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What causes bone loss?

Osteoporosis - causes; Low bone density - causes

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Osteoporosis

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Description

Osteoporosis, or weak bones, is a disease that causes bones to become brittle and more likely to fracture (break). With osteoporosis, the bones lose density. Bone density is the amount of calcified bone tissue that is in your bones.

A diagnosis of osteoporosis means you are at risk for bone fractures even with everyday activities or minor accidents or falls.

Your Changing Bones

Your body needs the minerals calcium and phosphate to make and keep healthy bones.

Sometimes bone loss occurs without any known cause. Some bone loss with aging is normal for everyone. Other times, bone loss and thin bones run in families and the disease is inherited. In general, white, older women are the most likely to have bone loss. This increases their risk of breaking a bone.

Brittle, fragile bones can be caused by anything that makes your body destroy too much bone, or keeps your body from making enough bone.

Weak bones can break easily, even without an obvious injury.

Bone mineral density is not the only predictor of how fragile your bones are. There are other unknown factors related to bone quality that are as important as bone quantity. Most bone density tests only measure the bone quantity.

Aging and Bone Loss

As you age, your body may reabsorb calcium and phosphate from your bones instead of keeping these minerals in your bones. This makes your bones weaker. When this process reaches a certain stage, it is called osteoporosis.

Many times, a person will fracture a bone before they even know they have bone loss. By the time a fracture occurs, the bone loss is serious.

Women over age 50 years and men over age 70 years have a higher risk for osteoporosis than younger women and men.

Your Lifestyle and Bone Loss

Your body needs calcium and vitamin D and enough exercise to build and keep strong bones.

Your body may not make enough new bone if:

Certain habits can affect your bones.

Younger women who do not have menstrual periods for a long time also have a higher risk of bone loss and osteoporosis.

Low body weight is linked to less bone mass and weaker bones.

Exercise is linked to higher bone mass and stronger bones.

Medical Disorders and Bone Loss

Many long-term (chronic) medical conditions can keep people confined to a bed or chair.

Other medical conditions that may also lead to bone loss are:

Sometimes, medicines that treat certain medical conditions can cause osteoporosis. Some of these are:

Any treatment or condition that causes calcium or vitamin D to be poorly absorbed can also lead to weak bones. Some of these are:

People with eating disorders, such as anorexia or bulimia, are also at higher risk for osteoporosis.

What's Next?

Talk to your health care provider about your risk for bone loss and osteoporosis. Find out how to get the right amount of calcium and vitamin D, what exercise or lifestyle changes are right for you, and what medicines you may need to take.

References

De Paula FJA, Black DM, Rosen CJ. Osteoporosis: basic and clinical aspects. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ , eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 30.

Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D. Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab. 2019;104(5):1595-1622. PMID: 30907953 pubmed.ncbi.nlm.nih.gov/30907953/.

Weber TJ. Osteoporosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 230.

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Review Date: 5/13/2020  

Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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