Rethinking Primary Osteoporosis

When osteoporosis is diagnosed in men, a great effort is made to uncover the causes of the excessive bone loss. In fact, most male osteoporosis is considered to have a secondary cause, that is, to be caused by something, whether it’s a disorder like celiac disease, the use of various medications, or habits such as smoking, etc. Most osteoporosis in women, however, is simply considered a normal development due to menopause or advancing age. However, outside of the Western world, women don’t necessarily develop osteoporosis as a matter of course — and that says it’s not normal.

We at the Center for Better Bones have come to challenge this distinction between what scientists call “primary” and “secondary” osteoporosis. Our work leads us to suggest that all osteoporosis is indeed caused by something, and in this sense, all osteoporosis is secondary to something else. For example, the American College of Rheumatology has estimated that 20% of all osteoporosis in the US is due to use of steroid medications. Other researchers have suggested that 20% of all hip fractures are related to smoking. The use of acid-blocking drugs has been shown to double fracture rates. Some studies suggest that almost 20% of those with osteoporosis have the disorder caused or worsened by an excessive loss of calcium in the urine. Vitamin D inadequacy could be causing half or more of all osteoporosis, and so forth.

The reasons why someone may develop osteoporosis are many and varied, including undiagnosed medical problems or unhealthy lifestyle issues, such as smoking, acidic diet, etc. But if you can pinpoint out why you’re losing bone, there may be some way to halt your bone loss and perhaps even restore your bones to health. Lifestyle issues are easy to spot; undiagnosed medical issues take a bit more work.

I always tell my clients, “Take heart, and take action.” If you are losing bone but don’t know why (or if you’ve been told that your bone loss is “normal” or “expected” for someone of your age and gender), then it’s time to find some answers. I encourage you to review my article on secondary osteoporosis so that you understand — and maybe recognize — some of the hidden sources of bone loss that might be affecting you.