In celiac disease, osteoporosis is primarily due to reduced absorption of which nutrients?

In celiac disease, osteoporosis is primarily due to reduced absorption of which nutrients?

• A. Iron and Vitamin B12
• B. Potassium and Magnesium
• C. Vitamin C and Vitamin E
• D. Calcium and Vitamin D

Answer: (D)

Osteoporosis in celiac disease stems from impaired calcium and vitamin D absorption. The disease damages the proximal small intestine (duodenum and proximal jejunum), where calcium and fat-soluble vitamins like vitamin D are absorbed. When calcium absorption falls, serum calcium drops and parathyroid hormone rises, increasing bone resorption and lowering bone density. Vitamin D deficiency further reduces calcium absorption and bone mineralization. Over time, a gluten-free diet can help restore mucosal health and improve absorption, but ongoing calcium and vitamin D intake is important. Other nutrient losses (like iron or B12) affect anemia, not primarily bone density, and potassium, magnesium, or vitamins C and E are not the main drivers of osteoporosis in this context.

Osteoporosis in celiac disease stems from impaired calcium and vitamin D absorption. The disease damages the proximal small intestine (duodenum and proximal jejunum), where calcium and fat-soluble vitamins like vitamin D are absorbed. When calcium absorption falls, serum calcium drops and parathyroid hormone rises, increasing bone resorption and lowering bone density. Vitamin D deficiency further reduces calcium absorption and bone mineralization. Over time, a gluten-free diet can help restore mucosal health and improve absorption, but ongoing calcium and vitamin D intake is important. Other nutrient losses (like iron or B12) affect anemia, not primarily bone density, and potassium, magnesium, or vitamins C and E are not the main drivers of osteoporosis in this context.