Coeliac Disease and Bone Health

Protecting bone health 

Bone health is an important part of your general health. When the structure of bone becomes weaker and less dense, there is an increased risk of breaking. This is osteoporosis. It can lead to a higher risk of bone breaking from a minor incident (such as a bump, fall or trip). Early diagnosis and management of osteoporosis can help protect bone health and reduce the risk of breaking a bone. 

Coeliac disease and bone health 

Coeliac disease affects the ability of the bowel to absorb vitamins, minerals and other nutrients from food. This can greatly impact your bone health. A delayed coeliac diagnosis can lead to weakened bones and a risk of osteoporosis.  

Absorbing nutrients for bone health 

Calcium gives bones strength and structure and can be poorly absorbed by people with coeliac disease.  Low calcium absorption over a long period, particularly during childhood and adolescence when the skeleton is growing, may increase the risk of osteoporosis and bone fractures in later adulthood.  

Vitamin D, which is essential for the proper absorption of calcium from the bowel, may also be lower in people with coeliac disease.  

Timing of coeliac diagnosis 

When coeliac disease is diagnosed in childhood or adolescence, and a gluten-free diet is followed, then your bone health is unlikely to be affected. Younger people who have their coeliac disease diagnosed early and under control do not commonly need an osteoporosis test (bone density scan). 

For people diagnosed in adulthood after several years of symptoms, calcium absorption is likely to have been affected for some time, and therefore your bones may have weakened. If you are diagnosed with coeliac disease as an adult, you may need a bone density scan to investigate your bone health. This is particularly important if adults also have other risk factors for poor bone health. 

Even with a late diagnosis of coeliac disease, following a strict gluten-free diet can help rebuild bone strength and reduce your risk of developing osteoporosis. If required, your doctor can refer you for a bone density scan, and Medicare rebates are available for people with diagnosed coeliac or malabsorption disorders. 

Other common risk factors

Review other common risk factors for osteoporosis. If any risk factors apply to you – discuss these with your doctor.

Personal history

• Previous fracture (from minor bump or fall)
• Family history of osteoporosis (parent/sibling)
• Loss of height (3 cm or more)
• Smoking/Excessive alcohol
• Inadequate calcium, vitamin D or lack of exercise
• Age 70 years and over

Medical conditions

• Coeliac disease
• Diabetes
• Rheumatoid arthritis
• Early menopause/Low testosterone
• Chronic kidney disease or liver disease
• Overactive thyroid or parathyroid

Medications

• Certain treatments for breast cancer
• Certain treatments for prostate cancer
• Glucocorticoids (steroids)
• Anti-epilepsy treatment

Calcium, Vitamin D, Exercise

Take simple steps to help support your bone health.

Focus On	Recommended
Calcium	• 1,000 mg per day from the diet • Increasing to 1,300 mg for women over 50 years and men over 70 years • If dietary intake is low a supplement may be required
Vitamin D	• Limited sun exposure – in summer, a few minutes per day, in winter slightly longer • Avoid UV index above 3 • If vitamin D deficiency is confirmed by your doctor, a supplement may be required
Exercise	• Specific mix of weight bearing, resistance training and balance exercises