to avoid, in addition to certain vitamins and nutritional supplements to take. If you stick to his or her advice for long enough, eventually, the symptoms of your celiac disease will fade.

Osteoporosis, on the other hand, exists on the opposite end of the spectrum. There are plenty of treatment options available for patients who suffer from this complication of celiac disease. Treatment for osteoporosis often depends on the risk of the patient breaking a bone within the next decade. (Your doctor can determine this by reviewing your bone mineral density scan.) If your case is severe enough, your doctor may resort to certain medications such as Fosamax or Boniva for treatment.

But, of course, medication is not your only option for handling osteoporosis. Sometimes, the best solution is simply following a well-balanced diet that is rich in vital nutrients such as calcium and vitamin D—providing that both sources are gluten-free, of course! Good sources of these nutrients include dark green vegetables and calcium-enriched beverages.

Another preventative strategy for osteoporosis is exercise. Like muscle, bone is a living tissue that becomes stronger through exercise. For osteoporosis, use weight-bearing and resistance exercises, such as walking and climbing steps, to build up bone strength.

Contact Us

Have you recently experienced problems with bone fractures that you think might be related to osteoporosis? If so, please contact New York City Spine at (855) 210-0899. We employ only the finest board-certified professionals who take pride in finding the perfect treatment plan for your specific needs. Dr. Daveed Frazier and his team will work night and day to help you reclaim your life from chronic pain. Contact our team of spine specialists today!