125 secondary causes (and more) for osteoporosis

The Better Bones Revolution Manifesto states in truth #4: “There is always a cause for excessive bone loss and bone fragility.”

How about 125 different causes?

That’s the number of secondary causes of osteoporosis — in addition to low vitamin D — researchers found in a recent study of patients who had already experienced low-trauma or fragility fractures.

Here’s a summary of the findings from the study, which focused on secondary causes:

• Study participants were 399 patients who had sustained fractures suspected to be due to osteoporosis.

• 54% of the patients were vitamin D insufficient or deficient.

• Nearly 33% had a secondary cause of osteoporosis other than lower than optimal levels of vitamin D.

• The 98 patients with acceptable vitamin D levels suffered from a combined total of 125 different secondary causes with the most common including medication use, smoking, excessive alcohol use, premature ovarian failure, kidney impairment, gastrointestinal conditions and endocrine conditions.

Of course, we know that there are many more secondary causes such as nutritional factors (including a high-acid diet) and lifestyle factors (lack of exercise or too much worry). You can see more details in my article Rethinking “primary” osteoporosis.

What this tells us about treatment for osteoporosis

Rather than simply reminding us that there’s always a cause for excessive bone loss and bone fragility, researchers also used their study as an opportunity to declare how investigating the cause of secondary osteoporosis can “inform and influence specific treatment regimen.”

I couldn’t agree more! Over and over, my work has shown that all osteoporosis is caused by something — it doesn’t just happen. And it’s my job to help each of you as individuals consider what could be putting you at risk, and how you can take steps to deal with these risks. You can find more in The Better Bones Revolution Manifesto, including truth #5: “Treating the root cause of sub-optimal bone health offers the greatest opportunity for creating life-long healthy bones.”



Bogoch, E., et al. 2012. Secondary Causes of Osteoporosis in Fracture Patients. J Orthop Trauma, 26 (9) e145-e152.


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