What're the risk factors for secondary osteoporosis?
A large number of medical disorders are associated with osteoporosis and increased fracture risk. These can be organized into several categories: genetic disorders, hypogonadal states, endocrine disorders, gastrointestinal diseases, hematologic disorders, connective tissue disease, nutritional deficiencies, drugs, and a variety of other common serious chronic
systemic disorders, such as congestive heart failure, end-stage renal disease, and alcoholism.
Osteoporosis can be secondary to a number of other conditions, including alcoholism, hyperthyroidism, epilepsy, 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. An overactive thyroid gland (hyperthyroidism) produces too much thyroid hormone. Overproduction of this hormone speeds up the bone remodeling process, eventually resulting in loss of bone density. Thyroid hormones, taken to treat an underactive thyroid gland (hypothyroidism), can have the same effect. In diabetes, more calcium is lost in urine. In inflammatory bowel disease, less calcium is absorbed from food. Rheumatoid arthritis and lupus (systemic lupus erythematosus) interfere with bone remodeling.
In Cushing's disease, the adrenal glands produce too much cortisol. Cortisol inhibits the cells that form bone. Thus, overproduction of parathyroid hormone or cortisol results in loss of bone density. Taking corticosteroids (such as prednisone), which act like cortisol, has the same effect. These drugs also decrease the amount of calcium that is absorbed from food and increase the amount of calcium lost in the urine.
More than 30 million Americans have disorders that are commonly treated using corticosteroids (also called glucocorticoids or steroids). It has been known for some time that oral glucocorticoids therapy reduces bone mass, although studies have been mixed on the effects of inhaled steroids on bone loss. Important studies in 2001 have strongly suggested that postmenopausal women (but not premenopausal women) are at risk for bone loss and possibly for fractures from inhaled steroids. The risk is higher with increasing doses, and is still lower than with oral steroids. (Children on inhaled steroids may have temporary impaired growth, but they do not appear to be at risk for bone loss.)
Disorders and drugs can cause osteoporosis by interfering with the body's absorption or use of calcium or vitamin D, by directly affecting the process of breaking down and re-forming bone (remodeling), or by doing both. For example, in hyperparathyroidism, the parathyroid glands produce too much parathyroid hormone. Normally, this hormone helps keep bone remodeling in balance. If too much parathyroid hormone is produced, more bone is broken down than re-formed, and calcium is removed from bone. Anti-epileptic agents increase the risk for bone loss (as does epilepsy itself). 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), and high-dose loop diuretics.
More information on osteoporosis
What is osteoporosis? - Osteoporosis is a thinning and weakening of the bones, usually associated with the aging process. Osteoporosis is a disease, often with no detectable symptoms.
Building and maintaining skeletal health - Factors involved in building and maintaining skeletal health are adequate nutrition and body weight, exposure to sex hormones at puberty, and physical activity.
What types of osteoporosis are there? - Osteoporosis can be classified in various ways based on diagnostic categories, etiology. Osteoporosis can be classified as either primary osteoporosis or secondary osteoporosis.
What causes osteoporosis? - Osteoporosis is related to the loss of bone mass that occurs as part of the natural process of aging. Osteoporosis results when there is excess bone loss without adequate replacement.
What are the risk factors for osteoporosis? - Many disorders are associated with increased risk of osteoporosis. Osteoporosis is far more prevalent in women after menopause due to the loss of the hormone estrogen.
What're the risk factors for primary osteoporosis? - Risk factors for primary osteoporosis include age, gender, race, figure type, lifestyle, diet, and lack of sunlight.
What're the risk factors for secondary osteoporosis? - Risk factors for secondary osteoporosis include genetic disorders, hypogonadal states, endocrine disorders,hematologic disorders, nutritional deficiencies, drugs.
What are the consequences of osteoporosis? - Consequences due to osteoporosis are increased risk of fracture with minor trauma, frequency of traumatic events from lifting and bending impact.
What are the symptoms of osteoporosis? - Patients with uncomplicated osteoporosis may be asymptomatic or may have pain in the bones or muscles, particularly of the back. Osteoporosis becomes apparent in dramatic fashion.
How is osteoporosis diagnosed? - The diagnosis of osteoporosis is usually made by your doctor using a combination of a complete medical history and physical examination.
What're the treatments for osteoporosis? - Treatment for osteoporosis includes eating a diet rich in calcium and vitamin D, getting regular exercise, and taking medication to reduce bone loss and increase bone thickness.
What osteoporosis medications (drugs) are available? - Medications (drugs) to cure osteoporosis include bisphosphanates (Fosamax), calcitonin (Miacalcin), raloxifene, estrogen, and selective estrogen receptor modulators (SERMs).
How to treat osteoporosis in men? - Alendronate and teriparatide have been approved to treat osteoporosis in men. Calcitonin may work in men, treatment with testosterone appears to increase bone density.
How to treat osteoporosis in women? - The non-hormonal bisphosphonate drugs, alendronate and risedronate prevent and treat postmenopausal osteoporosis. Raloxifene is approved for preventing and treating osteoporosis.
What lifestyle changes can help osteoporosis? - Alcohol consumption should also be kept within safe limits. Supplements of calcium plus vitamin D may help maintain bone density. Limiting sodium and avoiding junk food.
What osteoporosis exercises are suggested? - Exercise is very important for slowing the progression of osteoporosis. Taking regular exercise is the single most important action improve the strength of their bones.
What osteoporosis diet is suggested? - A good calcium intake is essential throughout life for healthy bones. Vitamin D helps the absorption of calcium from the intestines. Reducing salt may be useful for osteoporosis patients.
What can be done to prevent osteoporosis? - For prevention and treatment of osteoporosis, patients should be encouraged to stop smoking, limit alcohol consumption and perform weight-bearing exercise.
Osteoporosis and calcium - Calcium could alter the physical-chemical properties of the bone mineral. The daily recommended dietary calcium intake varies by age, sex, and menopausal status.
Osteoporosis and magnesium - Magnesium supplementation is as important as calcium supplementation in the treatment and prevention of osteoporosis.
Osteoporosis and vitamin D - Vitamin D is necessary for the absorption of calcium in the stomach and gastrointestinal tract and is the essential companion to calcium in maintaining strong bones to prevent osteoporosis.