• Osteoporosis is a condition of fragile bone with an increased susceptibility to fracture.
• Osteoporosis weakens bone and increases risk of bones breaking.
• Bone mass (bone density) decreases after 35 years of age, and bone loss occurs more rapidly in women after menopause.
• Key risk factors for osteoporosis include genetics, lack of exercise, lack of calcium and vitamin D, personal history of fracture as an adult, cigarette smoking, excessive alcohol consumption, history of rheumatoid arthritis, low body weight, and family history of osteoporosis.
• Patients with osteoporosis have no symptoms until bone fractures occur.
• The diagnosis of osteoporosis can be suggested by X-rays and confirmed by tests to measure bone density.
• Treatments for osteoporosis, in addition to prescription osteoporosis medications, include stopping use of alcohol and cigarettes, and assuring adequate exercise, calcium, and vitamin D.

Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia, by definition, is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

The following are factors that will increase the risk of developing osteoporosis:

• Female gender
• Caucasian or Asian race
• Thin and small body frame
• Family history of osteoporosis (for example, having a mother with an osteoporotic hip fracture doubles your risk of hip fracture)
• Personal history of fracture as an adult
• Cigarette smoking
• Excessive alcohol consumption
• Lack of exercise
• Diet low in calcium
• Poor nutrition and poor general health, especially associated with chronic inflammation or bowel disease
• Malabsorption (nutrients are not properly absorbed from the gastrointestinal system) from bowel diseases, such as celiac sprue that can be associated with skin diseases, such as dermatitis herpetiformis
• Low estrogen levels in women (which may occur in menopause or with early surgical removal of both ovaries)
• Low testosterone levels in men (hypogonadism)
• Chemotherapy that can cause early menopause due to its toxic effects on the ovaries
• Amenorrhea (loss of the menstrual period) in young women is associated with low estrogen and osteoporosis; amenorrhea can occur in women who undergo extremely vigorous exercise training and in women with very low body fat (for example, women with anorexia nervosa)
• Chronic inflammation, due to chronic inflammatory arthritis or diseases, such as rheumatoid arthritis or liver diseases
• Immobility, such as after a stroke, or from any condition that interferes with walking
• Hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland (as in Grave’s disease) or is ingested as thyroid hormone medication
• Hyperparathyroidism is a disease wherein there is excessive parathyroid hormone production by the parathyroid gland, a small gland located near or within the thyroid gland. Normally, parathyroid hormone maintains blood calcium levels by, in part, removing calcium from the bone. In untreated hyperparathyroidism, excessive parathyroid hormone causes too much calcium to be removed from the bone, which can lead to osteoporosis.
• When vitamin D is lacking, the body cannot absorb adequate amounts of calcium from the diet to prevent osteoporosis. Vitamin D deficiency can result from dietary deficiency, lack of sunlight, or lack of intestinal absorption of the vitamin such as occurs in celiac sprueand primary biliary cirrhosis.
• Certain medications can cause osteoporosis. These medicines include long-term use of heparin (a blood thinner), antiseizure medicine such as phenytoin (Dilantin) and phenobarbital, and long-term use of oral corticosteroids (such as prednisone).
• Inherited disorders of connective tissue, including osteogenesis imperfecta, homocystinuria, osteoporosis-pseudoglioma syndrome and skin diseases, such as Marfan syndrome and Ehlers-Danlos syndrome (These causes of hereditary secondary osteoporosis each are treated differently.)

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