Osteoporosis is a chronic bone disease where a person experiences a decrease in bone density. Anyone can develop osteoporosis, although certain factors, such as genetics, can increase a person’s risk.

Osteoporosis is a condition that can cause weak bones that are more prone to fractures. It occurs when the body reabsorbs more bone tissue and produces less to replace it. This lowers the bone density and makes them more fragile. Many different factors — including genetics — can contribute to the development of osteoporosis.

Read on to learn more about the influence of genetics on osteoporosis, as well as other potential causes and risk factors.

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Evidence notes that genetics play a role in the development of osteoporosis. For example, if a person has a family history of the condition, they are more likely to develop it themselves.

Additionally, genome-wide association studies highlight that the presence of certain genes could indicate a person’s risk for developing osteoporosis. As such, a 2018 study notes that genetic screening could be a useful tool for predicting a person’s future risk of osteoporosis and bone fractures.

Researchers have identified multiple genes that contribute to bone density and strength, which are key factors in the development of osteoporosis.

One such variation is in the gene encoding the vitamin D receptor. This gene plays a role in regulating calcium absorption and bone mineralization. Alterations in this gene may relate to lower bone mineral density and an increased risk of fractures.

Another gene — the COL1A1 gene — helps produce type I collagen, a major component of bone. A common variation in this gene can increase the risk of osteoporosis. This is likely due to the alteration affecting the body’s ability to produce type I collagen.

However, it is important to note that having these gene variations does not mean that a person will necessarily develop osteoporosis. It is a complex condition, and other factors, such as diet and exercise, also play a significant role in determining an individual’s overall bone health.

Osteoporosis is a multifactorial condition. This means there is a combination of causes and risk factors, some of which people cannot change. Some examples include:

Age

The risk of osteoporosis increases with age, particularly in postmenopausal people. As individuals age, bone mass naturally decreases, making them more susceptible to bone loss and fractures.

Sex

Biological females are at a higher risk of developing osteoporosis than biological males. This is because females generally have lower peak bone mass than men and also experience a significant decrease in estrogen levels during menopause, which accelerates bone loss.

Hormonal Imbalances

Low estrogen levels in biological females and low testosterone levels in biological males can contribute to bone loss and increase the risk of osteoporosis.

Low calcium and vitamin D intake

Inadequate intake of calcium and vitamin D, which are essential for bone health, can lead to decreased bone density and increase the risk of osteoporosis.

Sedentary lifestyle

Lack of regular weight-bearing exercises, such as walking, running, or weightlifting, can contribute to weaker bones and a higher risk of osteoporosis. Physical activity helps stimulate bone formation and strengthen existing bone tissue.

Smoking

Smoking may increase the risk of osteoporosis. It reduces estrogen levels in biological females, affects calcium absorption, and impairs bone formation.

Certain medical conditions and medications

Conditions such as rheumatoid arthritis, celiac disease, inflammatory bowel disease, and certain hormonal disorders can increase the risk of osteoporosis. Additionally, long-term use of certain medications, such as corticosteroids, can weaken bones and contribute to bone loss.

Osteoporosis typically progresses without noticeable symptoms until a fracture occurs. Symptoms of spine fracture may include:

  • severe back pain
  • loss of height
  • spine malformations such as a hunched posture

Living with osteoporosis means the affected bones may become fragile, leading to fractures occurring spontaneously or due to minor falls or typical stresses, such as coughing.

According to the International Osteoporosis Foundation, diagnosis of osteoporosis will typically involve a bone mineral density (BMD) test. This test uses a dual-energy X-ray absorptiometry (DEXA) machine. A healthcare professional then compares the results with an average, typical 30-year-old adult.

To determine if the bone density is in the usual range, the BMD uses a T-score against the standard deviation. This is a term that calculates how much a result varies from the average. A T-score of -2.5 or lower confirms osteoporosis, while a T-score between -1 and -2.5 indicates osteopenia, a precursor to osteoporosis.

Learn more about osteoporosis tests.

The primary goal of treatment for osteoporosis is to prevent fractures, relieve pain, and improve overall bone health. Treatment will vary as a healthcare professional will tailor plans depending on individual circumstances.

In combination with lifestyle recommendations such as gentle weight-bearing exercises, a balanced diet, and increasing calcium and vitamin D intake, a doctor may also recommend medication such as:

  • Bisphosphonates: This is a group of drugs that slow bone loss.
  • Estrogen-related therapy: This mimics the estrogen hormone to help improve bone mass density, particularly in menopausal females.
  • Parathyroid hormone analogs: This works by giving a person a synthetic form of the parathyroid hormone. It helps to regulate calcium distribution in the body.

There are several measures a person can take to prevent osteoporosis. These include:

  • Consuming foods that support bone health: A person should aim to get enough calcium, Vitamin D, and protein each day. In some cases, a person may want to consider supplements.
  • Increasing physical activity: Weight-bearing activities such as walking, dancing, and strength training can help build and strengthen bones.
  • Considering stopping smoking: As smoking can increase the risk of weakening bones, a person may consider quitting to lower the risk of developing the condition.
  • Limiting or reducing alcohol consumption: Similar to smoking, alcohol can weaken bone. As such, it is advisable to avoid alcohol or drink in moderation.

Genetics can play a role in the development of osteoporosis. Typically, this will involve variations in genes that help with bone health. As such, issues with these genes can affect bone density and increase the risk of fractures.

However, osteoporosis is multifactorial. This means that many other risk factors can also contribute toward the likelihood of developing the condition.