Monday, October 6, 2008

Celiac Disease in Men Threatens Bone Health

September 19, 2008 01:08 PM ET Adam Voiland

Did John F. Kennedy, a man generally remembered as one of our more youthful and vigorous presidents, actually have
celiac disease, an autoimmune disorder triggered by exposure to gluten proteins found in wheat, barely, and rye? Quite possibly, says Peter Green, the director of the Celiac Disease Center at Columbia University. Though Kennedy managed to hide his symptoms from public view, he suffered from a slew of ailments that hint at celiac disease, including abdominal pain, diarrhea, migraines, and osteoporosis. Throughout Kennedy's life, doctors diagnosed him with ulcers, colitis, irritable bowel syndrome, and food allergies, but their treatments never seemed to help much. He never received the blood testing and intestinal biopsy that might have revealed celiac disease.

While Green's theory about Kennedy remains speculative, the disease often does go undiagnosed, and it seems to hit men particularly hard—especially where bone health is concerned. One of Green's articles, published in the Scandinavian Journal of Gastroenterology, shows that celiac disease appears to progress faster in men, deprive men's bodies of more needed nutrients, and cause particularly acute damage to bones. In fact, says Alessio Fasano, the medical director at the University of Maryland's Center for Celiac Research, celiac disease is one of the leading causes of male osteoporosis, a condition that many men don't realize they can get. (History buffs may enjoy the History News Network's
overview of Green's theory about JFK, and the Atlantic has a thorough description of that president's medical ordeals.)

Increasingly, American doctors have begun to recognize that celiac disease, which causes damage to the surface of the small intestine and hampers its ability to absorb needed nutrients, is a fairly common affliction. It's present in about 1 percent of the population, possibly more. Nevertheless, there's a long way to go in terms of improving awareness of the disease among the American public and physicians. According to Shelley Case, the author of Gluten - Free Diet: A Comprehensive Resource Guide, experts estimate that only about 5 percent of Americans with the condition ever receive a diagnosis, and it typically takes doctors about 11 years to correctly identify a person who has celiac disease, since the problem is often misdiagnosed as irritable bowel syndrome or anemia.

That's troubling because untreated celiac disease significantly increases the risk of severe medical problems, including gastrointestinal cancers and
non-Hodgkin lymphoma, in addition to osteoporosis. And while osteoporosis is most common among postmenopausal women, the disease also poses a significant threat to more than 2 million men, according to the National Institutes of Health. More than 6 percent of men over the age of 50 will experience an osteoporosis-related hip fracture, NIH says.

The connection between the osteoporosis and celiac disease has important practical implications. Experts say that any man with osteoporosis should have himself screened for celiac disease—just as anyone, male or female, who has celiac disease should get screened for osteoporosis. For people who do have both diseases, research has shown that adopting a gluten-free diet halts the progression of osteoporosis and even improves bone density by 10 percent, Green says.

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