Risk Factors for Osteoporosis: Does Primary Osteoporosis Really Exist?

Have you ever been told that osteoporosis is inevitable as you get older and that it’s an expected part of aging? This is called primary osteoporosis. If you believe this, you may feel there is nothing you can do to prevent bone loss. However, this couldn’t be farther from the truth.

Have you ever been told that osteoporosis is inevitable as you get older and that it’s an expected part of aging? This is called primary osteoporosis. If you believe this, you may feel there is nothing you can do to prevent bone loss. However, this couldn’t be farther from the truth.

Everything has a root cause, including osteoporosis. Here at Optimal Bone Health, we see the root causes are not simply due to being at an “older age” but are true secondary causes that increase the risk for osteoporosis. This is also consistently seen in the research.

Being aware of these secondary causes can result in early screening and detection for bone loss, which can prevent fracture.

If you’re concerned about your bone health and want to reduce your risk of fracture, read on. This article will cover the most common secondary causes of osteoporosis, when to get screened, and how this can help prevent a fracture from happening in the first place.

What is Osteoporosis?

Osteoporosis is a condition that develops over time that causes bones to become weak and brittle, increasing the risk for fracture. Osteoporosis-related fractures occur most commonly in the hip, wrist, or spine, and affect men and women of all ages and races.

There are not many early warning signs of osteoporosis and therefore many people may experience a fracture before they even knew they were at risk. The good news is if you are armed with the knowledge to know your risk, you can take the steps to prevent further bone loss or strengthen weakened bones via a healthy diet, exercise, and medication regimen.

Secondary Causes of Osteoporosis

While it’s easy to say that bone loss is a given as you age, the truth is there is typically a secondary diagnosis present that is the underlying cause. Here are the most common causes of osteoporosis and why:

Adrenal disorders – The adrenal glands are located just above the kidneys and produce the hormones adrenaline as well as cortisol, the stress hormone. Conditions such as Cushing’s disease or any adrenal disorder lead to an overproduction of cortisol, which reduces bone density and increases the risk for fracture.

Eating disorders or chronic dieting – Clinical eating disorders such as anorexia or bulimia can lead to nutrient deficiencies, which can weaken the bones over time. This is not just a problem with clinically diagnosed eating disorders, but with chronic dieting for weight loss as well.

Due to their restrictive nature, weight loss diets can also result in vitamin and mineral deficiencies that affect bone health. Research has shown that especially rapid weight loss (which often occurs on strict diets) can reduce bone mineral density and increase the risk for fracture.

When it comes down to it, not getting in enough nutritious foods in any instance increases your risk.

Hyperthyroidism – This can occur when you have an overactive thyroid gland whereby your body produces too much thyroid hormone. More commonly though if you are being treated for HYPOTHYROIDISM with medication you can cause bone loss by being OVERTREATED! Unless balanced both situations can cause your body to pull calcium from your bone, increasing the risk of a fracture.

Low testosterone levels – A silent but concerning symptom of low testosterone in men is a decrease in bone mineral density. Optimizing hormones and determining the need for a testosterone replacement can help in this matter.

Postmenopausal hormone loss – A drop in estrogen, progesterone and testosterone levels during menopause increases the risk for bone loss. And while menopause does occur with age, hormone loss is not necessarily inevitable. With bioidentical hormone replacement therapy, you have the opportunity to optimize your hormones as you age.

Actively engaging in weight-bearing exercises can also help slow bone loss during this critical period.

Diabetes, Pre-Diabetes and Metabolic Syndrome – Both type 1 and type 2 diabetes are inflammatory conditions, and inflammation increases the risk for fracture. You are more at risk for bone loss if you take insulin or have uncontrolled diabetes, but studies show that even just having a diagnosis of diabetes or pre-diabetes puts you at risk. What’s more concerning is that while >50% of the American adult population is diabetic or pre-diabetic only 12% of us meet criteria to be considered metabolically healthy. That means that nearly 90% of us are at risk for bone loss from metabolic dysfunction.

Reversing diabetes and metabolic disease through a healthy diet and lifestyle can reduce the risk of fracture and most chronic diseases!

Gastrointestinal diseaseDigestive disorders such as Crohn’s disease, colitis, or reflux are linked to secondary osteoporosis. This is because these conditions can lead to the malabsorption of nutrients and reduce the digestion of bone-supporting nutrients like vitamin D and calcium.

It’s also common practice to take steroids to reduce the inflammation associated with these conditions, which further increases the risk for bone loss when taken long-term. This is true even at low doses.

Certain medication classes for acid reflux are also associated with nutrient malabsorption and should be stopped unless certain criteria are met.

Improving your symptoms with the right diet and supplements can reduce the need for steroids and potentially silence these disease states.

Celiac Disease – This occurs when your body cannot properly process gluten, a protein found in wheat. If left undiagnosed or treated, it can lead to inflammation and nutritional deficiencies, increasing the risk for fracture. Testing for gluten and other protein intolerance in wheat is a critical step in identifying reasons for bone loss!

Research shows osteoporosis is more prevalent in those with celiac disease. In fact, some experts report close to 75% of those with celiac may have underlying osteoporosis!

Pancreatic Insufficiency – This occurs in severe diseases such as pancreatitis but also in milder forms that result in poor nutrient absorption. This will affect bone metabolism and increase the risk of fractures. If you have a history of constipation, food in your stool, bloating after you eat or pancreatic insufficiency, it’s important to get your gut evaluated and a bone density test to know your risk.

Know Your Risk  

If you have any of these “secondary risk factors” for osteoporosis, getting screened early and identifying why you may have bone loss is the first step in preventing a fracture. Bone loss can be preventable when you understand your risk and take the necessary steps to improve your bone health.

Here at Optimal Bone Health, we don’t believe that osteoporosis is inevitable, and there are mounds of research to support this belief. If you want to optimize your bone health so you can enjoy an active lifestyle, schedule a 15-minute consultation with one of our OBH practitioners today!


  1. https://pubmed.ncbi.nlm.nih.gov/20542010/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217506/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230461/
  4. https://www.bones.nih.gov/health-info/bone/bone-health/exercise/exercise-your-bone-health
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950667/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4613168/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681138/
  8. https://www.primescholars.com/articles/osteoporosis-in-chronic-pancreatitis-outpatients-associates-withseveral-risk-factors-99224.html

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