Causes of Osteoporosis

Osteoporosis is a bone condition in which newly grown bone growth does not replace bone loss. As a result, bones become porous, weak, and susceptible to breaking more easily than healthy bones. The most common cause of this condition is the aging process. People in their mid-twenties and younger can regenerate bone mass faster than the body breaks down bone.

Unfortunately, this means that human bone mass reaches its zenith around age 30 and decreases as we age. In women, menopause also decreases bone growth and bone density. This disease impacts all races, as well as both men and women. However, Asian and Caucasian women 60 and older are the highest-risk population for this disease. Falls involving hip fractures become more prevalent around this age as well. Although Osteoporosis is most commonly caused by the aging process, there are some other circumstances that may cause the earlier onset of this disease.

One significant contributing factor to Osteoporosis is malnutrition. The body needs calcium and vitamin D to build bone. The body also requires a lot of protein to maintain muscle mass and strength to support bone and prevent fractures. Because of this, anyone with an eating disorder is at a higher risk of developing Osteoporosis. The longer the eating disorder went on, the higher the risk. Similarly, chronically underweight people are also at a higher risk. Anyone with an eating disorder or who has recovered from it should discuss this with their primary care physician and see if they need to alter their calcium supplement regimen.

A certain amount of exercise is required to maintain bone growth. People who lead sedentary lifestyles inadvertently accelerate their bone loss. Regular exercise causes the body to create bone and increases bone density. Because of this, people who cannot walk or exercise, especially those who are wheelchair-bound, experience the onset of Osteoporosis at an earlier age.

Unfortunately, some medications can also cause Osteoporosis by affecting bone remodeling or the process through which new bone is created. Chief among these is the steroid prednisone. Cyclosporine, thyroid medications, lithium, SSRI-related antidepressants (Paxil, Zoloft, Prozac), certain cancer drugs (doxorubicin, cisplatin), hormones such as medroxyprogesterone (used to treat endometriosis and abnormal menstrual cycles), blood thinners like warfarin, heparin (an anticoagulant), other steroids, including cortisone, dexamethasone, and triamcinolone. Medications used to treat seizures, and gastric reflux can also cause bone loss. Patients taking these medications, especially for extended periods, must discuss the effects with their doctor and develop an appropriate plan to monitor their bone density and offset the results of these medications.

Many medical conditions can also lead to Osteoporosis. These include cancer, rheumatoid arthritis, paralysis, inflammatory bowel disease, kidney disease, liver disease, celiac disease, thyroid disease, hormonal imbalances, and adrenal gland disorders. Additionally, patients who have had any kind of gastrointestinal surgery, specifically to decrease the stomach volume (weight loss surgery) or to remove part of the intestinal tract (as can happen with Ulcerative Colitis), have less surface area through which to absorb calcium from their diet.

Osteoporosis is diagnosed via an imaging test called a bone density scan. Anyone who has taken the medications listed above or has one of the medical conditions in the prior paragraph can request a bone density scan from their physician. Some insurance will require prior authorization if the individual is under a set age. There are ways around this when a patient is a high risk, but it may need the physician to complete additional paperwork or for the patient to appeal a denial of the test.

If the patient is experiencing symptoms of Osteoporosis, a request for a bone density scan should be made immediately. Symptoms include low-back and hip pain, fractured or collapsed vertebrae, height loss (over time), a stooped spinal posture or humped back, gum loss, or brittle bones that break too easily. Unfortunately, there can be few to no symptoms in the earlier stages of Osteoporosis.

Treatment often involves a multi-faceted approach focusing on self-care and prescription medications. Diet is often examined to maximize calcium and vitamin D intake and remove anything influencing calcium absorption. There is some evidence that consuming high quantities of carbonated sodas can reduce calcium in the body, so soda is typically eliminated. Additionally, weight-bearing exercises (tailored to the patient’s abilities) will be added to minimize bone loss. Prescriptions include hormonal treatment, bisphosphonates, calcitonin, teriparatide, raloxifene, romosozumab, and abaloparatide.

The best way to minimize one’s risk of Osteoporosis is to ensure daily calcium consumption and participate in regular weight-bearing or resistance exercise. Women under 50 should consume 1,000 milligrams a day, and women over 50 should consume 1,200 milligrams per day. Men require 1,000 milligrams of calcium daily until they reach age 70, at which time they should begin consuming 1,200 milligrams daily. The human body needs Vitamin D to absorb calcium and maintain bones. Adults require 400 IU (International Units) of vitamin D daily. Simply assuming that you are getting enough calcium through your diet, unfortunately, leads to earlier Osteoporosis for many, as most average Americans suffer from some form of malnutrition due to the widespread unhealthiness of the typical diet. For this reason, it is best to visit a licensed dietician to ensure one’s diet has all the necessary nutrients for bone health or take supplements.

Patients with Osteoporosis are at a very high risk of fracturing bones in auto-collision. Any impact, such as a fall, bumping into something, or in more severe cases, sneezing or coughing, can cause bone fractures. Because bone growth is not replacing bone loss, these fractures can be complicated to heal. These fractures occur in the hips, spine, and wrists most often but can involve any bone in the body. The patient will likely experience more extended hospitalizations, more loss of work, require more invasive treatment and intervention (including surgery), need more time in a recovery facility, and require support for a more significant period than crash victims who do not have Osteoporosis. In the most severe cases, especially with spine and hip fractures in patients with advanced Osteoporosis, the patient may never fully recover and require supportive care for the rest of their life.

Watch the YouTube video below to understand Osteoporosis and its risk for those living with it.

I'm Ed Smith, a Northern California Personal Injury Attorney. If you or a loved one has been injured in an auto collision and you have developed Osteoporosis, as a result, call our experienced legal team at (916) 921-6400 or (800) 404-5400 for free, friendly case advice.

See our previous cases of Verdicts and Settlements.

Photo by CHUTTERSNAP on Unsplash

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