Celiac disease can affect your ability to absorb nutrients from the foods you eat. This can increase your risk of osteoporosis.

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If you have celiac disease, you may not realize you’re at risk of long-term complications like osteoporosis.

This article will explore the links between celiac disease and osteoporosis and explain how to prevent bone loss.

Celiac disease contributes to the loss of bone density and increases your risk of developing osteoporosis. This happens when damaged villi in your intestines can’t absorb calcium and other nutrients vital to bone health.

People reach peak bone mass around the ages 25–30. After that, your bones slowly begin to lose density and your risk of osteoporosis (brittle bones) goes up.

If you have celiac disease, you also have an increased risk of developing osteoporosis at a younger age .

According to the pooled results of several studies, about 14% of men and premenopausal women with celiac disease have osteoporosis.

Nearly 40% have low bone density, also known as osteopenia, which typically precedes osteoporosis.

When you consume gluten, your immune system mistakenly attacks the lining of your small intestine, leading to inflammation and damage to the villi, the tiny hair-like structures that line the small intestine and help absorb nutrients from food.

Long-term complications occur when damaged villi aren’t absorbing enough nutrients. This can lead to deficiencies in vitamins and minerals, such as iron, calcium, and vitamin D. These deficiencies increase your risk of osteoporosis.

Vitamins, minerals, and bone health

  • Calcium is a mineral that’s stored in your bones. It works to keep your bones firm, strong, and dense. If celiac disease prevents you from absorbing enough calcium, it causes your bones to become weaker and more brittle over time.
  • Vitamin D also plays an essential role because it helps you absorb more of the calcium you eat. Even people without celiac disease need vitamin D to help aid calcium absorption.
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Researchers are exploring other reasons why people with celiac disease tend to have lower bone mass. For example, the chronic inflammation that occurs with celiac disease may also lead to bone loss.

Inflammation triggers the release of cytokines, which are messenger proteins. Cytokines can increase the activity of cells that break down bone tissue and decrease the activity of cells that build bone tissue.

Other theories about the links between celiac disease and osteoporosis involve the following factors:

  • sex hormones
  • growth hormones
  • gut microbiota

Untreated celiac disease increases your risk of fractures, ecspecially in the bones of your hips, spine, and wrists.

When you have osteoporosis, your bones are brittle and fragile. Even small things, like a minor fall or bumping into a table, can lead to broken bones.


Untreated celiac disease can cause osteopenia before it causes osteoporosis. Osteopenia is a condition in which the bones have lower-than-average density, just not low enough to be classified as osteoporosis.

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Fractures and related complications can cause chronic pain, limit your mobility, and affect your ability to perform everyday activities. They can also lead to decreased muscle strength and balance, which can increase your risk of falls.

Untreated celiac disease leads to bone loss, so early intervention is key to prevention.

Receiving an official celiac disease diagnosis is important, even if you’re sure you have it and already eat a gluten-free diet. This diagnosis will help doctors know what complications to look for and what steps you can take to prevent them.

There’s no cure for celiac disease. The most effective management strategy is eating a gluten-free diet. Eating a gluten-free diet is also your best chance of preventing osteoporosis.

Research has shown an association between untreated celiac disease (no gluten-free diet) and low bone mass density in younger adults.

A balanced, gluten-free diet can significantly improve your bone mass density. Research shows that bone mass density in the spine and femurs can improve after 2 years of eating gluten-free. After 5 years, bone mass density showed continued improvement.

You might still have difficulty absorbing some of the nutrients essential to bone health, such as:

  • calcium
  • vitamin D
  • magnesium
  • phosphorus
  • vitamin K

You may benefit from certain nutritional supplements. A doctor can help you decide whether supplements are right for you based on your bloodwork results.

How much calcium do I need?

According to the National Institutes of Health (NIH), the recommended daily calcium intake for adults is 1,000–1,200 milligrams (mg) per day.

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Another important part of osteoporosis prevention is tracking your bone mass density. A doctor might recommend a bone density scan, also known as a DEXA scan. These screenings can help you understand more about your individual osteoporosis risk level.

These screenings can also help detect bone loss early, allowing for early intervention and treatment.


Depending on your osteoporosis risk level, a doctor may recommend medications that help slow the rate of bone loss. Before prescribing preventive medications, a doctor will consider other osteoporosis risk factors, such as your age, sex, and overall health.

The most common medications used to prevent and treat osteoporosis are called bisphosphonates. These include:

  • alendronate (Fosamax)
  • ibandronate (Boniva)
  • risedronate (Actonel)
  • zoledronic acid (Reclast)

Treating celiac disease and osteoporosis can involve a combination of medications and lifestyle modifications to lower the risk of fractures and other bone-related complications.

Doctors may prescribe medications for osteoporosis, such as bisphosphonates, to help slow down bone loss.

Lifestyle modifications, such as regular physical activity, can also help you maintain strong bones and lower your risk of fractures. Weight bearing exercises, such as walking or jogging, are particularly helpful.

You may also want to institute some fall prevention strategies to help lower your risk of fracture. This can include things like:

  • removing tripping hazards
  • installing grab bars
  • wearing appropriate footwear
  • using assistive devices as needed

Celiac disease and osteoporosis are closely linked. People with celiac disease are at increased risk of developing osteoporosis due to difficulties absorbing nutrients essential to bone health, like calcium and vitamin D.

Early diagnosis and treatment of celiac disease can help prevent bone loss and lower your risk of osteoporosis.