Celiac Disease, Osteoporosis And Vitamin D Deficiency

Osteoporosis

Untreated Celiac Disease is a common cause of osteoporosis, a condition where low bone density leaves the individual prone to fractures. The gluten clogs the villi (the small, finger-like growths that line the intestine), preventing the digestion of nutrients, including lactose. This prevents the digestion of calcium, leading to low bone-density. Low bone-density is common in untreated and newly-diagnosed celiacs.

However, as mentioned before, even treated celiacs can still experience lactose intolerance, leading to low bone-density. Even once treated, celiacs without lactose intolerance may take up to two years to restore lost bone-density. A proportion of celiacs never recover the lost bone-density.

Low bone-density is usually diagnosed with a Bone Mineral Density test (usually a DXA scan). A DXA is a painless x-ray scan which measures your bone-density in your lower-spine and hip joint. A DXA scan can tell you whether you have normal bone-density, osteopenia (thinning bones, often a precursor to osteoporosis), or osteoporosis.

If you discover you have osteopenia or osteoporosis, you'll need to take care of your nutrition. A well-balanced diet should include lots of green, leafy vegetables and calcium-fortified foods. If you are lactose intolerant, you should also take a daily calcium supplement of 1200mg a day, fortified with Vitamin D of 800IU. And be sure to take regular weight-bearing exercise, such as walking, weight-training, and dancing.

Vitamin D Deficiency

Vitamin D is vital for supporting calcium-absorption and the development of strong, healthy bones. Celiacs often lack the ability to digest vitamin D from the food they eat (due to a digestive tract that may be permanently-damaged), or even to synthesise it from the sun.

Symptoms of vitamin D deficiency include muscle weakness and bone pain, which may include a specific and debilitating condition called "Osteomalacia". Osteomalacia, or "soft bones", occurs when the mineralisation of the bones fails to occur properly. It can cause severe bone pain, tiny fractures in the bone, muscle weakness, and back pain. These pains can be very severe and will last until the deficiency is diagnosed and treated. Occasionally, the partial fractures in the bone can lead to a complete fracture of the bone.

READ Vitamin D - How Much Do We Need And How Do We Get It?

Vitamin D deficiency is diagnosed by blood test and can be treated efficiently with tablets, an oral liquid, or (in extreme cases) by high-dose injection. You will usually take doses of 20-50mcg at a time, on a daily, weekly or monthly basis, depending on the extent of the deficiency.

If you have been diagnosed with vitamin D deficiency, you should be monitored when active treatment has finished, and retested to make sure you are not becoming deficient again. If your doctor finds that you're routinely becoming deficient, you may be prescribed a lower-dose of regular vitamin D to maintain your levels.

Strong bones for Celiacs

Celiacs can struggle to have the strong, healthy bones other people take for granted. However, by practicing good nutrition, taking weight-bearing exercise, and adding supplements to your diet as necessary, it is possible to make your bones stronger into the future.