There are two types:
primary and secondary osteoporosis.
Primary osteoporosis (95%)
Primary osteoporosis is osteoporosis that is not caused by another disease. There are two types of primary osteoporosis:
Type 1: Postmenopausal osteoporosis. This type affects women during the menopause. It is thought to be caused by a lack of the female sex hormone oestrogen, which speeds up bone metabolism and increases bone loss. 30% of all women develop clinically relevant osteoporosis after the menopause.
Type 2: Senile osteoporosis. This type mainly affects older people (over 70) of both sexes. However, women develop this type of bone loss twice as often as men.
Secondary osteoporosis (5%)
Here the increased bone loss is a consequence or side effect of another disease, for example:
Hormonal disorders:
- Overactive thyroid
Hypercortisolism (overactive adrenal glands):
- Cushing’s syndrome
Chronic gastrointestinal disorders:
- Malnutrition
- Anorexia
- Malabsorption (reduced uptake of nutrients)
Immobilisation:
- Prolonged bed rest
Restricted movement due to osteoarthritis
Long-term use of medicines that promote bone loss:
- Cortisone
- Antiepileptics
- Antidepressants
- Sedatives
- Neuroleptics (e.g. for psychoses)
- Medicines that cause orthostatic hypotension
- Glitazones (in women): oral blood-sugar-lowering medicines (active substances rosiglitazone and pioglitazone)
- L-thyroxine therapy (for thyroid disorders)
- Proton pump inhibitors (stomach protection)
Hereditary diseases:
- Osteogenesis imperfecta
- Hypophosphatasia
- Ehlers-Danlos syndrome
- Marfan syndrome
Neoplastic diseases (cancers):
- Multiple myeloma
- Mastocytosis
- Myeloproliferative diseases
Inflammation:
- Rheumatoid arthritis
- Crohn’s disease
- Ulcerative colitis
Other causes:
- Pernicious anaemia
- Vitamin B12 deficiency
- Folic acid deficiency
- Underweight
- A diet rich in meat and low in vegetables and fruit
- Drinking phosphate-containing cola drinks