Understanding the Risks of Osteopenia and Osteoporosis for People with Celiac Disease
Welcome to this week’s edition of The Coeliac Scientist. This blog has been inspired by my recent visit to a GP to discuss my bone health so I thought I’d share some thoughts with you. Celiac disease is often seen primarily as a dietary challenge, but its effects on long-term health—especially bone health—can be substantial. People with celiac disease face a higher risk of conditions like osteopenia and osteoporosis, which can weaken bones and increase fracture risks over time. Today, I want to share my own experience with bone health and celiac disease and discuss practical ways to help manage this aspect of health for others facing similar challenges. Now, before we get started I want to make it clear I am not an expert in bone health or bone conditions - I am writing based on my own experience and my own research.
Osteopenia and Osteoporosis: What’s the Difference?
To start, let’s clarify these terms. Osteopenia means a lower-than-normal bone density, which can eventually progress to osteoporosis if not managed. Osteoporosis is a more severe form of bone loss that makes bones brittle and susceptible to fractures. Many of us with celiac disease may need to watch out for both, as our condition can sometimes impair the body’s ability to absorb critical nutrients that maintain bone strength.
When I was diagnosed with celiac disease, my doctor recommended a DEXA (Dual-Energy X-ray Absorptiometry) scan to measure my bone density. A DEXA scan provides an in-depth picture of bone mineral density, giving insight into the health and strength of your bones. My scan revealed osteopenia, and at just 47, my bone density was equivalent to that of a 65-year-old male. This experience drove home the importance of looking beyond diet when managing celiac disease and making bone health a priority.
Why People with Celiac Disease Are at Higher Risk
Celiac disease damages the small intestine’s lining, especially the villi, which are tiny, hair-like structures essential for nutrient absorption. When these villi are damaged, nutrients such as calcium and vitamin D—both essential for bone health—may not be absorbed properly, even with a well-balanced diet. This limited absorption can lead to deficiencies over time, contributing to weakened bones and increasing the risk of fractures.
A DEXA scan is an excellent tool for monitoring bone health, particularly if you’ve struggled with nutrient deficiencies or have had celiac disease for a long time. For people with newer diagnoses or less severe nutrient absorption issues, doctors may decide that regular blood work for nutrient levels can help monitor bone health adequately. But for those with elevated risk, as I had, the scan provides invaluable insight into treatment needs.
My Experience with Supplements
After my osteopenia diagnosis, my healthcare provider prescribed calcium (with added Vitamin D) supplements. While it might seem that calcium alone would suffice, vitamin D is essential here, as it enables our bodies to effectively absorb calcium. Without sufficient vitamin D, our bodies can excrete calcium rather than incorporate it into our bones. The two work together to ensure that bones are well-supported, so for anyone concerned about bone health, supplementing both nutrients (with your doctor’s guidance) may be wise.
I have been asked in the past about sunlight’s role in vitamin D production. Sunlight exposure does indeed help our bodies produce vitamin D, but those with celiac disease often find that supplements provide a more reliable source, especially in climates where sunlight may be limited (like here in the UK where summer lasts about one day!). Sunlight and diet together may help maintain levels, but supplements are typically advised if nutrient absorption is impaired.
Practical Steps to Protect Your Bones
If you’re managing celiac disease, focusing on bone health early can be incredibly helpful. Here are practical steps that have worked well for me and may benefit others, too.
Schedule Regular Bone Density Tests
As mentioned, a DEXA scan can be invaluable for assessing bone density. However, not everyone with celiac disease will need one right away; your doctor can help determine when it might be necessary based on your nutrient absorption and overall health.Consider Calcium and Vitamin D Supplements
Especially if you’re at elevated risk, supplementing calcium and vitamin D together is important, as the two nutrients work synergistically to support bone health. Check with a healthcare provider for dosage guidance and for any necessary blood work to monitor these levels over time.Include Weight-Bearing Exercise
Physical activity, especially weight-bearing exercises like walking, running, or resistance training, can stimulate bone growth and strength. This type of exercise is a highly effective way to maintain or increase bone density naturally.Adopt a Nutrient-Rich Diet
Focus on foods rich in calcium, like leafy greens, almonds, and certain fish (such as sardines or salmon). Additionally, foods high in vitamin K and magnesium, like kale, broccoli, and nuts, contribute to bone health. Many gluten-free diets can naturally incorporate these foods, but intentional choices can help fill any gaps.Get Safe Sun Exposure or Consider Vitamin D Supplements
Sunlight is one of the best natural sources of vitamin D, so regular, moderate exposure can be beneficial. Aim for 10-30 minutes of midday sun exposure a few times per week, depending on your skin type and location. For those who don’t get enough sun, supplements can fill this gap, especially in winter or if you live at higher latitudes.Avoid Excess Alcohol and Smoking
Alcohol and smoking are known to decrease bone density, making it harder for the body to maintain bone health. Reducing or eliminating these habits can be crucial to preserving bone strength over time.
Engaging with Your Bone Health Journey
Living with celiac disease is a balancing act, but with knowledge and a proactive approach, managing bone health is possible. If you’ve had experience with bone health challenges as a result of celiac disease or have insights to share, I’d love to hear from you. How have you approached managing your bone health, and what has worked well for you?
Taking care of bone health is a long-term commitment, especially for those with celiac disease, but small actions now can prevent bigger issues down the line. Let’s open the conversation and support each other’s journey to better health.
And finally, if you enjoy my articles and would like to support me please consider subscribing or becoming a paid subscriber (it’s just £5 per month) as this helps me create more content.
Warm regards,
The Celiac Scientist