8 conditions you might not know are linked to osteoporosis

Written by: Dr Taher Mahmud
Published: | Updated: 19/08/2019
Edited by: Emily Lawrenson

Many people think osteoporosis is simply linked to old age – the older we get, the more chance we have of developing osteoporosis. While this is true in some ways, age isn’t the only factor involved, and osteoporosis is linked to various other medical conditions, some of which might be surprising. While it’s not certain that people will develop osteoporosis simply because they have these conditions, it is important for individuals to be aware of the increased risk and how other diseases are connected to osteoporosis. Dr Taher Mahmud of the London Osteoporosis Clinic explains more.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease, meaning the body attacks its own cells and tissues. Osteoporosis and rheumatoid arthritis are closely linked, and osteoporosis can be caused by RA in a number of ways. Rheumatoid arthritis has no cure, and is currently treated through management of the symptoms. Chronic inflammation over time has an effect on the body, accelerating bone loss, as do drugs which are used to control the inflammation. Everybody loses bone mass over time, but rheumatoid arthritis speeds up the process and contributes to bone damage, increasing the risk of fracture.

 

Inflammatory bowel disease & coeliac disease

Inflammatory bowel disease, or IBD, describes a group of intestinal disorders which cause inflammation in the digestive tract. Coeliac disease is a digestive condition in which the small intestine cannot absorb nutrients correctly, caused by an adverse reaction to gluten. IBD and other gastrointestinal diseases have been linked to osteoporosis, through nutritional factors (levels of calcium, vitamin D, and other minerals may not be as high as in those with no intestinal disorder), corticosteroid use over time, and the long-term inflammation.

 

Diabetes

Diabetes is linked to many medical conditions and illnesses, including osteoporosis. Type 1 diabetes is linked to low bone density, and difficulty reaching ideal bone mass. Our bones grow and get stronger until they reach their peak bone mass, so if this is low to begin with, patients have a greater chance of developing osteoporosis or experiencing a fracture. Diabetes is also associated with being overweight, which can contribute to osteoporosis and fracture risk. It is important for diabetes patients to get the correct nutrition and exercise regularly, in order to reduce the risk of osteoporosis and other medical conditions linked with diabetes.

 

Dementia

Both dementia and osteoporosis are commonly seen conditions in those with old age, but the two are also connected. Those who suffer from dementia run a significantly higher risk of hip fracture than those who have no cognitive disorder. There are many factors which increase the risk of hip fracture, but falls are more common in those with dementia – particularly multiple falls. In those with dementia, the correct care and attention is crucial and can help patients to reduce the risk of fracture.

 

Chronic kidney disease

Chronic kidney disease, or CKD, describes the gradual loss of kidney function, and is associated with bone disorders and an increased risk of fracture. In those with CKD, fractures in elderly patients are twice as common as in those with normal kidney function.

 

Hypogonadism

Hypogonadism refers to the decreased function of the gonads, which in men is the testes, and the ovaries in women. This means less oestrogen or testosterone is produced or there is a deficiency in production. Oestrogen deficiency is connected with osteoporosis – menopausal women have been proven to be more at risk – and some studies have shown there is a relationship between testosterone levels and bone density.  

 

COPD (Chronic Obstructive Pulmonary Disease)

Progressive lung diseases such as chronic bronchitis and emphysema fall under the umbrella of COPD, which is a term used to describe various inflammatory airway diseases. Reports have shown that low bone mineral density is prevalent in those with COPD, along with reduced physical activity, and vitamin D insufficiency/deficiency, increasing the risk of both osteoporosis and osteoporotic fracture. In those with COPD, screening is recommended as a routine procedure for earlier diagnosis of osteoporosis and appropriate treatment.

 

Chronic conditions in childhood

Some of the above conditions can also occur in childhood, such as inflammatory bowel disease, and diabetes. Other chronic conditions such as juvenile arthritis also increase the risk of osteoporosis, either through impact on skeletal health or inability to achieve ideal peak bone mass. 

By Dr Taher Mahmud
Rheumatology

Dr Taher Mahmud is a distinguished consultant rheumatologist based in central London and Tunbridge Wells. He is renowned for his expertise in osteoporosis, osteopenia, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and inflammatory arthritis.

Dr Mahmud qualified in medicine from King's College London before undertaking training at various esteemed institutions including St Thomas', and Pembury Hospitals. He also completed an esteemed research fellowship at King’s College Hospital, also gaining an MD and a Master’s in biochemistry. He further honed his skills in rheumatology through specialist training at King's College, the Lupus Unit at St Thomas', and Guy's Hospital Rheumatology Units. Dr Mahmud has served as a consultant rheumatologist since 2000, and was awarded fellowship of the Royal College of Physicians in 2014. Boasting more than 30 years of experience, Dr Mahmud has held various prominent roles throughout his career, including as cofounder and clinical lead for osteoporosis at the London Osteoporosis Clinic, and has also received a Clinical Excellence Award in recognition of his excellence and dedication to his practice. He currently sees private patients at HCA UK, The Shard and 25 Harley Street.

Additional to his clinical practice, Dr Mahmud has held a number of esteemed positions in public associations throughout his career, with a particular focus on improving patient experience and outcomes, including as a member of the MTW Patient Experience Committee and as an organiser and chair of conferences on patient experience at the Royal Society of Medicine. In recognition of his commitment to drive improvement in this area, he was awarded an NHS Innovations award for patient feedback. He has also been actively involved in medical education throughout his career, having lectured and trained a wide range of medical students and fellow practitioners.

With a wealth of expertise and experience, Dr Mahmud continues to make significant contributions to the field of rheumatology. He has appeared in numerous peer-reviewed publications and has authored his own book on the subject of patient care and feedback. Dr Mahmud is passionate about raising awareness of the prevention of osteoporosis fractures and maintaining healthy bones. He has appeared on several podcasts as an expert speaker on bone health and osteoporosis and the menopause. Dr Mahmud is also a member of various professional organisations, including the American College of Rheumatology, British Medical Association, British Society of Rheumatology, General Medical Council and the Royal Society of Medicine.

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