Bone Loss

Bone loss, also known as osteoporosis, is a condition that develops over time in many people. During your lifetime, natural aging, certain diet or lifestyle choices, and even some medications can make bones weaker and more brittle.

This doesn't mean that your bones get smaller; instead, they become airier or less dense and more prone to breaks or fractures.

This article will go over some symptoms you can expect if you suffer from bone loss, possible causes, and how to treat it.

Symptoms of Bone Loss

Bone loss usually develops slowly over time with few noticeable symptoms. Often called a silent disease, osteoporosis isn't usually diagnosed at all until you break or fracture a bone.

If you do develop symptoms of osteoporosis—either before or after an initial diagnosis—they can include:

• Severe back pain
• Height loss
• Changes in your posture (kyphosis)
• Easily broken or fractured bones

Causes of Bone Loss

To some extent, bone loss happens naturally with age as new bone growth slows down. Your gender and race can also play a role. White Americans, Asian Americans, and women have the highest rates of osteoporosis. Family history matters, too, so it's good to know if anyone in your family has a history of easily broken bones or fractures.

Another aspect of aging that can lead to bone loss is hormonal changes. While some of these changes happen during puberty or pregnancy, dropping levels of estrogen and testosterone that occur later in life are more likely to contribute to osteoporosis.

Outside of these factors—over which you have little to no control—there are other possible causes of bone loss, including:

• Low calcium and vitamin D intake
• Low protein diets
• Chronic diseases like gastrointestinal disease and rheumatoid arthritis
• Cigarette smoking
• Heavy, long-term alcohol use
• Lack of exercise or a sedentary lifestyle
• Certain medications

What Medications Can Cause Bone Loss?

There are several types of medications that can contribute to bone loss. The most common are:

• Glucocorticoids (steroids)
• Adrenocorticotropic hormones (stimulate the production of cortisol hormone)
• Seizure medications
• Cancer treatments
  
• Proton pump inhibitors (PPIs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Thiazolidinediones (treat type 2 diabetes)

It's important to talk to your healthcare provider about the risks and benefits of these medications, as well as any potential side effects you may experience. Do not stop taking any prescription medications without talking to your healthcare provider first.

How to Treat Bone Loss

There are several ways to address bone loss, and the first is usually to make dietary and lifestyle changes that can support strong bones. This can include increasing your intake of certain foods that are high in calcium and vitamin D and making exercise a part of your daily routine. Your healthcare provider may also offer education on nutrition, exercise, and fall prevention strategies.

If medications are required, a few options include:

• Bisphosphonates can help preserve bone density and slow bone loss.
• Calcitonin, a thyroid hormone, is used in postmenopausal women who can't tolerate other medications.
• Estrogen agonists/antagonists—either selective estrogen receptor modulators (SERM) or tissue-selective estrogen complexes (TSEC)—are used to treat and prevent osteoporosis in postmenopausal women.
• Estrogen and hormone replacement therapies may be used to counteract the damage caused by hormone changes.
• Parathyroid hormone (PTH) analog and parathyroid hormone related-protein (PTHrP) analog are used to help increase bone mass in postmenopausal women.
• RANK ligand (RANKL) inhibitors can help slow bone loss in both men and women.
• Sclerostin inhibitors can help slow bone loss and increase new bone production.

While these options each offer some benefit, there is little evidence of the safety and efficacy of their long-term use. Researchers have suggested that more research into existing medications and the development of new treatments is critical to improving the prevention and management of bone loss.

Complications and Risk Factors Associated With Bone Loss

Early recognition and management of bone loss can help improve long-term outcomes and reduce your chances of complications.

The most common complications of bone loss are related to the brittle nature of your bones. Hip and spinal fractures are considered the most serious complications of osteoporosis, as they can contribute to significant disability and even increased mortality.

Other fractures, like spinal fractures without a fall and compression fractures, can also cause complications like pain, posture changes, and disability.

Are There Tests to Diagnose the Cause of Bone Loss?

Most tests that evaluate bone loss have the goal of measuring the extent of bone loss using a T score. Your T score is a measurement of your bone density in comparison to the mean bone density found in young adults.

In some cases of bone loss, however, your healthcare provider may perform more testing to determine what underlying issues could be contributing to your osteoporosis. Osteoporosis caused by factors like malnutrition, vitamin deficiencies, or certain chronic diseases may require additional medications like nutrition supplements. Examples of tests that might help narrow down contributing factors to bone loss include:

• Thyroid testing
• Calcium level testing
• Vitamin D testing
• Kidney function tests
• Hormone testing
• Dual X-ray absorptiometry scan

When to See a Healthcare Provider

Seeing a primary care provider on a regular basis can help identify issues like bone loss before you experience serious injuries or complications. If you know you have a high-risk condition or a family history of osteoporosis, talk to your healthcare provider about what you can do to slow bone loss.

If you don't have an increased risk of bone loss, but notice you are having frequent fractures or broken bones from things like minor falls or even regular movements like coughing, ask your healthcare provider about measuring your bone density. Early treatment of bone loss can help reduce your chances of serious complications or disability.

Summary

Bone loss happens normally with age, but there are a number of dietary and lifestyle choices—and even medications—that can speed the process along. Talk to your healthcare provider about the risks of bone loss and preventive measures you can take.

A Word From Verywell

Many of the systems and structures in our bodies weaken over time as we age. In many cases, as with osteoporosis, you might not notice these changes until you experience significant injuries or disabilities.

Staying active with regular exercise and eating a healthy, well-balanced diet can go a long way in preventing bone loss, but your healthcare provider can tailor a preventive strategy to your individual health needs and medical history.