Osteoporosis risk factors

Most people identify growing older and being female with osteoporosis risk but many other factors also play a role.

Risk factors include

• Getting older
• Being small and thin
• Having a family history of osteoporosis
• Taking certain medicines
• Being a white or Asian woman
• Having osteopenia, which is low bone mass

Getting older

Up to 90 percent of peak bone mass is acquired by age 18 in girls and by age 20 in boys. Total bone mass doesn’t change much in women between age 30 and menopause. In the first few years after menopause, the rate of bone mass loss increases significantly. After this initial high bone loss, the rate slows but continues to be a net loss of bone mass throughout the post-menopausal years.

Being small and thin

Being small and thin usually means that there is less skeletal mass. In other words, the bones are smaller and have less mass. Having less bone mass means that you can tolerate less bone loss before seeing issues such as osteoporosis in later years.

Having a family history of osteoporosis

Recent studies of twins have shown that there are some genetic components that can change the risk of osteoporosis by influencing not only bone mineral density but also bone size, bone quality, and bone turnover. The relationship of these genetic components and other risk factors are quite complex and currently no genetic test exists to predict an individuals risk of osteoporosis.

If you have a family history of osteoporosis in combination with other risk factors, your doctor may monitor you more closely for osteoporosis or suggest some life style changes or supplements.

Taking certain medicines

Use of corticosteroids has been most frequently associated with bone loss. Corticosteroid osteoporosis is a common problem associated with their long term high dose use. Since the trabecular bone is affected more rapidly than the cortical bone, the risk of vertebral (backbone) fractures is greatly increased. Epidemiological data suggest that corticosteroid treatment doubles the risk of  fractures of the hip and distal radius (often called a wrist fracture)  and at least quadruples the risk of vertebral (backbone) fracture.

Various prevention therapies have been proposed because treatment of corticosteroid osteoporosis after it has progressed is quite difficult. A discussion of prevention options should be discussed between the patient and their physician prior to long term corticosteroid therapy.

Other medications associated with an increased risk of osteoporosis include

• Lithium
• Aluminum including antacids containing aluminum
• Barbituates, phenobarbital, phenytoin, , carbamazepine, and primidone
• Heparin
• Methotrexate (at high doses usually given to cancer patients)
• Certain progestins commonly found in contraception medications

Being a white or Asian woman

Race may play a role in the risk of osteoporosis. Studies have shown that black women tend to have the highest bone mass while Asian women have the lowest mass.Though all races can develop osteoporosis, the highest risk was for white or Asian women