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Low Bone Mineral Density in Adult Celiac Disease

Celiac.com 09/02/2013 - Most people with celiac disease are now diagnosed as adults, and many suffer from impaired bone mineralization.

Photo: CC--zeeweezResearchers A.J Lucendo and A. García-Manzanares recently conducted a review of bone mineral density in patients with adult celiac disease.

Their goal was to provide an updated discussion on the relationship between low bone mineral density (BMD), osteopenia and osteoporosis, and celiac disease.

They conducted a search of relevant articles published in PubMed over the last 15 years. They also reviewed all sources cited in the article results to identify potential sources of information.

They found that up to 75% of celiac patients can suffer from low BMD, which can occur at any age, independently of positive serological markers and presence of digestive symptoms.

Patients with osteoporotic issues have significantly higher rates of celiac disease.

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The team proffers two theories which may explain the origins of low BMD in celiac patients. The first says that low BMD may result from malabsorption of micronutrients (including calcium and vitamin D) determined by villous atrophy, which has has been related to secondary hyperparathyroidism and incapacity to achieve the potential bone mass peak;

The second theory says that low BMD may result from chronic inflammation, which was also related with RANKL secretion, osteoclasts activation and increased bone resorption.

Whatever the cause of the low BMD, people with celiac disease have more than 40% higher rates of bone fractures compared to matched non-celiac individuals.

Treatment of low BMD in celiac disease includes gluten-free diet, supplementation of calcium and vitamin D, and the use of biphosphonates, the effects of which on celiac disease have not been specifically studied.

Up to 75% of people with celiac disease, and 40% of those diagnosed in adulthood show low BMD, along with increased risk of bone fractures.

This information shows the potential importance of bone density scans for adults with celiac disease.

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3 Responses:

 
W. Jackson
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated
said this on
09 Sep 2013 9:48:12 PM PDT
Good information to know.

 
Jean Mascarenhas
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
10 Sep 2013 1:33:21 PM PDT
Glad to know this. Used to put it down to lack of estrogen due to relatively early total hysterectomy. However Evista did not help and oral Fosamax caused havoc with my digestive system. Lost faith in all such meds. BMD deteriorated and caused lumbar stenosis. Now on Prolia and can only hope for some improvement. Dread a fracture!

 
Jammy
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated
said this on
11 Sep 2013 4:45:56 AM PDT
Depressing to know...what's the remedy? The article doesn't say.




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^^^^^^ good info, tips and tricks^^^^^^^^^ yes, crumbs will make you sick. also, breathing flour/pancake mix, etc that is in the air because eventually, you're going to swallow some.

Hello I was diagnosed Dec 15 of last year and went totally gluten-free the next day. I actually got worse before I got better - it's a steep learning curve - but now, 4 1/2 months later I'm finally seeing improvement. Hang in there.

Called my GI doctor today to make sure he is going to look at my small intestine and do biopsy for Celiac for my EGD and he is. Thanks for the tip everyone about have to start eating gluten again. The office told me to break my gluten free diet and start eating gluten everyday until my EGD. Here's to being miserable again for a few weeks ???

I can completely relate! The horrible mental effects that I have been living with for years is the absolute worst side effect of eating gluten, HANDS DOWN. Worse than the endless tummy aches, worse than the constant diarrhea, worse than the week long migraines, worse than the daily fatigue and body pain.... I honestly though there was something seriously wrong with me and hated my life because of how I felt mentally. I always felt like I was drowning, not in control of my thoughts, trapped in some unexplained misery. My head was always so cloudy, and I was mad because I always felt so slow and stupid. I would feel so lethargic and sad and empty while at the same time be raging inside, wanting to rip out of my own skin. I was mean, terrible, would snap at the people closest to me for no good reason and just felt like I hated everyone and everything. Think of how crappy you feel when you have a terrible cold and flu - I felt that crappy, but mentally. Some days were really bad, some were mild. I always thought it was because I was getting a migraine, or because I had a migraine, or because I had just overcome a migraine, because I didn't sleep well, because....always a random reason to justify why we have all these weird unrelated symptoms before we get diagnosed. I'm happy to say that I have been gluten-free for about 2 months now and though I am not symptom free, the first thing that improved was my mood. I no longer feel foggy and miserable. For the first time in years, my head is clear, I can actually think, and I feel positive and like I am in control of what's going on in my head. I don't hate the world. I don't spend every day bawled up on the corner of the couch depressed and angry. The release of these horrible symptoms is enough to never make me want to cheat, no matter what I have to miss out on. So insane how a little minuscule amount of a stupid protein can wreck such havoc.

I wanted to collect some of the info on NCGI in one place so that visitors who test negative but may still have an issue with gluten can be directed there. I'll add to this post as I find new links, but feel free to add or contribute anything you think may be of use! Matt --- Useful links: An overview from Alessio Fasano, one of the world's leading researchers on celiac and gluten sensitivity: https://www.youtube.com/watch?v=VvfTV57iPUY Umberto Volta, another leading researcher in the field gives some of the latest findings about NCGI: Presentation slides from Dr Volta's visit to Coeliac UK - NCGS about halfway through A scholarly overview from celiac disease magazine: https://www.researchgate.net/profile/Knut_Lundin/publication/232528784_Non-celiac_Gluten_Sensitivity/links/09e415098bbe37c05b000000.pdf A good overview from a sceptical but fair perspective: https://sciencebasedmedicine.org/a-balanced-look-at-gluten-sensitivity/ Another overview: https://celiac.org/celiac-disease/understanding-celiac-disease-2/non-celiac-gluten-sensitivity-2/ University of Chicago's excellent celiac site's take: http://www.cureceliacdisease.org/category/faq-non-celiac-gluten-sensitivity/ A compelling account in the British Medical Journal from an NCGI patient: http://www.bmj.com/content/345/bmj.e7982 Here's some positive news about a potential new test: http://www.medicaldaily.com/non-celiac-gluten-insensitivity-blood-test-392850 NCGI in children: NCGI and auto immune study: https://www.ncbi.nlm.nih.gov/pubmed/26026392 Also consider: Fodmaps: http://www.kcl.ac.uk/lsm/research/divisions/dns/projects/fodmaps/faq.aspx This Monash study: http://fodmapmonash.blogspot.co.uk/2015/03/the-truth-behind-non-celiac-gluten.html suggested some who think they're reacting to gluten should actually be reducing fodmaps Sibo: http://www.webmd.boots.com/digestive-disorders/small-intestinal-bacteria-sibo