Table 1.
Conditions, diseases, and medications that cause or contribute to osteoporosis and fractures
| Lifestyle factors | ||
| Alcohol abuse | Excessive thinness | Excess vitamin A |
| Frequent falling | High salt intake | Immobilization |
| Inadequate physical activity | Low calcium intake | Smoking (active or passive) |
| Vitamin D insufficiency | ||
| Genetic diseases | ||
| Cystic fibrosis | Ehlers-Danlos | Gaucher’s disease |
| Glycogen storage diseases | Hemochromatosis | Homocystinuria |
| Hypophosphatasia | Marfan syndrome | Menkes steely hair syndrome |
| Osteogenesis imperfecta | Parental history of hip fracture | Porphyria |
| Riley-Day syndrome | ||
| Hypogonadal states | ||
| Androgen insensitivity | Anorexia nervosa | Athletic amenorrhea |
| Hyperprolactinemia | Panhypopituitarism | Premature menopause (<40 years) |
| Turner’s and Klinefelter’s syndromes | ||
| Endocrine disorders | ||
| Central obesity | Cushing’s syndrome | Diabetes mellitus (types 1 and 2) |
| Hyperparathyroidism | Thyrotoxicosis | |
| Gastrointestinal disorders | ||
| Celiac disease | Gastric bypass | Gastrointestinal surgery |
| Inflammatory bowel disease | Malabsorption | Pancreatic disease |
| Primary biliary cirrhosis | ||
| Hematologic disorders | ||
| Hemophilia | Leukemia and lymphomas | Monoclonal gammopathies |
| Multiple myeloma | Sickle cell disease | Systemic mastocytosis |
| Thalassemia | ||
| Rheumatologic and autoimmune diseases | ||
| Ankylosing spondylitis | Other rheumatic and autoimmune diseases | |
| Rheumatoid arthritis | Systemic lupus | |
| Neurological and musculoskeletal risk factors | ||
| Epilepsy | Multiple sclerosis | Muscular dystrophy |
| Parkinson’s disease | Spinal cord injury | Stroke |
| Miscellaneous conditions and diseases | ||
| AIDS/HIV | Amyloidosis | Chronic metabolic acidosis |
| Chronic obstructive lung disease | Congestive heart failure | Depression |
| End-stage renal disease | Hypercalciuria | Idiopathic scoliosis |
| Post-transplant bone disease | Sarcoidosis | Weight loss |
| Medications | ||
| Aluminum (in antacids) | Anticoagulants (heparin) | Anticonvulsants |
| Aromatase inhibitors | Barbiturates | Cancer chemotherapeutic drugs |
| Depo-medroxyprogesterone (premenopausal contraception) | Glucocorticoids (≥5 mg/day prednisone or equivalent for ≥3 months) | GnRH (gonadotropin-releasing hormone) agonists |
| Lithium cyclosporine A and tacrolimus | Methotrexate | Parental nutrition |
| Proton pump inhibitors | Selective serotonin reuptake inhibitors | |
| Tamoxifen® (premenopausal use) | Thiazolidinediones (such as Actos® and Avandia®) | Thyroid hormones (in excess) |
From: The Surgeon General’s Report [1], with modification