How many of you with a thyroid disorder or diabetes are aware of their potential effects on your bone strength? Most of us associate bone loss and fractures with aging, and osteoporosis is generally considered an affliction of older menopausal women. While this is true, the younger among us may also be at risk for brittle bones if they suffering from other hormonal problems, some of them quite common and others rare but still possible. And they are more than a few, but usually easy to treat and even cure as long as you know you have them!
Low estrogen is notorious for causing bone loss. If you are a woman in menopause, you may have reasons to be screened for osteoporosis by bone mineral density before the usual recommended age of 65 since other factors may precipitate bone loss during menopause such as medications and illnesses or just plain genetics! But younger women with irregular menses or menses that have stopped for many months have the same risk. Some types of contraception such as Progesterone depots may also affect the bones.
Vitamin D deficiency: Yes, Vitamin D is a true hormone that we make on our skin when we are exposed to sunlight! In the wintertime we virtually make none and using a sunscreen in the summertime reduces composition by 95%! You should still protect yourself from skin cancer but could take at least 800 units of Vitamin D3 a day to avoid mobilizing other hormones that cause bone loss when Vitamin D is low.
Most of us have a dear friend of family member with diabetes and some of us may be extra sweet ourselves! Whereas most people with diabetes focus on their eyes, kidneys, small nerves and heart, they may not know that high sugars also affect bone quality and increase risk of fractures.
Thyroid balance is important not only for our weight and energy level, but also for our bones. An overactive thyroid or taking too much thyroid hormone to replace an underactive thyroid can make them brittle within a few months.
Extra parathyroid hormone made by an enlarged parathyroid gland in our neck is a common cause of fragile bones and osteoporosis. If your calcium level is higher than normal, you may have this easily treated condition.
High cortisol, a stress hormone made in our adrenals, although quite rare often presents with osteoporosis. If you have unexplained weight gain, diabetes, high blood pressure and fractures ask you doctor about the possibility of high cortisol. Better safe than sorry!
Dr. Panagiota (Penny) Andreopoulou is an Attending Endocrinologist in the Department of Medicine at Hospital for Special Surgery. Her clinical and academic interests include osteoporosis, calcium and phosphate metabolism and metabolic bone disorders. She is board-certified in Internal Medicine and Endocrinology, Diabetes and Metabolism.