Gluten Sensitivity and Osteoporosis

Gluten sensitivity is a reaction to the ingestion of gluten, a protein found in wheat, barley and rye grains. It is estimated that 6 to 10% of the U.S. population have adverse reactions to gluten. Symptoms may be gastrointestinal in nature (diarrhea, constipation, gas, bloating, abdominal pain) or manifest as other health related issues: anemia, weight loss, fatigue, general weakness, muscle cramps, achy legs, tingling sensations in the face or extremities, rash, mouth sores and tooth discoloration. But often, gluten sensitivity goes undiagnosed--silently lurking beneath the surface, causing system inflammation and the development of disease entities such as osteoporosis.

It is estimated that almost 1 out of every 100 people suffer from celiac disease--the more severe autoimmune form of gluten sensitivity, where the mucosa villi in the small intestines are flattened, limiting the body's ability to absorb nutrients--even if they are plentiful in the diet. But gluten sensitivity does not always manifest with gastrointestinal involvement. In fact, the disorders that have been linked to gluten sensitivity are extremely diverse. The following is just a sampling of those disorders: ADHD (attention deficit hyperactivity disorder), depression, migraines, cancer, heart disease, psoriasis, ulcerative colitis, rheumatoid arthritis, lupus, Hashimoto's thyroiditis, Sjogren's syndrome, recurrent pancreatitis, and osteoporosis. Because it has the potential to cause so many symptoms and has been linked to so many disorders, gluten sensitivity is frequently mistaken for other conditions or is overlooked entirely. However, awareness of gluten sensitivity is improving dramatically as more people speculate that gluten could be at the root of their health problems.

Doctors don't often look for gluten sensitivity in the assessment of their patients with osteoporosis. Unfortunately, this is a problem because gluten sensitivity can lead to bone loss not just from malabsorption but also through a systemic release of pro-inflammatory cytokines throughout the body. When mucosal cells become irritated (this can be from ANY food sensitivity, not just gluten) it causes gaps to appear at the junctions between the cells of the intestines. These gaping holes are large enough for undigested food molecules such as gluten to permeate the gut wall and set off an inflammatory response. Of all the food molecules that can potentially penetrate this "leaky gut," gluten seems particularly prone to producing a large inflammatory response.

If you have osteoporosis--even if you do not have the gastrointestinal signs and symptoms of celiac disease--you should still be tested for gluten sensitivity. It may be a contributing factor in your bone loss. The following tests can determine if you are sensitive to gluten: anti-tissue transglutaminase (tTG) IgA, total IgA, antigliadin antibodies (AGA) IgA and IgG.

The treatment for celiac disease and gluten sensitivity is to go on a gluten-free diet, to control signs and symptoms and prevent complications. Initially, following a gluten-free diet may be frustrating. But with time, patience and creativity, you'll find there are many foods that you already eat that are gluten-free and you will find substitutes for gluten-containing foods that you can enjoy.

If you are just starting a gluten-free diet, it's a good idea to consult a dietitian who can answer your questions and offer advice about how to avoid gluten while still eating a healthy, balanced diet. For gluten-free recipes and even hands-on classes in how to cook gluten-free, Leslie Cerier, "The Organic Gourmet" is a great resource. Leslie wrote Gluten-Free Recipes for the Conscious Cook which I highly recommend.