Beyond Common Risk Factors: Hidden Causes of Osteoporosis

PJ Hamel Health Guide
  • You may be aware of the common risk factors for osteoporosis: being female; getting older; being small-boned. Lack of calcium and vitamin D; smoking.

    But what if you’re young, have a normal frame, live a healthy lifestyle, take vitamins? Can you just assume your bones are normally healthy?

    In most cases, yes. But there are certain other little-known osteoporosis risk factors that might be impacting you right now, without you knowing it.

    Knowledge is power. Let’s take a look at these less-common risk factors, one of which may be silently affecting your bones:

    •Being a young, super-fit female athlete. If you burn a lot of calories on a regular basis, without replacing enough of those calories to maintain a healthy weight, you’re starving your bones of the nutrients they need. And if you develop amenorrhea (your periods stop), you’re also depriving your system of estrogen – a prime hormone for ensuring bone health.

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    •Type 1 diabetes. If you have this type of diabetes, your bone density is probably lower than normal. Scientists theorize that high blood sugar may affect bone formation. And, since this type of diabetes usually occurs in childhood – when bone-building is at its height – your bones never have the opportunity they need to reach their peak density.

    In addition, it’s been shown that both type 1 and type 2 diabetes put you at increased risk for bone fracture, even if your bone mass isn’t much lower than normal.

    •Alcoholism, including binge drinking at a young age. Too much alcohol use is actually a leading risk factor for male osteoporosis. But it’s not just older guys who should worry: studies show that “party hearty” athletes in their 20s may be putting their bones at risk as well, by interfering with their body’s ability to absorb calcium.

    •Celiac disease. This allergic disease – in fact, any condition affecting your body’s ability to absorb nutrients – puts you at higher risk for osteoporosis. Inflammatory Bowel Syndrome (IBS), Crohn’s disease, even a gastrectomy (stomach stapling surgery) can severely reduce the amount of calcium and vitamin D you absorb from food and supplements. And lack of calcium and vitamin D is a prime osteoporosis risk factor.

    •Kidney problems. If your kidneys aren’t working properly, you may be excreting too much calcium, which upsets the balance of bone growth/resorption.

    •An overactive thyroid. Your bones are constantly breaking themselves down, and building themselves back up– this is called bone remodeling. Before age 30, bones tend to build themselves up more than they break down; after age 30, the reverse is true. Hyperthyroidism (an “overactive thyroid”) causes your bones to go through their remodeling cycles more quickly than normal. Thus, after age 30, an overactive thyroid speeds bone loss. Graves disease is the chief cause of hyperthyroidism.

    •Chronic autoimmune diseases. Rheumatoid arthritis, lupus, and certain other diseases are called “autoimmune” – which means your body is attacking itself, causing inflammation and a host of other problems. Autoimmune disease appears to increase the rate of bone turnover, leading to faster bone loss as you age.


  • •Corticosteroid drugs. Asthma, autoimmune diseases, and multiple sclerosis are often treated with steroid-based drugs. These drugs – think prednisone – have a significant impact on your bones. Specifically, corticosteroids inhibit osteoblasts, the cells responsible for building bone; they encourage osteoclasts, the cells responsible for breaking bone down; and they inhibit calcium absorption, and increase its excretion.

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    Does that mean you should stop using your asthma inhaler? Not at all. The benefits of corticosteroids outweigh the risks in many cases. But if you’re embarking on a long-term regimen of these drugs, please at least discuss with your doctor the downside. S/he can help you decide how much is just enough – for the condition you’re treating, and your bones.

    Unfortunately, most of the conditions above are beyond your control. You treat them as best you can, and move forward with your life. But if you have diabetes, or asthma, or IBS, it’s good to at least know about bone loss. Eating right, taking supplements, exercise, and avoiding other controllable risk factors might be even more important to you than they are to most people.


Published On: January 20, 2010