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We are the product of the foods we consume, and there is a growing focus on managing and understanding various health conditions through nutrition. Among the numerous dietary components under scrutiny, gluten has garnered significant attention, particularly for its potential impact on osteoporosis and arthritis. Understanding the relationship between gluten and bone health is crucial for those with these conditions.

What is Gluten?

Gluten is a protein found in wheat, barley, and rye. It gives dough its elasticity and helps it rise and maintain its shape. While many people consume gluten without issue, it can cause adverse reactions in others, particularly those with celiac disease or non-celiac gluten sensitivity.

Gluten and Osteoporosis

Osteoporosis is characterised by weakened bones and an increased risk of fractures. It’s often referred to as a “silent disease” because bone loss occurs without symptoms. Research indicates that there is a notable connection between gluten and osteoporosis, primarily through celiac disease.

Celiac Disease and Bone Health

Celiac disease is an autoimmune disorder where ingestion of gluten leads to damage in the small intestine, impairing nutrient absorption. This malabsorption can include critical nutrients for bone health, such as calcium and vitamin D. Individuals with untreated celiac disease are at a higher risk of osteoporosis.

Mechanisms of Impact

  1. Nutrient Malabsorption: Damage to the small intestine reduces the body’s ability to absorb calcium and vitamin D, both essential for bone health.
  2. Inflammation: Chronic inflammation from untreated celiac disease can negatively impact bone density.
  3. Hormonal Imbalances: Celiac disease can affect the absorption of vitamins and minerals that regulate hormone production, further influencing bone health.

Incidence and Impact

Studies show that low bone mineral density (BMD) can affect up to 75% of individuals diagnosed with celiac disease, regardless of age​ (Coeliac UK)​. This underscores the importance of early diagnosis and treatment to prevent long-term bone health issues.

Managing Osteoporosis with a Gluten-Free Diet

Adhering to a strict gluten-free diet can help restore normal nutrient absorption, improving bone health. Individuals with celiac disease should undergo regular bone density scans and work with healthcare providers to ensure adequate intake of bone-supporting nutrients.

Gluten and Arthritis

Arthritis encompasses a range of conditions that cause joint inflammation and pain. The most common forms are osteoarthritis and rheumatoid arthritis. Emerging research suggests that gluten may play a role in exacerbating these conditions, particularly rheumatoid arthritis, an autoimmune disorder.

Rheumatoid Arthritis and Gluten

Rheumatoid arthritis (RA) is characterized by an overactive immune response, leading to joint inflammation and damage. There is evidence suggesting that gluten may trigger or worsen symptoms in some individuals with RA.

Potential Mechanisms

  1. Immune System Activation: In individuals with gluten sensitivity, gluten intake can activate the immune system, potentially worsening RA symptoms.
  2. Inflammatory Response: Gluten can promote inflammation, a key factor in arthritis pain and joint damage.

Dietary Management

For those with RA who suspect gluten sensitivity, trialling a gluten-free diet may help reduce symptoms. However, it’s crucial to approach this under medical supervision to ensure nutritional adequacy and monitor health outcomes.

Practical Advice for Patients

  1. Get Tested: If you suspect gluten affects your bone or joint health, discuss testing for celiac disease and gluten sensitivity with your healthcare provider.
  2. Dietary Adjustments: If you have been diagnosed with celiac disease or gluten sensitivity, adopting a gluten-free diet is essential. Work with a dietitian to ensure you receive all the necessary nutrients.
  3. Monitor Bone Health: Regular bone density tests can help track the impact of dietary changes on bone health.
  4. Stay Informed: Keep abreast of new research linking gluten with bone and joint health to make informed dietary decisions.


While the relationship between gluten, osteoporosis, and arthritis is complex, it is clear that gluten can have significant impacts, particularly for individuals with celiac disease or gluten sensitivity. Understanding and managing these impacts through diet and medical guidance can improve health outcomes and quality of life.

For more information on bone health and managing osteoporosis, visit London Osteoporosis Clinic and Coeliac UK.