Celiac disease is an autoimmune disease. The immune system attacks the small intestine. It’s triggered by gluten, a protein found in barley, rye and wheat. Oats may also be a problem. But only if small amounts of the other grains get mixed with them during milling or at some other time.

Celiac disease can lead to thin bones (osteopenia or osteoporosis). Here’s how. The immune system attack on the small intestine injures the inner lining. The result is that many important nutrients, including vitamin D, don’t absorb as well. This can lead to vitamin D deficiency. You need adequate vitamin D to maintain healthy bones.

Thin bones are more common in women. But it’s an important problem for men, too. In fact, a 60-year-old man has a one-in-four chance of developing a fracture from thin bones before he dies. That’s true even if he doesn’t have celiac disease.

You need to take a vitamin D supplement. Talk with your doctor about the right dose for you. Your diet should be loaded with calcium-rich foods. Also, look for drinks that are fortified with calcium, such as certain brands of orange juice.

Getting into an exercise routine that includes weight-bearing activity is a must. Jogging, walking, climbing stairs — anything that gets your bones and muscles working against gravity is weight-bearing activity.

If the combination of exercise and a vitamin D doesn’t improve your bone density, then you may be a candidate for a prescription drug. There are several good ones to choose from.  And they work as well in men as they do in women.

Whatever approach you and your doctor decide to take, I urge you to take action sooner rather than later. Taking a few pills and following an exercise program can go a long way toward protecting you from painful and disabling fractures.