1. AUTOIMMUNE DISORDERS
“With autoimmune disorders, there are circulating chronic inflammatory factors that make people prone to bone loss,” says Robert Recker, MD, professor of medicine, and director of the Osteoporosis Research Center, Creighton University. In addition, a common treatment for autoimmune disorders is taking steroid medications to reduce inflammation, but steroids can weaken bones. Rheumatoid arthritis, an autoimmune disease of the joints, has been strongly linked to osteoporosis. Because the disease causes pain and loss of movement, patients tend to be less active, which can also weaken bones. “Almost everyone who has rheumatoid arthritis should be also given osteoporosis medication, as well as calcium and vitamin D,” says Dr. Recker. Other autoimmune disorders, such as lupus and multiple sclerosis, also increase the risk for osteoporosis, and patients should discuss their risk with their physician.
2. DIGESTIVE & GI DISORDERS
People with gastrointestinal (GI) disorders may also have issues with digesting food and absorbing enough of the nutrients that help rebuild bone. Those with Celiac disease, for example, have problems absorbing nutrients, including calcium and vitamin D. “Some of the worst cases of osteoporosis are in celiac patients,” says Dr. Recker. If you’re on a strict gluten-free diet, that can reduce the risk, but many people are not aware that they’re gluten intolerant until they’ve had significant bone loss, he says. Two autoimmune diseases of the GI tract—Crohn’s disease and ulcerative colitis—carry a one-two punch. They reduce absorption of nutrients needed to maintain healthy bones, plus they’re often treated with steroids, which can cause bone loss.
3. TYPE 1 AND TYPE 2 DIABETES
People with type 1 and type 2 diabetes, have a higher risk of fractures. “Interestingly, it’s not so much a problem with bone loss, it’s more a reduction in the bone quality among diabetics,” says Dr. Recker. “Diabetics will fracture with bone densities not nearly as low as non-diabetic patients,” he says. The chronic high blood sugars damage bones, but it’s not yet clear how. Some research has shown that bone rebuilding is suppressed.