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Autoimmunity, Gluten, & Osteoporosis

A new report in the New England Journal of Medicine identifies antibodies against osteoprotegerin (a protein that prevents bone breakdown) in several patients with celiac disease. This protein is responsible for helping maintain bone density. When it is attacked by the body’s immune system, bone loss becomes accelerated leading to osteoporosis.


N Engl J Med 2009;361:1459-65.

Gluten Free Society’s Stance:

It is a common thought that osteoporosis associated with celiac disease is a result of malabsorption of vitamins and minerals (mainly vitamin D and calcium). The above report links an autoimmune process of bone loss to gluten sensitivity separate and distinct from gluten induced malabsorption. This finding begs the question – Is Osteoporosis an autoimmune process?

Why is this an important link?

If osteoporosis has an autoimmune component, then we have to go back and look at gluten as a potential cause as it is the only known cause for any of the autoimmune diseases. That means that everyone with osteoporosis should potentially be screened for gluten sensitivity. Additionally, we have to consider the possibility that osteoporosis is another manifestation of the “gluten syndrome”. Very few are aware of the field of research called Osteoimmunology. This relatively new field of research explores the connection between a healthy immune system and bone tissue. It has been well established that many immune system derived chemicals help regulate inflammation, bone cell growth, bone resorption, and more. That being said, we know that gluten can cause a dysfunctional immune system leading to a host of different immune chemical reactions that have negative impacts on human health (especially bone health). The diagram below displays some common effects gluten can have on bone:

7 Responses

  1. I just got diagnosed with fibromyalgia in March this year and osteopenia in the spine (-1.5) and osteoporosis in the hips (-3.7) a few weeks ago…..I just turned 40 in July. I’ve had fatigue, gastrointestinal problems since middle school, et. I think I am a classic case!

  2. I’ve been gluten free pretty much for a year and the gastro problems have disappeared but the fatigue remains

  3. My daughter, her family & I have been GF ~ 19 months, & have recently noticed that the excess curvature of our lower spine (lordosis) seems to be much less now!
    Ashley, sometimes other grains (oats & corn) may trigger some of the same issues, & many people benefit by going dairy free for at least 6 months while the gut heals. Digestive enzymes can help, & noticing which other things make you tired! Good luck

  4. Ashley, I was told I had osteopenia when I was 45 and it actually worsened two years later, even after two years on a GF diet. I had my Vitamin D level checked after that and it was extremely low. My naturopath put me on a short term high dose and then a maintenance dose until blood work showed it was at the optimal level. The next bone scan I had (after another two years) showed actual improvement in both values, so much that I was back to a bit better than the first scan. The nurse at my old doctor’s office said, “I don’t know what you’re doing, but keep doing it.” I started to tell her about the Vitamin D level since I thought it was something they should look in to with other patients with bone loss, but she reacted as if “I wasn’t taught this so I don’t know what you’re talking about.” All kinds of good reasons to have optimal D levels though, so if you haven’t checked, please do so.

  5. This is such an exciting article! I became osteoporotic in my early 50s, after a life of gut issues, which started in childhood when I was treated with antibiotics for frequent infections.
    About five years ago, I fell off a chair and broke my wrist in 22 places. This was a wake-up call! After lots of internet research, I went grain-free, and within six months my bone density had improved markedly. I am now back to normal – and in addition my depression disappeared and has never returned, my gut is working fine, and seasonal allergies are a thing of the past. I’m no longer a vegetarian (which I was very committed to, but which in retrospect was really bad for my health) and am thriving on a low carb, high fat diet, which has fixed my blood sugar issues and my mood swings. YES YOU CAN get better with age!

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