Conditions, Diseases, and Medications that Contribute to Osteoporosis and Fractures
| Lifestyle factors | ||
| Alcohol abuse | High salt intake | Falling |
| Low calcium intake | Inadequate physical activity | Excessive thinness |
| Vitamin D insufficiency | Immobilization | Prior fractures |
| Excess vitamin A | Smoking (active or passive) | |
| Genetic factors | ||
| Cystic fibrosis | Homocystinuria | Osteogenesis imperfecta |
Ehlers-Danlos syndrome Gaucher's disease Glycogen storage diseases Hemochromatosis | Hypophosphatasia Idiopathic hypercalciuria Marfan's syndrome Menkes' steely hair syndrome | Parental history of hip fracture Porphyria Riley-Day syndrome |
| Hypogonadal states | ||
| Androgen insensitivity | Hyperprolactinemia | Athletic amenorrhea Panhypopituitarism |
| Anorexia nervosa and bulimia | Premature menopause Premature ovarian failure | |
| Turner's & Klinefelter's syndromes | ||
| Endocrine disorders | ||
| Adrenal insufficiency | Cushing's syndrome | Central adiposity |
| Diabetes mellitus (types 1 and 2) | Hyperparathyroidism | Thyrotoxicosis |
| Gastrointestinal disorders | ||
| Celiac disease | Inflammatory bowel disease | Primary biliary cirrhosis |
| Gastric bypass | Malabsorption | |
| Gastrointestinal surgery | Pancreatic disease | |
| Hematologic disorders | ||
| Multiple myeloma | Monoclonal gammopathies | Sickle cell disease |
| Hemophilia | Leukemia and lymphomas | Systemic mastocytosis |
| Thalassemia | ||
| Rheumatologic and autoimmune diseases | ||
| Ankylosing spondylitis | Lupus | Rheumatoid arthritis |
| Other rheumatic and autoimmune diseases | ||
| Central nervous system disorders | ||
| Epilepsy | Parkinson's disease | Stroke |
| Multiple sclerosis | Spinal cord injury | |
| Miscellaneous conditions and diseases | ||
AIDS/HIV Alcoholism Amyloidosis Chronic metabolic acidosis Chronic obstructive lung disease | Congestive heart failure Depression End-stage renal disease Hypercalciuria Idiopathic scoliosis Muscular dystrophy | Posttransplant bone disease Sarcoidosis Weight loss |
| Medications | ||
Aluminum (in antacids) Anticoagulants (heparin) Anticonvulsants Aromatase inhibitors Barbiturates Cancer chemotherapeutic drugs Cyclosporine A and tacrolimus Depo-medroxyprogesterone (premenopausal contraception) | Glucocorticoids (≥5 mg/d prednisone or equivalent for ≥3 months) Gonadotropin-releasing hormone antagonists and agonists Proton pump inhibitors Selective serotonin reuptake inhibitors | Tamoxifen (premenopausal use) Thiazolidinediones (such as pioglitazone and rosiglitazone) Thyroid hormones (in excess) Parenteral nutrition |
Source: From the 2014 National Osteoporosis Foundation Clinician's Guide to the Prevention and Treatment of Osteoporosis. © National Osteoporosis Foundation.