Bottom line: Osteoporosis is a long-term serious consequence of celiac disease. Traditionally thought to be a problem of poor absorption of nutrients such as calcium and vitamin D, a new study suggests that it might also be the result of autoimmunity against a person’s bones.
Celiac has been getting a lot more attention lately, but I find in my practice there is still a lot of confusion about what celiac actually is.
What is celiac (briefly)?
Celiac is an autoimmune disease triggered when a susceptible person eats gluten. Celiac is not a “wheat allergy”, it is possible to have an allergy or reactivity to wheat or other grains and not have celiac disease.
What makes celiac different from other problems with wheat, grains and gluten is autoimmunity, in celiac disease the body is attacking itself.
What is gluten?
Gluten is a family of proteins found in wheat (gliaden & glutenin) and wheat relatives such as spelt and kamut, triticale, barley (hordein), and rye (secalin). There is conflicting information on whether oats contain gluten (avenin). Most of the gluten in oats appears to come from contamination with wheat during harvesting, storage, and processing. Certified gluten-free oats seem to be tolerated by many people with celiac disease.
What happens in celiac disease (briefly)?
Gluten is an irritating and mildly inflammatory substance to all humans. In susceptible individuals (with celiac disease) inadequate digestion of gluten leads to inflammation and damage of the cells of the small intestine. This allows gluten proteins to enter the damaged cells where they are exposed to enzymes (tissue transglutaminases) which modify them and make them more inflammatory. This sets up a vicious circle of inflammation leading to the formation of auto-antibodies (antibodies against the body) which leads to the characteristic destruction of the intestines in celiac disease.
This damage to the small intestines can severely damage the body’s ability to absorb nutrients leading to significant nutrient deficiencies.
Celiac & Osteoporosis – Nutrient deficiencies
In order to form healthy bone the body needs calcium, magnesium, vitamin D, vitamin K, sufficient protein and a host of other vitamins and trace minerals. In celiac disease the damage to the intestines can prevent the body from absorbing enough of these nutrients. Over time the body is not able to build bone and this can lead to early and severe osteoporosis.
Celiac & Osteoporosis – Autoimmunity
A recent study by scientists at the University of Edinburgh found that in 20% of celiac patients tested, they found antibodies to a protein called osteoprotegerin which is important in maintaining bone strength. The antibodies prevented osteoprotegerin from functioning effectively and are thought to be an additional reason for osteoporosis in at least some patients with celiac disease.
How to prevent osteoporosis?
While the study authors were quick to propose a drug to block the antibodies interfering with osteoprotegerin as an answer to celiac induced osteoporosis, there are far more effective therapies that you can do now.
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Photo attribution – https://bit.ly/2KiRg7p
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