Risk factors of osteoporosis

Dr Dirk Steyn educates us on the risk factors of osteoporosis and why you should consult a bone health specialist if you have any.

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Osteoporosis is a silent disease meaning that it doesn’t cause any discomfort, pain or symptoms. Therefore, the diagnosis is usually made after the first fracture. 

Unfortunately, you can never improve bone mass, but you can slow the decline. So, if you have established osteoporosis, you will have it for the rest of your life. 

The only way to prevent osteoporosis is to make the diagnosis of increased bone mass decay early on and to start treatment early. If you have the following risk factors and are older than 55, you should consult a bone health specialist to mitigate the risk of getting osteoporosis at a later stage in life.

Risk factors

A number of factors can increase the likelihood that you will develop osteoporosis, including your age, race, lifestyle choices, and medical conditions and treatments.

Unchangeable risks

Some risk factors are out of your control. These include:

• Your sex – Women are much more likely to develop osteoporosis than men.
• Age – The older you get, the greater your risk.
• Race – You’re at greatest risk if you are Caucasian or of Asian descent.
• Family history – Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father fractured a hip.
• Body frame size – Men and women who have small body frames tend to have a higher risk because they might have less bone mass to draw from as they age.

Hormone levels

Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Examples include:

• Sex hormones – Lowered sex hormone levels tend to weaken bone. The fall in oestrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis. Treatments for prostate cancer that reduce testosterone levels in men and treatments for breast cancer that reduce oestrogen levels in women are likely to accelerate bone loss.
• Thyroid problems – Too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.
• Other glands – Osteoporosis has also been associated with overactive parathyroid and adrenal glands.

Dietary factors

Osteoporosis is more likely to occur in people who have:

• Low calcium intake – A lifelong lack of calcium plays a role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures.
• Eating disorders – Severely restricting food intake and being underweight weakens bone in both men and women.
• Gastrointestinal surgery – Surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients, including calcium. These surgeries include those to help you lose weight and for other gastrointestinal disorders.

Steroids and other medications

Long-term use of oral or injected corticosteroid medications, such as prednisone and cortisone, interferes with the bone-rebuilding process. 

Osteoporosis has also been associated with medications used to combat or prevent:

• Seizures
• Gastric reflux
• Cancer
• Transplant rejection

Medical conditions

The risk of osteoporosis is higher in people who have certain medical problems, including:

• Celiac disease
• Inflammatory bowel disease
• Kidney or liver disease
• Cancer
• Multiple myeloma
• Rheumatoid arthritis

Lifestyle choices

Some bad habits can increase your risk of osteoporosis. Examples include:

• Sedentary lifestyle – People who spend a lot of time sitting have a higher risk of osteoporosis than those who are more active. Any weight-bearing exercise and activities that promote balance and good posture are beneficial for your bones, but walking, running, jumping, dancing and weight-lifting seem particularly helpful.
• Excessive alcohol consumption – Regular consumption of more than two alcoholic drinks a day increases the risk.
• Tobacco use – The exact role tobacco plays isn’t clear, but it has been shown that tobacco use contributes to weak bones.

Early detection

To prevent osteoporosis and its devastating consequences early detection of increased bone mass decay is mandatory and must be managed and treated before osteoporosis ensues. If you are at high risk for developing osteoporosis, you need to see a bone health specialist to assess your risk and to start management and treatment early.

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