Osteoporosis Secondary Causes

Aka: Osteoporosis Secondary Causes

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II. Causes: Endocrine Causes

  1. Hyperparathyroidism
  2. Grave's Disease or Hyperthyroidism
  3. Cushing's Disease
  4. Hyperprolactinemia (Prolactinoma)
  5. Hypogonadism
    1. Women: Menopause
    2. Men: "Male Menopause"
      1. Declining Testosterone and Estradiol
      2. Orchiectomy in Prostate Cancer

III. Causes: Nutrition

  1. Vitamin D Deficiency (very common in elderly)
    1. Community-dwelling elderly: 36% men, 47% women
    2. Long-term Care Residents: 80-100% Prevalence
  2. Alcoholism or Alcohol use more than 2 drinks per day
  3. Tobacco Abuse
  4. Gastric Bypass Surgery
  5. Low Body Weight or Body Mass Index
  6. Malabsorption syndromes (esp. Celiac Sprue)
  7. Malnutrition
  8. Vitamin A Excess
  9. Anorexia Nervosa (and Female Athlete Triad)
  10. Bulimia Nervosa
  11. Calcium deficiency (e.g. Hypercalciuria)

IV. Causes: Miscellaneous Chronic Disease

  1. Chronic Renal Failure
  2. Rheumatoid Arthritis
  3. Systemic Lupus Erythematosus
  4. Chronic Liver Disease
  5. Chronic Obstructive Pulmonary Disease (COPD)
  6. Human Immunodeficiency Virus or AIDS
  7. Mastocytosis
  8. Organ transplant

V. Causes: Malignancy

  1. Multiple Myeloma
  2. Leukemia
  3. Lymphoma
  4. Ectopic ACTH Syndrome

VI. Causes: Genetic Syndromes

  1. Osteogenesis imperfecta
  2. Marfan Syndrome
  3. Ehlers-Danlos Syndrome
  4. Homocystinuria
  5. Glycogen Storage Diseases
  6. Hypophosphatasia

VII. Causes: Neurologic

  1. Seizure Disorder
  2. Multiple Sclerosis
  3. Parkinonism
  4. Spinal Cord Injury
  5. Cerebrovascular Accident

VIII. Causes: Medications

  1. See Medication Causes of Osteoporosis
  2. See Corticosteroid Associated Osteoporosis

IX. References

  1. Harris (2023) Am Fam Physician 107(3): 238-46 [PubMed]
  2. Jeremiah (2015) Am Fam Physician 92(4): 261-8 [PubMed]
  3. Mauck (2006) Mayo Clin Proc 81(5):662-72 [PubMed]
  4. Sweet (2009) Am Fam Physician 79(3): 193-202 [PubMed]

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