Symptoms
There typically are no symptoms in the early stages of bone loss. But once your bones have been weakened by osteoporosis, you may have signs and symptoms that include:
- Back pain, caused by a fractured or collapsed vertebra
- Loss of height over time
- A stooped posture
- A bone fracture that occurs much more easily than expected
When to see a doctor
You may want to talk to your doctor about osteoporosis if you went through early menopause or took corticosteroids for several months at a time, or if either of your parents had hip fractures.
Causes
Your bones are in a constant state of renewal — new bone is made and old bone is broken down. When you’re young, your body makes new bone faster than it breaks down old bone and your bone mass increases. Most people reach their peak bone mass by their early 20s. As people age, bone mass is lost faster than it’s created.
How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. The higher your peak bone mass, the more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age.
Risk factors
A number of factors can increase the likelihood that you’ll develop osteoporosis — including your age, race, lifestyle choices, and medical conditions and treatments.
Unchangeable risks
Some risk factors for osteoporosis are out of your control, including:
- Your sex. Women are much more likely to develop osteoporosis than are men.
- Age. The older you get, the greater your risk of osteoporosis.
- Race. You’re at greatest risk of osteoporosis if you’re white or of Asian descent.
- Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father experienced a hip fracture.
- Body frame size. Men and women who have small body frames tend to have a higher risk because they may 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 reduction of estrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis. Men experience a gradual reduction in testosterone levels as they age. Treatments for prostate cancer that reduce testosterone levels in men and treatments for breast cancer that reduce estrogen 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.
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
- Lupus
- 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 do 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 weightlifting seem particularly helpful.
- Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis.
- Tobacco use. The exact role tobacco plays in osteoporosis isn’t clearly understood, but it has been shown that tobacco use contributes to weak bones.
Complications
Bone fractures, particularly in the spine or hip, are the most serious complication of osteoporosis. Hip fractures often are caused by a fall and can result in disability and even an increased risk of death within the first year after the injury.
In some cases, spinal fractures can occur even if you haven’t fallen. The bones that make up your spine (vertebrae) can weaken to the point that they may crumple, which can result in back pain, lost height and a hunched forward posture.
