Medical Conditions
Musculoskeletal and Auto-Immune Disorders
Rheumatoid arthritis and lupus are among the many conditions that contribute to osteoporosis. Mobility may be impaired, which hastens bone loss, and medications used to treat the illnesses impair bone health.
Chronic Kidney Disease
Healthy kidneys enable an inactive form of vitamin D to convert to the form that bones need to remain healthy. Individuals who have chronic kidney disease may not be able to convert the inactive vitamin to its usable form.
In addition, the deficiency may promote the development of other conditions that hasten bone loss. Bone formation may actually increase; however it is of poor quality and subject to fracture.
Immobility
Exercise stimulates bone-building cells to produce more bone – unless it is excessive and results in hormonal disturbances. Therefore, any illness or injury that interferes with mobility hastens bone loss.
People who are bedbound for extended periods of time are at risk for osteoporosis. In addition to immobility, bedbound people often take medications that impair bone health. Intravenous fluids and nutrients may be needed, and artificial nutrition may precipitate bone loss.
The bones suffer as a direct result of immobility, medication side effects, and impaired nutrition.
Medications
Many types of medications have the potential to harm the skeleton:
- Medications that reduce the occurrence of seizures. Anticonvulsants interfere with the body’s ability to use vitamin D.
- Proton pump inhibitor medications are especially problematic when used by post-menopausal women. Proton pump inhibitors are commonly used for the treatment of gastroesophageal reflux disease (GERD) and other digestive ills.
- People who have had blood clots frequently require the use of heparin for extended periods of time. Heparin may cause bone loss.
- Corticosteroids are often prescribed as a means to reduce inflammation. People who have chronic health issues, such as respiratory problems and rheumatoid arthritis, may require them. Corticosteroids promote bone loss.
- Methotrexate is a medication which is used to treat cancer and rheumatoid arthritis. It has powerful side effects, including the creation of secondary osteoporosis.
- Lithium, thyroxine, some hormonal drugs, tacrolimus, and cyclosporine A increase the risk of secondary osteoporosis.
Screening for Secondary Osteoporosis
Screening for secondary osteoporosis includes an evaluation of health and medication review. Blood tests, urinalysis, and imaging studies are employed.
Dual energy x-ray absorptiometry, DXA, is the most commonly used test for determining bone density. The procedure is quick, reliable, and painless.
X-rays of specific areas, such as the spine, are sometimes used. Blood and urine tests can help to determine the underlying causes if bone loss occurs.
CT scans show bone loss but are expensive and rarely used for this purpose.
Treatment of Secondary Osteoporosis
Treatment focusses on correcting underlying causes and enhancing bone strength. Medications and supplements may be employed and dietary changes can be beneficial.
The goals of treatment include strengthening and preserving bone health. Prevention of injury, pain, and impairment are stressed.
