Risk Factors & Causes

Understanding the risk factors for Osteoporosis is an incredibly important starting point! 

Recognize is the first "R" of the 4R Bone Optimization method for a good reason. If we don't know what's causing your bone loss, how will we know how to stop it?

Blood work and Functional Testing are Helpful, and covered in future modules, but we need to take holistic look at your ENTIRE Osteoporosis Story to truly understand the root cause of your bone loss.


This talk discusses the risk factors for osteoporosis and emphasizes the importance of understanding why bone loss occurs. Dr. Doug highlights the role of genetics, nutrient deficiencies, gut dysfunction, sarcopenia, chronic stress, chronic inflammation, hormones, certain medications, smoking, alcohol, bariatric surgery, and peak bone mass in the development of osteoporosis. The talk also emphasizes the need for testing and early intervention to prevent and reverse bone loss.

Risk Factors for Osteoporosis: 

  • Genetics
  • Nutrient Deficiencies
  • Gut Health
  • Scarcopenia
  • Chronic Stress
  • Inflammation
  • Hormones
  • Pharmaceuticals
  • Lifestyle - Smoking/Alcohol Use
  • Bariatric Surgery
  • Peak Bone Mass


  • Understanding the risk factors for osteoporosis is crucial for preventing and reversing bone loss.
  • Genetics play a significant role in determining the likelihood of developing osteoporosis.
  • Nutrient deficiencies, especially in calcium and vitamins, can contribute to bone loss.
  • Gut dysfunction, such as low stomach acid and celiac disease, can impair nutrient absorption and impact bone health.
  • Sarcopenia, or low muscle mass, is closely related to bone health and can be mitigated through adequate protein intake and resistance training.
  • Chronic stress and inflammation are risk factors for osteoporosis and should be managed.
  • Hormone optimization, when appropriate, can help slow down bone loss.
  • Certain medications, such as PPIs, H2 blockers, oral birth control pills, and antidepressants, can negatively affect bone health.
  • Smoking and excessive alcohol consumption increase the risk of osteoporosis.
  • Bariatric surgery can lead to nutrient deficiencies and bone loss.
  • Peak bone mass, determined by genetics and early-life factors, is an important indicator of future bone health.

Additional Resources