Causes of Osteoporosis

Osteoporosis occurs when the body fails to form enough new bone, or when too much old bone is reabsorbed by the body, or both. Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, the body uses these minerals to produce bones. If calcium intake is not sufficient, or if the body does not absorb enough calcium from the diet, bone production and bone tissues may suffer.

Osteoporosis can be secondary to a number of other conditions, including alcoholism, hyperthyroidism, chronic liver or kidney disease, celiac disease, scurvy, rheumatoid arthritis, leukemia, cirrhosis, gastrointestinal diseases, vitamin D deficiency, hypogonadism (impaired development of reproductive organs), lymphoma, and rare genetic disorders, such as Marfan's and Ehlers-Danlos syndrome. Hyperparathyroidism is a condition where the body either underproduces or doesn't recognize a hormone called parathyroid hormone. It may occur spontaneously or as a result of other diseases such as cancer. Other agents that increase the risk for bone loss include heparin, progestin without estrogen (such as Depo-Provera or other progestin-based contraceptives), hormonal agents that suppress estrogen (such as gonadotropin-releasing hormone agonists), seizure medications, and high-dose loop diuretics. Other causes include corticosteroid excess from Cushing's syndrome, hyperthyroidism, hyperparathyroidism, being confined to a bed, and bone cancers.

Some of the common factors that may contribute to the increase or aggravation of the condition of Osteoporosis include:

• Immobilization
• Alcohol abuse
• Exposure to glucocorticoid medications
• Low levels of testosterone
• Gastrointestinal disease
• High levels of calcium present in the urine.

In the case of Primary Osteoporosis, mostly the disease occurs because of age. At other times, especially with people under the age of 70, Osteoporosis also occurs due to unknown factors, which is known as idiopathic Osteoporosis.

In the case of secondary Osteoporosis, lifestyle factors, diseases, or even medications may be the cause of loss in bone mass, resulting in Osteoporosis.

Risk Factors of Osteoporosis

Although advanced age is a well-known risk factor for both men and women, the disease is far more prevalent in women after menopause due to the loss of the hormone estrogen. Other risk factors for women include an early or premature menopause, either naturally or by surgical removal of the ovaries, with no hormone replacement therapy; exercising so strenuously that one's menstrual period stops; having a small body frame; excessive use of alcohol; cigarette smoking; a diet low in calcium; and a diet low in protein. For men, low levels of the male hormone testosterone increase risk, as does chronic alcoholism. Certain medications, such as glucocorticoids (e.g., prednisone), heparin, and phenytoin (Dilantin©) and a family history of osteoporosis also increase the risk for osteoporosis in both men and women. Certain medical conditions such as hyperparathyroidism, hyperthyroidism, and celiac disease can cause osteoporosis as well.

There are certain factors which might increase the risk of developing Osteoporosis, these are:

• Having a thin and small body frame.
• Being of the feminine gender.
• Belonging to the Caucasian or Asian race.
• Excessive alcohol and cigarette consumption
• Having a family history of Osteoporosis
• History of frequent fractures
• Lack of exercise
• Low estrogen levels
• Low doses of Vitamin D in the body
• Low diet in calcium
• Long-term use of medicines like- use of oral corticosteroids, heparin (a blood thinner medicine), anti-seizure medications.
• Malabsorption (nutrients are not properly absorbed from the gastrointestinal system) from conditions such as celiac sprue.
• Low estrogen levels (such as occur in menopause or with early surgical removal of both ovaries).
• Chemotherapy can cause early menopause due to its toxic effects on the ovaries.
• Amenorrhea (loss of the menstrual period) in young women also causes low estrogen and osteoporosis; Amenorrhea can occur in women who undergo extremely vigorous training and in women with very low body fat (example: anorexia nervosa).
• Chronic inflammation, due to diseases (such as rheumatoid arthritis and chronic liver diseases).
• Immobility, such as after a stroke, or from any condition that interferes with walking.
• Hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland (as in Grave's disease) or is caused by taking too much thyroid hormone medication.
• Hyperparathyroidism, a disease wherein there is excessive parathyroid hormone production by the parathyroid gland (a small gland located near the thyroid gland). Normally, the parathyroid hormone maintains blood calcium levels by, in part, removing calcium from the bone. In untreated hyperparathyroidism, excessive parathyroid hormone causes too much calcium to be removed from the bone, which can lead to osteoporosis.
• Vitamin D deficiency. Vitamin D helps the body absorb calcium. When vitamin D is lacking, the body cannot absorb adequate amounts of calcium to prevent osteoporosis. Vitamin D deficiency can result from lack of intestinal absorption of the vitamin such as occurs in celiac sprue and primary biliary cirrhosis.
• Certain medications can cause osteoporosis. These include long-term use of heparin (a blood thinner), anti-seizure medications phenytoin (Dilantin) and phenobarbital, and long term use of oral corticosteroids (such as Prednisone).

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Date of Publication: 07/21/2009
Article Last Updated: 06/26/2009