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Causes and risk factors
Hormones are to blame for brittle bones in about 70 percent of cases. Since oestrogens inhibit the cells that break down bone, the menopause, when the body produces less oestrogen, has a negative effect on bone metabolism. Incidentally, women who had their first period relatively late as adolescents or who entered the menopause very early are particularly at risk for osteoporosis. Women who have not had children or whose ovaries have been removed also have an increased risk of osteoporosis. Other causes can be diet, too little exercise, hereditary factors or certain medications.
Risks that cannot be influenced
- Age and gender: Early diagnosis is recommended for women in the menopause; a basic diagnosis should always be made from the age of 70 onwards.
- Long-standing illnesses: such as asthma, rheumatism, hyperthyroidism, diabetes, kidney problems, chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.
- Long-term therapies with certain medicines, for example cortisone or antidepressants.
- Genetic make-up
Influenceable risks
- Nutrition
- Eating disorders, low body weight: BMI below 20
- Vitamin D and calcium deficiency
- Too little exercise
- Smoking
- Alcohol
- Heavy consumption of laxatives, coffee
Many triggers can be reduced through a healthy diet rich in vitamins and a balanced lifestyle with plenty of exercise in the fresh air. Slim, petite or underweight people are more at risk than those of normal weight. According to recent studies, vegetarian or vegan diets can also have a negative impact on bone density. A slightly higher body weight seems to protect the bones. People who do not get much fresh air and therefore only produce a small amount of vitamin D are also at risk, as are patients with metabolic diseases.
Our tip: Assess your risk factors now with the online risk test.
The menopause and age favour osteoporosis. Osteoporosis is particularly rapid in the first five years of menopause. If you test in time and strengthen your body and bones preventively, you make an important contribution to healthy ageing. Even if a temporary illness confines you to bed, you can strengthen your body and bones again afterwards through gentle exercise and abstinence from alcohol and cigarettes.
The general rule is: reduce or avoid stimulants, eat a healthy diet rich in vitamins and get enough exercise!
Medication that promotes osteoporosis
Regular use of certain medications can also lead to accelerated bone loss. These include the following drugs:
Glucocorticoids: Inhibit inflammatory reactions, among other things, e.g. prednisone, dexamethasone, betamethasone, prednisolone, cortisone.
GnRH analogues (gonadoropin-releasing hormones): For endometriosis, prostate or breast cancer, e.g. buserelin, gonadorelin, histrelin, goserelin
Aromatase inhibitors: For breast cancer in postmenopausal women and for gynaecomastia, e.g. anastrozole, letrozole, exemestane, formestane, aminoglutethimide.
Anti-depressants: For depression, e.g. citalopram, escitalopram, fluoxetine, fluvoxamine, sertraline, amitriptyline, imipramine, desipramine, doxepin.
Proton pump inhibitors: For reflux, e.g. omeprazole, pantoprazole, lansoprazole, esomeprazole.
Loop diuretics: In e.g. heart failure, chronic renal failure and water retention in the body, e.g. sulfonamide derivatives, furosemide, torasemide, bumetanide, piretanide
Heparin: for the treatment or prevention of coagulation disorders, e.g. certoparin, dalteparin, enoxaparin, nadroparin
Thyroid hormone (thyroxine): For hypothyroidism, goitre and thyroid cancer, e.g. levothyroxine (L-thyrox).
Glitazone: In type 2 diabetes, e.g. pioglitazone, rosiglitazone.
Anti-epileptic drugs: In epilepsy to suppress cerebral seizures, e.g. barbiturates and derivatives, benzodiazepine derivatives, oxazolidine, hydantoin.
These diseases can cause osteoporosis:
- Long-term glucocorticoid therapy, e.g. for bronchial asthma or rheumatoid diseases.
- Hyperthyroidism
- Hyperparathyroidism (primary hyperparathyroidism)
- Kidney diseases with increased calcium excretion or vitamin D metabolism disorders
- Adrenal problems with increased cortisol levels
- Chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis
Rheumatoid arthritis can also trigger osteoporosis
Patients with rheumatoid arthritis, a chronic inflammation of the joints, have an increased risk of developing osteoporosis. This is because the rheumatic inflammation itself reduces bone density through various reinforcing mechanisms. The same applies to arthrosis, a joint disease that is often accompanied by severe pain. Arthrosis occurs when the joint cartilage is irreparably damaged by chronic overloading. This is also referred to as joint wear and tear.
Unfortunately, osteoporosis cannot yet be cured. However, careful prevention can prevent the disease from developing in the first place. Timely treatment, in turn, can slow down the progression of the disease and prevent complications.