In our last post, we have learned some information on osteoporosis . Today going to see what are the causes or risk factors behind developing osteoporosis.

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Remember: Menopause is the main risk factor.

Apart from it, there are other causes too. Broadly, we can divide the factors/causes into following categories:

Constitutional/ non-modifiable risk factor (we can’t do anything about these):

• Sex: Female sex is more prone to osteoporosis (due to menopause)
• Aging
• Body build: A thin person with short stature and BMI less than 18 is more susceptible
• Race: Asian and Caucasians are mostly affected
• Family history: If there is history of hip fracture in ladies of a family before age of 75 years, the future generations are at higher risk
• Late menarche, early menopause and long-standing secondary amenorrhea in between. All these 3 conditions lead to reduced estrogen hormone in a female.

Modifiable risk factors:

• Cigarette smoking and high alcohol intakes are both considered as a risk factor for developing osteoporosis. Smoking a cigarette brings not single benefit while taking a small amount of alcohol may be beneficial for some condition. But an excess of it brings bad news.
• Lack of vitamin D and low calcium intake is the main risk factor for osteoporosis. If these food trends persist for a long time, fragile bones will be the end result
• Physical inactivity is also associated with increased risk of osteoporosis

Medical causes of osteoporosis:

• Anorexia nervosa: An eating disorder where the patients can’t eat even the minimum amount of food required for maintaining a healthy body
• Malabsorption syndrome: A collection of disorders of the digestive system where patient eats but the ingredients of food don’t go into the blood stream; hence body doesn’t get what is necessary. Coeliac disease is on the top of the list of the disorders.
• Prolonged immobilization (in disabled patients due to stroke, or during recovery period after a major surgery)

Some hormonal disorders:

• Cushing syndrome: An excess of cortisol in our blood which is a catabolic hormone

Catabolism (from Greek κάτω kato, "downward" and βάλλειν ballein, "to throw") is the set of metabolic pathways that breaks down molecules into smaller units that are either oxidized to release energy, or used in other anabolic reactions

• Diabetes mellitus
• Hyperparathyroidism (@cryptopie is suffering from it)
• Thyrotoxicosis (an excess of thyroid hormone)
• Hypogonadism/sex hormone deficiency
• Acromegaly (an excess of Growth hormone)

Some drugs are responsible for osteoporosis:

• Corticosteroids
• Anti-epileptic drugs, especially hepatic enzyme Inducers (Carbamazepine, phenytoin, phenobarbital and primidone)
• Thiazolidinediones for diabetes mellitus
• Long-term use of heparin
• Excessive use of thyroid hormone which turns into drug-induced thyrotoxicosis
• Prostate and breast cancer hormone therapy

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