Gluten intolerance is often associated with osteoporosis. The main cause is chronic GI malabsorption due to the ongoing inflammation of the GI lining due to undigested gluten fragments. Chronic malabsoprtion of calcium leads to loss of bone mass. Once bone mass loss reaches a certain threshold, an individual receives a diagnosis of osteoporosis.

Lifestyle changes including a gluten- and casein-free diet represent the best long-term solutions. Calcium and vitamin D supplmentation, themselves "supplemented" by regular exercise, will help one's body to begin to build new bone mass. Of course, for persons who have not exercised in months or years, a physician's supervision and guidance is very important.

If intestinal malabsorption from gluten is so bad that it results in osteoporosis, isn't that enough cause to say the person has celiac rather than just "gluten intolerance" or "gluten sensitivity"?

Is the ONLY allowable diagnostic criteria the infamous intestinal biopsy, even if intestinal malabsorption and osteoporosis and gluten sensitivity genes and gliadin antibodies have been shown?

I just saw my answer in the link provided by jcc: http://jccglutenfree.googlepages.com/diagnostictesting

That said that some doctors will diagnose the celiac based on the other testing. I would presume that in the case above that David presented where the malabsorption is so severe that osteoporosis resulted, that if the person is gluten sensitive, celiac could be diagnosed. In fact, in my opinion it would take an idiot of a doctor to NOT diagnose it in that case.

But, I might not be understanding the situation, and welcome other opinions.

Ya'd think!

But, it really depends on the doctor. Gluten sensitivity can cause malabsorption and every other symptom and complication that celiac disease does, but by definition, unless there is damaged intestinal villi to show for it... it is not celiac disease.

Most GI's are 'purists' and will insist upon the "gold standard" diagnosis equating to biopsy proof of damaged villi. After all, this is what they were taught, this is what the book says, and they are following standard of care. Some of the most reknown celiac doctors have been the hardest core purists of the bunch. These doctors will say there is absolutely no place for a gluten free diet except in the case of biopsy proven celiac disease. (Ack! This STILL infuriates me after almost ten years.)

Other doctors are willing to reach a logical conclusion and make a diagnosis of "celiac disease" based upon gluten related symptoms that respond to a gluten free diet. A 'common sense' diagnosis. Really, does it matter if the villi are actually damaged if consuming gluten is making you sick and causing all sorts of systemic problems? Does it matter what you call it?

I always thought the better fight was to make sure gluten sensitivity was recognized in its own right, rather than squabble over the definition of celiac disease. I can accept that the definition of celiac disease = villous atrophy.

The good news is that gluten sensitivity is finally starting to be recognized in the absence of villous atrophy. In fact, attempts are even being made to define it. For so many years it was just disregarded, period. Thankfully, some maverick doctors like Dr. Kenneth Fine and Dr. Marios Hadjivassiliou stood out on a limb, often scoffed by their own profession, and through their efforts have proven that gluten sensitivity can cause wide ranging disease even in the absence of celiac disease. And those of us with gluten sensitivity (not celiac disease) have been pretty noisy, too, asking tough questions at celiac symposiums, in the doctors office, and via the Internet.

Today, you will find many, many more physicians who believe in and understand the broader reach of gluten sensitivity. Lots of them talking about it on blogs and websites of their own. And even some of the "purist" of the top celiac doctors are now studying gluten sensitivity that isn't celiac disease.

Definitions of gluten sensitivity:
More about the definitions of Gluten sensitivity vs. celiac disease
http://jccglutenfree.googlepages.com...sceliacdisease