We know osteoporosis can come with age, especially for post-menopausal women, but there are other causes for osteoporosis that aren't as well known. What are the hidden causes of this dangerous bone disease?

Osteoporosis is a condition that causes bones to become porous, lose density and strength, and become brittle and prone to breaking. This is due to reduction in mineral deposits (like calcium) in the bone. While aging and hormone reduction is one of the main culprits in the development of osteoporosis, other factors are major contributors. They include:

1. Poor Nutrition

People who don't consume enough calcium, protein and vitamin D don't have enough of the essential ingredients for healthy bone structure. The good news is that calcium is readily available in dairy products, leafy green vegetables, fish and foods fortified with calcium like orange juice. When that's not enough, calcium and vitamin D supplements can provide enough to keep bones strong.

A word about protein: While it was thought (and may be true) that too much protein interferes with calcium absorption, too little protein consumption can be just as harmful to bone health. Protein is essential for bone strength. Eat an adequate amount (divide your weight in half—that's how many grams of protein you need). The best protein choices include lean meat, skinless poultry, beans, fish, eggs, soy, tempeh, and yogurt.

2. Not Enough Exposure to the Sun

Vitamin D is essential for calcium absorption into the bloodstream and bone. The natural source of vitamin D is sunshine. We've seen an increase in vitamin D deficiency since the use of sunscreen became popular. It's also a problem in areas of the country that don't receive enough sunlight year-round, like the Pacific Northwest. Doctors agree that 15 minutes of daily sun exposure (without sunscreen) is enough for your skin to absorb all the vitamin D you need for healthy bones. When that's not possible, a vitamin D supplement can provide the boost you need.

3. Alcohol Abuse

Drinking more than two drinks per day or drinking alcohol during adolescence can lead to poor bone health. That's because alcohol prevents the stomach from absorbing calcium. Plus, the increased risk for falls that comes with inebriation, the combination of drinking and osteoporosis can cause serious injuries.

4. Hyperparathyroidism

Our body stores calcium in the bones and withdraws what it needs to operate vital organs with the help of a hormone called parathyroid, which comes from tiny glands on top of the thyroid gland. If the parathyroid glands send out too much hormone (hyperparathyroidism), the body will leach calcium out of bones, which can lead to osteoporosis. This condition is rare, but it can be diagnosed through blood tests and diagnostic imaging and cured through minor surgery.

5. Smoking

Smoking is a known contributor to bone loss. One study suggested that women who smoke one pack per day throughout adulthood have a 5 to 10 percent reduction in bone density by menopause, resulting in an increased risk of fracture. Quitting smoking isn't easy, but the payoff is better health.

6. Sedentary Lifestyle

People who don't exercise, specifically through strength training activities, are at increased risk for poor bone density. Weight lifting, high-impact aerobics and other fitness or lifestyle activities that give the bones and the muscles that surround them a workout are proven to help bones maintain density.

7. Medications

Long-term use of certain medications is linked with bone loss. Here are a few on the list:

  • Steroid medications like prednisone and other glucocorticoids.
  • Heparin is a common blood thinning medication used to treat clotting disorders.
  • Certain antiepileptic drugs including phenytoin, carbamazepine, primidone, phenobarbital, and valproate.

What should you do if anything on this list applies to you? Talk to your doctor about your risks for osteoporosis and take measures to prevent it from happening. Improve your diet, start exercising, quit smoking, reduce alchohol consumption, and consult your doctor about the medications you take. Have regular bone density scans as recommend by your physician.




Up-To-Date Patient Information: osteoporosis prevention and treatment (beyond the basics) Hillel N. Rosen, MD Assistant Professor of Medicine, Harvard Medical School