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Weak, easily broken bones are an epidemic in the United States. They’re often tied to osteoporosis, a disease that causes bones to degenerate over time. This makes them less flexible, more brittle, and easier to break.

According to the International Osteoporosis Foundation, more than 44 million Americans aged 50 and older either have or face the threat of developing osteoporosis due to low bone density levels. Projections put this number at more than 60 million by 2020. Across the world, a fracture due to osteoporosis happens about once every three seconds, causing nearly 9 million fractures—just from stress being put on weak bones.

Osteoporosis is treatable, reversible, and can be prevented for longer periods of time with the knowledge of what it is and how to attack it. So let’s dig into osteoporosis to find out what it is, how to notice it, its causes, and what to do once you or a loved one have it.

What Is Osteoporosis?

Osteoporosis is a degenerative bone disease that causes the loss of bone mass and bone tissue. Over the course of your life, old bone is removed from your body through a process called resorption, and new bone replaces it through formation, according to the National Resource Center for Osteoporosis and Other Bone Diseases.

However, there comes a time when your body can no longer keep up with the amount of bone you are losing. Most humans reach their “peak bone mass” in their early 20s, and then your body slowly (very slowly) starts lose more bone than it creates. This process takes a long time, though, especially when it comes to impacting the strength of your bones. The resource center also says that the process of resorption usually starts to outpace the process of formation by the time you hit 30, whether you’re a man or a woman. In most cases, men develop more bone over the course of their lives than women do, which leaves women more susceptible to suffering from osteoporosis.

Osteoporosis has onset once your bones get to a point where they are brittle, weaker, and easily broken. There are little to no symptoms of the disease, so easily breaking a bone may be the first sign that you have osteoporosis.

Osteoporosis is a large reason why seniors falling is such a big deal. If bones become easier to break, they also become a lot harder to heal, because not as much bone is being created to heal the fracture. The longer bones take to heal—especially hips and legs—the longer the elderly have to stay in the hospital. Longer hospital stays have been proven to show increased rates of mortality. They’re are related to increased complications while you’re in the hospital, because you’re more likely to develop more issues the longer you stay. You can even reach a point where your bones are no longer able to completely heal themselves, which causes issues with normal daily routines for the rest of your life.


How Does Osteoporosis Develop?

Osteoporosis can develop from a wide range of reasons, some of them medical (like autoimmune diseases, cancer and mental illness), and some of them from medications you take that can have bone loss as a side effect. This is why more than 10 million people have been officially diagnosed with osteoporosis. Let’s take a look at what exactly causes it to develop.

Medical Causes

The main cause of osteoporosis is other medical conditions, which either hinder the body from creating bone at a necessary rate or contribute to the speed at which bone deteriorates. The types of medical conditions that foster the development of osteoporosis are vast, covering various cancers, autoimmune diseases, and more. Let’s take a look at some of these issues.


One demographic most at risk for developing osteoporosis is postmenopausal women. During the menopause process, women experience a dramatic decrease in hormones being produced by their bodies, and this can result in bone loss.

While researchers aren’t completely sure why menopause is directly related lower bone density, the connection is there, especially in the first couple years following the ceasing of periods. Some women lose nearly half their bone density in the decade following menopause. Treatment for bone loss needs to be taken seriously and efficiently during the menopausal process, because women already have smaller bones.


The effect cancer has on the skeletal system is two-sided: the cancer itself affects the deterioration of your bones, and many treatments for cancer (chemotherapy, steroids, etc.) can also inhibit bone loss. Also, a 2013 study points out that “the skeleton is also the most common site of metastatic disease,” which is the most advanced type of cancer. This is due to osteoblasts and osteoclasts—the two main parts of the bone that focus on formation and resorption, respectively—inhibiting the rapid advancement of cancer cells, the study says.

Some of the main cancers that reap osteoporosis as a main side effect include breast and prostate cancers. Premenopausal women who receive chemotherapy for breast cancer have been shown to start the menopausal process almost a decade earlier than the average (early 50s), according to the aforementioned study. Both the menopause process—as we just discussed—and the treatment for menopause and breast cancer can all contribute to the proliferation of osteoporosis. Similarly, men who develop prostate cancer have similar issues with a hormone imbalance, which affects bone growth and development.

Low Calcium Levels

Calcium is the most important mineral in our body when it comes to bone strength. Calcium is constantly replaced in your bones to help keep them flexible and sturdy, so low calcium levels can result in weaker and brittle bones. Low calcium levels can stem from a variety of reasons, including:

  • Poor diet, especially as a child. The stronger and bigger your bones become in your youth (with the help of calcium), the more bone you have to potentially lose as you age.
  • Gastrointestinal surgery, which can impact how your body can absorb necessary nutrients like calcium, according to the Mayo Clinic.
  • Hypocalcemia, a calcium deficiency disease that can come about from aforementioned reasons like dieting or medications, or from genetic reasons.


Autoimmune Diseases

There are certain autoimmune diseases that, if present, can increase the risk of osteoporosis, both because of their direct effects on the body and the medications used for treatment. These autoimmune diseases include:

Rheumatoid arthritis: Aside from the medication used for rheumatoid arthritis—a disease that affects the joints all around your body—increasing your chances for osteoporosis, the inactivity caused by the condition can contribute to bone loss. The less certain parts of the skeletal system are used, like your wrists and hips for lifting weights and exercising, the more likely you are to lose bone density in those areas.

Lupus: Similar to rheumatoid arthritis, lupus—an autoimmune disease where the body attacks, inflames, and damages certain organs like your skin, joints, and tissues—can be a risk factor to osteoporosis through inactivity. The less you use these parts of your body, which can be in great pain due to the disease, the less chance your bones have to remain strong and healthy.

Celiac disease: This disease makes the body reject gluten, a protein largely found in wheat and rye products. If left untreated, the disease can affect your stomach and intestines’ ability to function and absorb the nutrients it needs, like calcium, which can then affect how strong and dense your bones are.



In addition to the medical reasons for why osteoporosis develops, there are also a slew of medicines you may be taking that aid in its development. Some are used to help combat the very diseases that are causing bone loss, like cancer. It’s a vicious cycle, but it’s also important to know what kinds of medicine have bone loss as a side effect. Let’s take a look at some of the medications that contribute to osteoporosis, courtesy of a 2014 study:

Steroids: Known in the medical world as glucocorticoids, these are used to treat conditions like lupus, allergies, rashes, autoimmune diseases, and plenty more. The aforementioned study notes that 30 to 50 percent of those who use these medications develop fractures, and that steroids can cause a range of bone density-decreasing habits like accelerating bone resorption and supporting fractures before bone density levels have even decreased to osteoporosis levels. Medication that helps prevent osteoporosis works well to combat osteoporosis-via-steroids.

Proton pump inhibitors: PPIs, which are used to help fight acid reflux, have shown to increase the risk of fractures, though it’s not clear why. The correlation is there, though, and in 2010, the FDA made PPIs come with a warning of an increased risk of fractures in certain areas of the body.

Type 2 diabetes medication: The study pointed out that certain medications used to treat type 2 diabetes—specifically, certain thiazolidinediones—have features that prevent the body from recognizing when it needs to create new bone, which can then lead to osteoporosis.

Epilepsy medication: Medicine used to help combat epilepsy—a disease that provokes random seizures—has shown to contribute to the reduction of bone density in people of all ages, but it largely affects postmenopausal women and those over the age 65. Studies in animals have shown antiepilepsy medication inhibits certain receptors that contribute to the proliferation of bone growth.

MPA (birth control/hormonal control): This specific medication is most commonly used for birth control and hormone replacement therapy for menopausal women, but it also contributes to the rapid loss of bone mass within a couple years of using it. The study pointed out, though, that bone loss suffered from MPA is reversible.

Aromatase inhibitors: These are used for hormone therapy is perimenopausal and postmenopausal women and “promote accelerated bone loss” due to the loss in estrogen, according to the study.

The Hormone Health Network notes that other medications used to treat medical issues can also contribute to the development of osteoporosis, and these include medications used to treat:

  • Various cancers
  • Heartburn
  • Heart failure
  • Blood-clot prevention
  • The prevention of organ transplant rejection

Given the wide range of medications that have osteoporosis as a side effect, it’s important you keep your dosage under control. Take the least amount of medicine you have to for the least amount of time possible. Don’t take the medications that cause osteoporosis unless your doctor prescribes them for a lengthy period of time. If you do need these medications for a long time, consult your doctor about how you can combat unhealthy side effects like osteoporosis.

Lifestyle Causes

How active you are and the kinds of food and drink you consume play into how likely you are of developing osteoporosis. Whether they can be explained by researchers or not, some of the following lifestyle habits have been proven to contribute to increased levels of bone loss:

  • Excessive alcohol consumption
  • Tobacco use
  • Inactive lifestyle (not regularly exercising)
  • Diet lacking in vitamin C and vitamin D

Osteoporosis can stem from many facets of life. Whether it’s a medical reason or medication you’re using to combat those medical issues or just a plain old lifestyle, how do you know if you’re suffering from the condition?


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