Did anybody ever hear about this? Do you know where it would be possible to get this test?
I contacted the author a while back, but didn't hear back from him.
I'm also wondering if you can have this autoimmune response even if you don't have celiac and what the medication is that they are talking about.
My friend has osteoporosis and collagenous colitis, but celiac was ruled out at this point.
http://www.sciencedaily.com/releases/20 ... 171735.htm
New Link Found Between Osteoporosis And Celiac Disease
Oct. 8, 2009 — People with celiac disease may develop osteoporosis because their immune system attacks their bone tissue, a new study has shown.
It is the first time an autoimmune response – a condition whereby the body can attack itself – has been shown to cause damage to bones directly.
Researchers from the University of Edinburgh studied a protein called osteoprotegerin (OPG) in people with celiac disease – a digestive condition that affects 1 in 100 people.
In healthy people, OPG plays a crucial role in maintaining bone health by controlling the rate at which bone tissue is removed.
The latest research shows that 20 per cent of celiac patients produce antibodies that attack the OPG protein and stop it working properly. This results in rapid bone destruction and severe osteoporosis.
It was previously thought that osteoporosis – a known complication of celiac disease –develops in celiac patients because they cannot properly absorb calcium and vitamin D from their diet. Both nutrients are essential for healthy bone development.
Osteoprotegerin and Osteoporosis
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Hi Michael,
Yes, we discussed that issue about 3 and a half years ago, when the original research was published. Unfortunately, I'm not aware of anyone who has had the test, or if the test is even available in this country (or anywhere else in the world, for that matter).
I'm not sure why anyone would need that test, because anyone who is sensitive to gluten can safely assume that they will have osteoporosis problems if they do not avoid gluten 100% (and that includes the vast majority of us who have any form of MC, in additional to all celiacs).
Here's a link to our discussion:
Bone Loss Link To Celiac Disease Discovered
Tex
Yes, we discussed that issue about 3 and a half years ago, when the original research was published. Unfortunately, I'm not aware of anyone who has had the test, or if the test is even available in this country (or anywhere else in the world, for that matter).
I'm not sure why anyone would need that test, because anyone who is sensitive to gluten can safely assume that they will have osteoporosis problems if they do not avoid gluten 100% (and that includes the vast majority of us who have any form of MC, in additional to all celiacs).
Here's a link to our discussion:
Bone Loss Link To Celiac Disease Discovered
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
what's the mechanism behind that?because anyone who is sensitive to gluten can safely assume that they will have osteoporosis problems if they do not avoid gluten 100%
Gluten - causes inflammation - causes malabsorption of calcium and other minerals - low serum calcium levels - body compensates with calcium from the bones -Osteoporosis?
Or is it something else?
Michael,
Sorry about the search problem. Years ago I modified the code that operates this board, so that new members had to write at least 5 posts before they could see certain attributes of the board, such as email addresses and personal message addresses for other members, and the ability to utilize the search function was also included in that restriction. The reason for doing that is to prevent spammers or data miners from joining, just so that they can "harvest" personal information or contact information of other members. After one more post, you will have full access to those other features of this discussion board.
Thank you, I appreciate the kind words about the book.
Tex
Sorry about the search problem. Years ago I modified the code that operates this board, so that new members had to write at least 5 posts before they could see certain attributes of the board, such as email addresses and personal message addresses for other members, and the ability to utilize the search function was also included in that restriction. The reason for doing that is to prevent spammers or data miners from joining, just so that they can "harvest" personal information or contact information of other members. After one more post, you will have full access to those other features of this discussion board.
Thank you, I appreciate the kind words about the book.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Most people probably get enough calcium in their diet, but the problem is that it isn't utilized by the body to generate new bone tissue. The fact that most of us are deficient in both vitamin D and magnesium is probably a major part of the problem, since vitamin D and magnesium are a necessary part of the process.michaelt wrote:what's the mechanism behind that?because anyone who is sensitive to gluten can safely assume that they will have osteoporosis problems if they do not avoid gluten 100%
Gluten - causes inflammation - causes malabsorption of calcium and other minerals - low serum calcium levels - body compensates with calcium from the bones -Osteoporosis?
Or is it something else?
You probably recall from the book that I make a case for the possibility that celiac disease and MC may simply be symptoms of another disease, namely gluten sensitivity (because the two diseases have a huge overlap in the histological changes that they impose on the intestines). So it's possible that the osteoporosis association may be connected with the fact that MC (or celiac disease) causes the healing process to be stuck in the first stage of healing (inflammation), and because the inflammation is chronic, healing cannot progress. This is certainly true in the mucosa of the intestines, and both MC and celiac disease are capable of affecting so many organs in the body that it's not impossible that this may somehow spill over into the regeneration of bone tissue, also.
That's just speculation, of course, but the fact of the matter is that there hasn't been enough research on this topic for anyone to know the exact mechanism. All we know is that untreated gluten sensitivity effectively throws a monkey wrench into the works of the digestive system to cause many seemingly unrelated problems. You may recall from the book that observant dentists have reported many cases of celiac disease/gluten sensitivity after noticing that certain patients have problems with thinning enamel on their teeth. We have many members who have been diagnosed with osteoporosis, even though they test negative to celiac disease. And, of course, for members who use corticosteroids to treat their disease, the drugs tend to add to the bone porosity problem.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Test for Calcium Absorption
Not so worried about Vitamin D - as level was 46 in Feb test - and we upped the Vitamin D supplement (previous test showed close to 60)
Magnesium, RBC seems to be no problem either 2.1 (range 1.5-3.1)
What we are really worried about is the calcium (Serum Calcium usually on the high side 9.7-10.2)
Because we also have a diagnosis of severe osteoporosis, if it is caused by severe malabsorption of calcium
So I'm wondering is there to check for Ca Malabsorption. I've seen they do something with slightly radioactive calcium in Australia. Kind of scary, but maybe if it works - do you know of any other way to check Ca absorption levels in the GI tract?
Magnesium, RBC seems to be no problem either 2.1 (range 1.5-3.1)
What we are really worried about is the calcium (Serum Calcium usually on the high side 9.7-10.2)
Because we also have a diagnosis of severe osteoporosis, if it is caused by severe malabsorption of calcium
So I'm wondering is there to check for Ca Malabsorption. I've seen they do something with slightly radioactive calcium in Australia. Kind of scary, but maybe if it works - do you know of any other way to check Ca absorption levels in the GI tract?
That appears to be a blood test result, which means that it is worthless for determining the actual level of magnesium available in the body, because the body will pull magnesium from cells in tissues all over the body to insure that the blood level remains within a "normal" range. The problem is that magnesium levels in tissue may actually be critically low, even though the blood level appears fine. The blood magnesium level will not drop below a "normal" range until virtually all of the magnesium is depleted from cells all over the body. IOW, a tissue test is necessary in order to determine one's actual magnesium level. Doctors invariably order the wrong test for magnesium, because they are in love with simple blood tests.Michael wrote:Magnesium, RBC seems to be no problem either 2.1 (range 1.5-3.1)
If your (or your friend's) serum calcium level is at the upper end of the normal range, then there is absolutely no point in being concerned about calcium absorption in the intestines, because malabsorption is clearly not a problem. A blood level of calcium that high indicates that there is plenty of calcium available in the bloodstream. "Malabsorption" refers to a compromised ability to transfer nutrients from digested food in the lumen of the small intestine, into the bloodstream. Obviously, with a serum calcium level at the upper end of the normal range, calcium is being absorbed quite well.
This suggests that the production of antibodies against osteoprotegerin might possibly be responsible for the osteoporosis problem, because clearly there is plenty of calcium available in the blood — it's just not being utilized by osteoblasts, to produce new bone tissue. But that seems to be the case with most celiacs, as noted in the article that I cited at the end of this post, and most celiacs clearly do not produce antibodies against osteoprotegerin.
So before pursuing a determination of possible osteoprotegerin antibody problems, you need to make sure that an adequate level of magnesium is actually available, by doing a tissue test for magnesium.
I don't understand why your doctor can't provide lab testing for osteoprotegerin level. The test kits are available. Here is a site that offers them, for example:
http://www.abcam.com/Osteoprotegerin-Hu ... 00617.html
In spite of all that, please remember that this entire osteoprotegerin antibody issue may be a moot point, because as I've mentioned many times in previous posts, celiac disease/gluten sensitivity is strongly associated with osteoporosis, regardless of any osteoprotegerin antibody issue. Please see the following research article for data to verify that claim. The link below will allow you to access the full article.
No evidence of circulating autoantibodies against osteoprotegerin in patients with celiac diseaseAIM: To investigate risk factors for low bone mineral density (BMD) in celiac disease (CD) patients, focusing on circulating autoantibodies against osteoprotegerin (OPG).
METHODS: Seventy asymptomatic CD adult patients on gluten-free diet (GFD) and harbouring persistent negative CD-related serology were recruited. Conventional risk factors for osteoporosis (e.g., age, sex, menopausal status, history of fractures, smoke, and body mass index) were checked and BMD was assessed by dual energy X ray absorptiometry. Serum calcium and parathyroid hormone (PTH) levels were evaluated. Thirty-eight patients underwent repeat duodenal biopsy. Serum samples from a selected sub-group of 30 patients, who were also typed for human leukocyte antigen (HLA) DQ2 and DQ8 haplotype, were incubated with homodimeric recombinant human OPG and tested by western blotting with an anti-OPG antibody after immunoprecipitation.
RESULTS: Despite persistent negative CD-related serology and strict adherence to GFD, 49 out of the 70 (74%) patients displayed low BMD. Among these patients, 13 (24%) showed osteoporosis and 36 (76%) osteopenia. With the exception of age, conventional risk factors for osteoporosis did not differ between patients with normal and low BMD. Circulating serum calcium and PTH levels were normal in all patients. Duodenal mucosa healing was found in 31 (82%) out of 38 patients who underwent repeat duodenal biopsy with 20 (64%) still displaying low BMD. The remaining 7 patients had an incomplete normalization of duodenal mucosa with 6 (84%) showing low BMD. No evidence of circulating antibodies against OPG was found in the serum of 30 celiac patients who were tested for, independent of BMD, duodenal histology, and HLA status.
CONCLUSION: If any, the role of circulating autoantibodies against OPG in the pathogenesis of bone derangement in patients with CD is not a major one.
The red emphasis in that quote is mine, not the authors'.
The bottom line is that patients who produce antibodies against osteoprotegerin are apparently quite rare, and according to medical experts, they are the lucky ones, because according to claims made in the article that you cited, that is a treatable condition. I have a hunch, though, that the drugs that they are referring to are the bisphosphonates, and as far as I can tell, using those drugs is worse than using no treatment at all, because they do not allow any new bone tissue to be formed — they simply prevent old bone tissue from being destroyed. In the long run, this results in old, dead, brittle bones, rather than healthy bones. That's why the recommendations are to not use those drugs for longer than 5 years. So what does the patient do after those 5 years have passed with absolutely no new growth of bone tissue?
Hope for a miracle, I suppose. A much better treatment option, IMO, is strontium ranelate.But whether or not a viable treatment option for those who produce antibodies against osteoprotegerin is available, those of us who are sensitive to gluten and who do not produce antibodies to osteoprotegerin, have no practical medical recourse if we develop osteoporosis (as the majority of us will, according to the data presented in the article cited above. IOW, osteoporosis comes with the turf.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.