Health conditions that increase your risk
Some health conditions may increase your chance of osteoporosis and broken bones.
Risk factors are things that increase your chance of developing a condition or outcome. This information looks at some of the risk factors that can lead to osteoporosis or broken bones. Osteoporosis is a condition where your bones lose strength, making you more likely to break a bone. The terms ‘broken bone’ and ‘fracture’ mean the same thing.
The more risk factors you have for osteoporosis, the greater your chance of developing it. But having one or more risk factors does not mean you will definitely develop osteoporosis. And having osteoporosis does not necessarily mean you will break a bone.
Many health conditions have been linked with osteoporosis and broken bones. On this page, we look at some of the most common conditions, where there is good evidence of a link.
This is not a list of all the conditions linked to osteoporosis. Keeping other health conditions well controlled is important for your bone health. Speak to a healthcare professional if you are worried about your bone health and any other conditions you have.
Diabetes
Diabetes is a condition that causes your blood sugar level to become too high. There are two main types of diabetes, type 1 and type 2.
People with diabetes have a higher chance of osteoporosis and breaking a bone. This may be due to several factors including:
reduced bone strength
increased risk of falls
reduced muscle mass in people with type 2 diabetes.
The chance of breaking a bone is greater in people with diabetes who:
have had diabetes for longer than 5 years
are taking certain diabetes medicines, such as pioglitazone
have poor control of their diabetes.
It is important to keep your diabetes well controlled. Speak to your doctor or diabetes nurse if you need support with this.
If you are over 50 and have diabetes and other risk factors for osteoporosis and broken bones, speak to your doctor about a fracture risk assessment.
Find out more about diabetes from Diabetes UK (www.diabetes.org.uk).
Chronic kidney disease (CKD)
Chronic kidney disease (CKD) is a long-term condition where the kidneys do not work as well as they should. Your kidneys help to control minerals such as calcium and phosphate. Kidney function normally reduces as you get older. As this happens, problems with bone and mineral balance can increase. This leads to weaker bones that are more likely to break.
So, the chance of breaking a bone is higher in people with CKD. The more severe your CKD, the greater your chance of breaking a bone. The highest risk is in people on haemodialysis (CKD stage 5). People with stage 5 CKD are usually monitored closely for any bone and mineral changes.
People with CKD may also have other risk factors for osteoporosis and broken bones. These include:
low levels of sex hormones
taking steroids
being underweight
poor nutrition.
If you have moderate to severe CKD (stage 3 or 4) and are worried about your bone health, speak to your doctor about a fracture risk assessment.
Find out more about CKD from:
Thyroid disease
Thyroid hormone helps control how fast your bones break down and are built up again.
Find out more in our information on thyroid disease.
Hyperparathyroidism
The parathyroid glands help to control the amount of calcium in your body.
Find out more in our information on hyperparathyroidism.
Early menopause
Early menopause increases your chance of osteoporosis and of breaking a bone later in life.
Menopause is when your periods stop because hormone levels fall. It is a normal part of ageing in women and usually happens between the ages of 45 and 55. It can affect anyone who has periods.
Early menopause is when menopause occurs before the age of 45. If it occurs before the age of 40, it is called premature menopause. If you have an early or premature menopause, your oestrogen levels will start to fall at a younger age than usual. This means your bones have less protection for longer.
You have a higher chance of early or premature menopause if other family members have also had it. It is also more likely if you:
started your periods early
smoke
are underweight.
Early or premature menopause can also be caused by:
radiotherapy or chemotherapy
medicines that affect your hormones
hysterectomy, with or without removal of the ovaries.
For most people with early or premature menopause, no cause will be found.
If you have an early menopause, hormone replacement therapy (HRT) can help to reduce the increased chance of broken bones. But some women cannot have HRT. If you had an early menopause and did not receive HRT, talk to your doctor about a fracture risk assessment.
Eating disorders
Anorexia nervosa (often called anorexia) is an eating disorder and serious mental health condition. People with anorexia nervosa (AN) often have low bone strength and a higher chance of breaking a bone.
Find out more in our information on eating disorders.
Low levels of testosterone in men
Some treatments and conditions may lower the level of the hormone testosterone in men. This can increase the chance of osteoporosis and broken bones. For more information see Osteoporosis in men.
Coeliac disease
Coeliac disease is a condition where the body’s immune system reacts to gluten. As a result, the gut becomes inflamed, and the body cannot absorb food as it should. Treatment for coeliac disease is a life-long strict gluten-free diet. This helps to heal the gut and relieve symptoms.
People with coeliac disease have a higher chance of osteoporosis and broken bones. This is because of several factors including:
not getting enough key nutrients for healthy bones
ongoing inflammation of the gut
being underweight.
If you have coeliac disease, a strict gluten-free diet is the best way to improve your bone health. You may also need calcium and vitamin D supplements.
If you have coeliac disease and other risk factors for osteoporosis, your doctor may recommend that you have a fracture risk assessment and bone density scan.
You can find out more about coeliac disease from
Guts UK (gutscharity.org.uk)
Watch: Does coeliac disease cause osteoporosis and broken bones?
In this video, Osteoporosis Specialist Nurse, Niki, answers your questions about coeliac disease and osteoporosis.
Inflammatory bowel disease
The two main types of inflammatory bowel disease (IBD) are Crohn’s disease and ulcerative colitis. In people with IBD part of the gut becomes inflamed. Symptoms include diarrhoea, pain and tiredness.
Having IBD increases your chance of osteoporosis and broken bones. This seems to be greater in people with Crohn’s disease than those with ulcerative colitis.
This is due to several factors. These include:
long-term or repeated use of steroids
not getting enough calcium and vitamin D
avoidance of dairy products in some people
being underweight
long-term uncontrolled inflammation.
If you have IBD and have other risk factors for osteoporosis, your doctor may recommend you have a fracture risk assessment or a bone density scan. They may also check the levels of vitamin D in your blood. If your vitamin D level is low, they may recommend a calcium and vitamin D supplement.
For more information about Crohn’s disease and ulcerative colitis, see the Crohn's & Colitis UK website (www.crohnsandcolitis.org.uk). They also have information on inflammatory bowel disease and bones.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is a condition that causes pain, swelling and stiffness in the joints.
People with RA have a higher chance of osteoporosis and broken bones than those who do not have RA. This chance increases, the longer you have had RA.
This may be due to several factors, including:
reduced physical activity
use of steroids
poor disease control
increased falls.
If you are over 50 and have RA and other risk factors for osteoporosis, your doctor may recommend that you have a fracture risk assessment.
Find out more about RA from:
NRAS (nras.org.uk). NRAS also has information about osteoporosis in RA
Systemic lupus erythematosus (lupus)
Systemic lupus erythematosus, or lupus, is a condition where your immune system mistakenly attacks your own body. Lupus can affect the joints, skin, kidneys, and other organs.
People with lupus have lower bone strength than people without lupus. So, they have a higher chance of osteoporosis and broken bones. This may be partly due to steroid use and lower levels of vitamin D in people with lupus.
If you are over 50 and have lupus and other risk factors for osteoporosis, your doctor may recommend that you have a fracture risk assessment.
Find out more about lupus from Lupus UK (www.lupusuk.org.uk)
Respiratory diseases
People with chronic obstructive pulmonary disease (COPD) have a higher chance of osteoporosis and broken bones. Some features of COPD can contribute to bone loss. These include:
long-term inflammation
being less active because of breathing difficulties
weight loss
vitamin D deficiency because of reduced exposure to sunlight.
Long-term steroid use, which is common in people with COPD, can also increase bone loss.
If you have COPD and other risk factors for osteoporosis, speak to your doctor about a fracture risk assessment.
People with asthma also have a higher chance of osteoporosis and broken bones. This is thought to be mainly due to steroid use in asthma. See steroids and bone health for more information.
Parkinson’s
Parkinson's is a progressive neurological condition. This means that it causes problems in the brain that get worse over time. The main symptoms are a tremor (shaking), slowness of movement, rigidity (muscle stiffness) and low mood.
People with Parkinson’s have a higher chance of osteoporosis and broken bones. This chance is made even higher because people with Parkinson’s are more likely to fall. People with Parkinson’s are also more likely to have complications if they break a bone.
Despite this, osteoporosis often goes unrecognised and untreated in people with Parkinson’s. If you or someone you care for has Parkinson’s and has not had their bones checked, ask your doctor about a fracture risk assessment.
You can get more information and support for Parkinson’s from Parkinson's UK (www.parkinsons.org.uk). This includes information about Bone health and Parkinson's.
HIV
Early diagnosis, better treatments and easier access to them mean people living with HIV can lead long and healthy lives. But there is still a chance that HIV infection can lead to reduced bone strength. And some medicines used to treat HIV can also affect bone health. Studies have shown that people living with HIV have a higher chance of developing osteoporosis and breaking a bone.
If you have HIV and are worried about your bone health, speak to your doctor about a fracture risk assessment.
Prolonged immobility
Immobility is when a person can only move a little, or not at all. If this continues over the longer term, it can increase the chance of osteoporosis and broken bones.
Some conditions that can cause immobility include:
spinal cord injury
neuromuscular disease.
If you are immobile, it is important to try and keep your bones and muscles as strong as possible. Ask your healthcare professional about a suitable activity program for you. Choosing other bone-healthy habits will also help to keep your bones strong.
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