Bones are very sensitive to other diseases. Bone loss is seen with decreased mechanical forces (bedrest), weight loss for any reason, decreased hormone levels, acidosis, most catabolic stresses and any kind of inflammation. Often osteoporosis is a result of combinations of risk factors and chronic diseases. Some of the hereditary diseases should logically be classified as primary osteoporosis but are listed here just to remind readers that there are many kinds and causes of osteoporosis.
Here is a list of diseases to consider when a person suffers from a fragility fracture or has low bone density Z-scores. This is certainly not the complete list of causes of osteoporosis, but does include the most common ones:
| Medications | corticosteroids, dilantin and other anticonvulsants, gonadotropin releasing hormone agonists, loop diuretics, methotrexate, excess thyroid, heparin, depo-medroxyprogesterone acetate, anti-neoplastic agents, cyclosporin, proton-pump inhibitors, selective serotonin reuptake inhibitors, aromatase inhibitors |
| Hereditary skeletal/connective tissue diseases | osteogenesis imperfecta, rickets, hypophosphatasia, Marfan's syndrome, pseudoglioma. |
| Endocrine and metabolic | HYPOGONADISM, prolactinoma, hypopituitarism, hyperparathyroidism, hyperthyroidism, Cushing syndrome, acidosis, diabetes type I and type II, androgen insensitivity, Gaucher's disease, hemochromatosis |
| Gastro-intestinal | Celiac sprue, malabsorption, malnutrition, inflammatory bowel disease, chronic hepatic disease |
| Rheumatologic diseases | systemic lupus, ankylosing spondylitis, rheumatoid arthritis |
| Marrow diseases | myeloma, mastocytosis, thalassemia, leukemia |
| Renal disease | Chronic Kidney Disease, renal tubular acidosis, Hypercalciuria |
| Neurologic diseases | spinal cord injury, stroke, Parkinson's disease, history of polio |
| Psychiatric diseases | alcoholism, depression, anorexia nervosa |
| Pulmonary diseases | chronic obstructive pulmonary disease, cystic fibrosis |
| Other | organ transplantation, lactation, AIDS, transient regional osteoporosis, any disease that causes serious weight loss or prolonged bedrest |
| Fractures not caused by osteoporosis | severe trauma, cancer metastasis to the bone, Paget's disease, tuberculosis (Pott's disease), avascular necrosis, fibrous dysplasia, osteomalacia, repetitive injury (March fractures) |
