Because their bodies cannot tolerate a protein called gluten found in some grains, people with celiac disease can't eat such ordinary foods as bread, pasta, and cereal. One effect of the disease is a weakening of the bones, which has led to talk in the medical community about screening osteoporosis patients for celiac disease with a quick blood test. The question is whether such a test would turn up enough celiac patients to be worthwhile. Researchers from Washington University School of Medicine and the University of Alabama School of Medicine set out to find the answer.

What the researchers wanted to know: How often is osteoporosis a tip-off for celiac disease?

What they did: The researchers tested almost 850 patients at Washington University's Bone Clinic, most of them postmenopausal women, for celiac disease. About one third had osteoporosis and two thirds did not. Those who tested positive for celiac disease were referred to a dietitian, who advised them on a gluten-free diet. Six months and 12 months later, doctors asked the celiac patients about their adherence to a gluten-free diet and tested their bone strength using a measure called bone mineral density, or BMD.

What they found: Celiac disease was uncommon overall, but patients with osteoporosis were much more likely to have the disease than those without it. Nine patients (3.4 percent) with osteoporosis had celiac disease, while only one (0.2 percent) without osteoporosis had it. Eight of the nine patients with osteoporosis maintained a gluten-free diet for a year; in six of the eight, their bones became stronger. Other symptoms, such as weight loss and diarrhea, also improved. In fact, they felt better than patients usually do with standard treatment.

What it means to you: The researchers recommend that anyone with osteoporosis be screened for celiac disease, especially given that the screening is not difficult or invasive. For people with both disorders, a gluten-free diet may improve health remarkably, making bones stronger and easing digestive symptoms.

Caveats: An accompanying editorial by Alan Buchman, a gastroenterologist at Northwestern University's Feinberg School of Medicine, suggests that treating osteoporosis patients with celiac disease through a gluten-free diet might not be enough. Buchman also notes that screening all U.S. osteoporosis patients would cost an estimated $2 billion a year, an expense that might not be justifiable given previous studies that conflict with the conclusions from this report.

Find out more: The Celiac Disease Foundation has general information on the disease.

Celiac.com has gluten-free recipes and information on the link between osteoporosis and celiac disease.

Read the article: Stenson, W.F. et al. "Increased Prevalence of Celiac Disease and Need for Routine Screening Among Patients with Osteoporosis." Archives of Internal Medicine. Feb. 28, 2005, Vol. 165, No. 4, pp. 393-399.

Abstract online: http://archinte.ama-assn.org