Osteoporosis – causes

See also steroids and bisphosphonates

See Osteoporosis Assessment and treatment

Osteoporosis is defined by WHO by a bone density of 2.5 standard deviations below the mean value for young adults.

Primary Osteoporosis

  • Age related
  • Postmenopausal
  • “Natural mechanisms”
  • Smoking / alcohol / family history / low BMI make these natural processes more likely

Secondary osteoporosis

  1. Endocrine
  2. Iatrogenic
  3. Inflammatory
  4. Malignant
  5. Gastrointestinal

GRIME (G=Gastrointestinal, R=Really Our Fault  – iatrogenic, Inflammatory, M=Malignancy, E=endocrine)

1. Gastrointestinal

  • Malabsorption

2. Really Our Fault – Iatrogenic

  • steroids
  • Anticonvulsants
  • Heparin

3. Inflammatory

  • Rheumatoid arthritis
  • Inflammatory bowel disease

4. Malignant

  • Myeloma
  • Leukaemias

5. Endocrine

  • Hyperthyroidism
  • Hyperparathyroidism
  • Hypogonadism
  • Cushing’s syndrome
  • Premature menopause