Celiac disease symptoms: osteoporosis, osteopenia, and other bone problems

Joint pain is a common symptom of untreated celiac disease. However, many community members were asking about bone pain. They were very specific that they felt pain in their bones, not joints. Therefore, we start collecting medical literature to answer their questions about how common is developing bone problems in celiac disease.

Community questions about bone problems and celiac disease

After an autoimmune attack triggered by gluten consumption, the intestinal villi is damaged. Since these villi are responsible for absorbing nutrients, people with celiac disease may develop vitamins and minerals deficiencies, particularly vitamin D and calcium, which are very important to have healthy bones.

Besides malabsorption, there are other conditions that could contribute to bone damage in person with untreated celiac disease. For instance, it is common that some people with a gluten-related condition develop lactose intolerance, which may prevent them from having a consistent intake of calcium. Listed below you can find several conditions that could contribute to bone damage adapted from Table 2 of Krupa-Kozak (2014).

Source: https://doi.org/10.1016/j.nut.2013.05.027

List of factors that contribute to bone damage in people with celiac disease

When bones are not receiving the right amount of calcium and vitamin D, their density starts deteriorating. After a comprehensive meta-analysis about bone health in people with celiac disease, Ganji and colleagues (2019) indicate that osteopenia and osteoporosis are bone density problems commonly linked to people with celiac disease, especially when they are not adhering to a strict gluten-free diet.

Source: https://doi.org/10.1186/s12937-019-0434-6

Osteopenia and osteoporosis frequency in people with celiac disease

Serious bone density problems make bones weaker and easier to be broken. With a systematic review of more than 400 research articles related to celiac disease and bone problems, Olmos and collleagues (2008) conclude that celiac disease could lead to bone fractures.

Source: https://doi.org/10.1016/j.dld.2007.09.006

In addition, the malabsorption caused by celiac disease could affect how bones grow in kids and teenagers. Esmaeilzadeh and colleagues (2016) compared groups of people with celiac disease with age- and sex-matched control groups during 6 years to determine a significant height difference between them.

Predisposition to bone fractures and higher likelihood of short stature in people with celiac disease

Evidence from Mustalahti and colleagues (1999) shows that people with celiac disease without apparent symptoms (aka., silent celiac or asymptomatic celiac) could have greater bone issues that the symptomatic people with celiac disease. This is attributed to the fact that they had no symptoms, they did not start a gluten-free diet, their intestines were damaged, and their bones suffered of lack of vitamin D and calcium for a longer time.

Source: https://doi.org/10.1016/S0140-6736(99)01990-X

Too much information, do not worry ! We summarized the main takeaways of this article for you.

If you have further questions related to celiac disease or other gluten-related condition, you can email them to us or leave the questions on the website chat. If your question can help more people with celiac disease, we will search scientific references and prepare content about it to share on our website.

Main takeaways about celiac disease and bone problems