As I’m posting about this blog series and my recent diagnosis, a dear friend reached out via text to say, “Sorry to hear about your osteoporosis diagnosis… phew… aging!!”
I felt both her caring energy and the common belief we hold about bone loss:
It happens to old people.
Or, at least, it’s a disease of aging.
Let’s take a moment or two to consider if this is true.
So, if not only age…
What causes osteoporosis?
As we’ve identified in a previous post, low bone density most often occurs in menopausal women over age 50.
According to Stanford Medicine:
“Osteoporosis is caused by a lack of bone strength or bone density.
As a natural part of aging, bone tissue breaks down. It is absorbed faster than new bone is made, and bones become thinner. You are more likely to have osteoporosis if you didn’t reach your ideal bone density during your childhood and teen years.” 1
Seems like a clear case of age-related degeneration. Here’s what is lesser known about the causes of osteoporosis.
According to Touch Immunology:
“Osteoporosis is a common and clinically significant comorbidity in patients with autoimmune and inflammatory diseases, affecting a substantial proportion of individuals with conditions such as rheumatoid arthritis (RA), spondyloarthritis (SpA), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc).” 2
As one of my Instagram followers commented yesterday, those with celiac disease are also at risk of increased bone loss.
In a 2021 article in PubMed:
“Celiac disease, an autoimmune condition causing gluten intolerance and disrupted absorption of nutrients, predisposes to osteoporosis.” 3
The Endocrine Centre in Houston has this to say:
“Your bones naturally reach their peak density and strength around age 30. After that, the process of bone breakdown starts to outpace bone rebuilding. Aging accelerates this imbalance, making older adults more susceptible to osteoporosis. However, there are instances when osteoporosis can appear earlier.” 4
They continue to include the instances of early-onset osteoporosis:
- Chronic conditions such as celiac disease, lupus, or inflammatory bowel disease
- Hormonal disorders like hyperthyroidism or low sex hormones (such as women with early menopause or men with hypogonadism)
- Prolonged use of medications like corticosteroids
- Nutritional deficiencies, especially in calcium and vitamin D
- Smoking, heavy alcohol use, or a sedentary lifestyle
It’s hard to think of osteoporosis as a condition of aging since we don’t tend to think about age 50 as old. However, if we consider global average life expectancy has soared from about 30 years in 1870 to over 70 years today, 50 used to be considered a ripe ol’ age. 5
The point worth considering is that we stop identifying osteoporosis as a disease of aging and start looking after bone health earlier.
As well, it is important to focus on bone management alongside autoimmune conditions or other inflammatory processes.
I dug to find research that shows the number of people diagnosed with osteoporosis under age 50 but couldn’t find any because bone density screening doesn’t happen until after 50 and usually not until someone breaks a bone.
What can we do?
When I think about my own path here — the spinal injury, the early menopause at 44, the decade of disrupted sleep, the autoimmune diagnosis layered on top — I don’t see a woman aging into a predictable disease. I see a body that was dealing with inflammation and hormonal loss years before anyone thought to check my bones. Nobody screens a 44-year-old for osteoporosis. Why would they?
That’s the real problem. Not that osteoporosis happens to “old” people, but that we’ve built our entire system of awareness around an age we assume it starts at, so the people it’s actually happening to, silently, in their 30s and 40s, have no reason to ask, and no one asking on their behalf.
Awareness, education and information. It sounds simple. But it starts with a single shift: stop asking “How old are you?” and start asking “What has your body been carrying?”
Much love,
Stephanie
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1 https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/osteoporosis/causes.html
2 https://touchimmunology.com/insight/osteoporosis-in-autoimmune-and-inflammatory-diseases/
3 https://pmc.ncbi.nlm.nih.gov/articles/PMC8780933/
4 https://www.endocrinecenter.com/blog/am-i-too-young-to-have-osteoporosis
Stephanie Hrehirchuk - Author 