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Celiac Disease in an inheritable autoimmune disorder that causes your body to have an adverse reaction to gluten (a protein found in wheat, barley and rye). Symptoms vary in adults and children and may or may not include symptoms of the digestive system. Many patients' symptoms of bloating, diarrhoea and abdominal pain are routinely dismissed as Irritable Bowel Syndrome, while other symptoms such as depression and irritability are easily missed and misdiagnosed. This delay in diagnosis (research shows it takes an average of 13 years for Celiac Disease to be diagnosed) may make the bone symptoms outlined here more prominent.
However, even when properly diagnosed and treated with a strict gluten-free diet, there are still several co-morbid conditions that may seriously effect the long-term health of your bones.
These conditions include: Lactose Intolerance, Osteoporosis, and Vitamin D deficiency.
Lactose is broken-down by an enzyme in your gut, "lactase". The lining of the gut is badly damaged by eating gluten, meaning that it cannot produce the lactase enzyme, causing symptoms of bloating, nausea, diarrhoea, stomach cramps, and foul-smelling stools if you eat milk products containing lactose (which is found in human's milk, cow's milk, goat's milk, and sheep's milk, but not in soy or rice milk).
Many celiacs have only temporary damage to their gut, and the ability to produce the lactase enzyme will return. For others, however, this intolerance is permanent. It's worth being retested after one year on a strict gluten-free diet to see if the ability to eat lactose has returned.
Lactose intolerance is diagnosed with a hydrogen breath test. Generally, it's more pleasant than most other tests a celiac will undertake. It involves drinking a very sweet solution of pure lactose and breathing regularly into a device. The room is always very near a toilet, because ingesting that amount of lactose tends to have a rather unfortunate effect on lactose intolerant individuals. Based on the amount of times you experience diarrhoea during the test, you may be able to accurately predict whether or not you are lactose intolerant before you officially receive the results.
Although being lactose intolerant means you have to avoid all foods with high levels of lactose, an intolerance is not an allergy. You don't have to avoid all lactose-containing products. This is very good to know, as products that contain lactose are often also very high in calcium.
You will have to avoid milk, soft cheeses and ice creams that contain lactose. However, many hard cheeses, yoghurts, butters and margarines have very low levels of lactose and may be safely eaten by many lactose intolerant individuals. That's good to know, because 30g of cheddar cheese contains a whopping 220mg of lactose. That's more than one-sixth of your recommended allowance.
Lactose intolerance can still cause problems for your bones. Because most of the products that contain the most lactose also contain the highest levels of calcium, it may be difficult to consume enough calcium to avoid the risk of osteoporosis. If you are lactose intolerant, make sure you watch out for milk-substitutes that are enriched with calcium (not all of them are).
If your doctor has found that you're lactose intolerant, you should take a calcium supplement. It's recommended that celiacs take 1200mg daily, to ward off dangerous osteoporosis.