What Causes Osteopenia?

By Dr. Ananya Mandal, MDReviewed by April Cashin-Garbutt, MA (Editor)

Osteopenia is loss of bone mineral density that is a common precursor of osteoporosis. These are some risk factors that increase the propensity for osteopenia and osteoporosis.

Some of the causes and risk factors for osteopenia include:

Post-menopausal women

During reproductive age women produce estrogen from their ovaries. After menopause decline of this hormone leads to bone loss.

Genetics

Many individuals are genetically predisposed to osteopenia and osteoporosis

Aging

Bone loss is a normal feature of aging.

Lifestyle factors:

• Lack of exercise and sedentary lifestyle
• Excess alcohol consumption
• Excessive smoking
• Excessive stress
• Crash dieting and eating disorders
• Excessive coffee, tea, soda, chocolate or sports and energy drinks
• Young female athletes with eating disorders and amenorrhea. These women have lower body weight, lower fat percentage, and higher incidence of asthma. This increases the risk of osteopenia.
• Teenage pregnancy

Drugs and medications and medical conditions:

• Glucocorticoids – Individuals on long term steroids are at risk of bone mineral loss
• Those treated for Chronic inflammatory diseases such as Arthritis, Leukemia, Lupus, Lymphoma, organ transplant, cancers are at risk of lowered bone density due to long term steroid use
• Anorexia and bulimia
• Asthma
• Vitamin B 12 deficiency
• Cancers
• Celiac disease
• Crohn’s disease, Ulcerative colitis and other inflammatory bowel diseases
• Malabsorption syndromes
• Chronic kidney disease or patients on dialysis
• Cerebral palsy
• Cushing’s syndrome leading to excess steroids
• Diabetes
• Drugs used in epilepsy
• Those with hyperthyroidism and with hyperparathyroidism
• Those with Hypogonadism
• Liver disease, lactose intolerance
• Patients with Multiple myeloma, Osteo-genesis imperfect, polio, Sickle Cell anemia, Skin disorders, Thalassemia.

Drugs that lead to lowered bone density include:

• Phenytoin
• Depot provera
• Drugs with Aluminum
• Dilantin
• Phenobarbital
• Anticancer drugs
• GNRH – agonsists like leuprolide
• Aromatase inhibitors
• Immunosuppressants like Cyclosporine A and FK506
• Methotrexate
• Proton pump inhibitors like omeprazole
• Heparin
• Lithium,
• Thyroid hormone replacement,
• Certain diuretics can all cause loss of bone mineral density and predispose to osteopenia

Further Reading

• All Osteopenia Content
• Osteopenia - What is Osteopenia?
• Osteopenia Treatment