Skeleton Pirate

Skeleton Pirate
Artist: LindaB


Have you experienced, or read about, negative, and even dangerous, side effects from Fosamax (alendronate), Boniva (ibandronate), Actonel (risedronate), and other bisphosphonates prescribed for osteoporosis? If you have, then rest assured there is a safe, effective treatment for this condition. Strontium, primarily in the form of strontium citrate, is taken orally once a day.

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Monday, December 15, 2014

Fixed Risk Factors for Osteoporosis

Fixed risk factors determine whether an individual is at heightened risk of osteoporosis. Also, unlike modifiable risks, they are factors which we can’t change, including age, gender and family history.
In addition, people may have secondary risk factors. These include disorders and medications that weaken bone and affect balance (heightening the risk of fracture due to falling). Read more about Secondary Osteoporosis.

Low bone mineral density, one of the most important indicators that a person is at risk of a fracture, is considered both fixed and modifiable since it is determined by a wide range of factors, including family history, age and lifestyle factors.

Although fixed risk factors for osteoporosis cannot be changed, people need to be aware of these risks so that they can take steps to reduce bone mineral loss as early as possible. These risks include:
The majority of hip fractures (90%) occur in people aged 50 and older. This is partly due to reduced bone mineral density as we age. But age can also be a risk factor independent of bone mineral density. In other words, even older adults with normal bone mineral density are more likely to suffer a fracture than younger people1.
Female gender
Women, particularly post-menopausal women, are more susceptible to bone loss than men, because their bodies produce less estrogen. This hormone is an important component in bone formation. Women are more likely to sustain an osteoporotic fracture than men. Lifetime risk of any fracture ranges between 40-50% in women, compared to 13-22% in men.
Family history
A parental history of fracture (particularly a family history of hip fracture) is associated with an increased risk of fracture that is independent of bone mineral density2.
Previous fracture
A previous fracture increases the risk of any fracture by 86%, compared with people without a prior fracture. Both men and women are almost twice (1.86 times) as likely to have a second fracture compared to people who are fracture free3.
Studies have found osteoporosis is more common in Caucasian and Asian populations, and the incidence of osteoporosis and fractures of the hip and spine is lower in black than in white people.
Menopause or hysterectomy
Hysterectomy, if accompanied by removal of the ovaries, may also increase the risk for osteoporosis because of estrogen loss. Post-menopausal women, and those who have had their ovaries removed, must be particularly vigilant about their bone health.
Long term glucocorticoid therapy
Long-term corticosteroids use is a very common cause of secondary osteoporosis and is associated with an increased risk of fracture4.
Rheumatoid arthritis
Rheumatoid arthritis and diseases of the endocrine system can take a heavy toll on bones. Hyperparathyroidism, for example, results in elevated levels of parathyroid hormone, which signals bone cells to release calcium from bone into the blood.
Primary or secondary hypogonadism in men
Like estrogen deficiency in women (which is observed in case of primary or secondary amenorrhea and premature menopause), androgen deficiency in men (primary or secondary hypogonadism) increases the risk of fracture.

At any age, acute hypogonadism, such as that resulting from orchidectomy for prostate cancer, accelerates bone loss to a similar rate as seen in menopausal women. The bone loss following orchidectomy is rapid for several years, and then reverts to the gradual loss that normally occurs with aging.
Secondary Risk Factors
Secondary risk factors are less prevalent but they can have a significant impact on bone health and fracture incidence. These risk factors include other diseases that directly or indirectly affect bone remodeling and conditions that affect mobility and balance, which can contribute to the increased risk of falling and sustaining a fracture.
Disorders that affect the skeleton:
  • Asthma
  • Nutritional/gastrointestinal problems (e.g. Crohn’s or celiac disease)
  • Rheumatoid arthritis
  • Hematological disorders/malignancy
  • Some inherited disorders
  • Hypogonadal states (e.g. Turner syndrome/Kleinfelter syndrome, amenorrhea)
  • Endocrine disorders (e.g. Cushing’s syndrome, hyperparathyroidism, diabetes)
  • Immobility
Medical treatments affecting bone health:

Some medications may have side effects that directly weaken bone or increase the risk of fracture due to fall or trauma. Patients taking any of the following medications should consult with their doctor about increased risk to bone health.
  • Glucocorticosteroids
  • Certain immunosuppressant (calmodulin/calcineurine phosphatase inhibitors)
  • Thyroid hormone treatment (L-Thyroxine)
  • Certain steroid hormones (medroxyprogesterone acetate, leutenising hormone releasing hormone agonists)
  • Aromatase inhibitors
  • Certain antipsychotics
  • Certain anticonvulsants
  • Certain antiepileptic drugs
  • Lithium
  • Methotrexate
  • Antacids
  • Proton pump inhibitors 
1. Kanis JA, Johnell O, Odén A, Dawson A, De LAet C, Jonsson B. Ten year probabilities of osteoporotic fractures according to BMD and diagnosis thresholds. Osteoporosis Int 2001; 12:989-95
2. Kanis JA, Johansson H, Odén A, Johnell O, De LAet C, Eisman JA, McCloskey EV, Mellström D, Melton LJ III, Pols HA, Reeve J, Silman AJ, Tenenhouse A. A family history of fracture and fracture risk: a meta-analysis. Bone 2004; 35:1029-37
3. Kanis JA, De LAet C, Delmas P, Garnero P, Johansson H, Johnell O, Kriger H, McCloskey EV, Mellstrom D, Melton LJ III, Odén A, Pols H, Reeve J, Silman A, tenehouse A. A meta-analysis of previous fracture and fracture risk. Bone 2004; 35: 375-82
4. Kanis J A, Johansson H, Odén A, Johnell O, De Laet C, Melton LJ III, Tenenhouse A, Reeve J, Silman AJ, Pols H, Eisman JA, McCliskey EV, Mellström D. A meta-analysis of prior corticosteroid use and fracture risk. J Bone and Miner Res 2004;19: 893-99


Chloe Jones said...

Hi BoneLady,

I don't know whether you might be able to help me? I work for a research company in the UK called Alterline (, and I am currently working on a research project to explore what life is like for people with osteoporosis in the US.

We are looking to get some people in the US with osteoporosis to take part in a video project in the new year, and I was wondering if you, or anyone else you know would be interested? The project would require people to film video diaries of their day-to-day life with osteoporosis, and will go towards a project that will help medical professionals understand the real life impact of the condition a little more.

All participants will remain anonymous. We will not share data with any third party.

If you have anymore questions, please do not hesitate to contact me by email or phone.

Best Regards,

Chloe Jones

BoneLady said...

Dear Chloe Jones,

I appreciate the work you are doing. I can help by posting your comments and mine for others to see and, possibly, respond. I would not be a good subject for several reasons: (1) I no longer have osteoporosis. Thanks to strontium citrate, my latest DXA scan showed I am at the osteopenic stage. (2) I have never had a fracture. (3) Because I have never fractured, my independence, mobility and quality of life are not in any way compromised.

The National Osteoporosis Foundation (NOF) recommends the osteoporosis support group at You may find more people for your project there.

I wish you much luck with your project. I see you have done work for the National Osteoporosis Society (NOS) in the UK.

Best Regards,


Wandering Skeleton

Wandering Skeleton
Artist: Joel Hoekstra

Osteoporotic Bone

Osteoporotic Bone

How Strontium Builds Bones

Strontium is a mineral that tends to accumulate in bone. Studies have shown that oral doses of strontium are a safe and effective way to prevent and reverse osteoporosis. Doses of 680 mg per day appear to be optimal. See my "For More Information About Strontium" links section.

Osteoporosis is caused by changes in bone production. In healthy young bones there is a constant cycle of new bone growth and bone removal. With age, more bone is removed and less new bone is produced. The bones become less dense and thus more fragile.

Scientists believe that strontium works in two ways. It may stimulate the replication of pre-osteoblasts, leading to an increase in osteoblasts (cells that build bone). Strontium also directly inhibits the activity of osteoclasts (cells that break down bone). The result is stronger bones.

When taking strontium, be sure to take 1200 mg calcium, 1000 IU vitamin D3, and 500 mg magnesium daily. It is best to take strontium late at night on an empty stomach. Calcium and strontium may compete with each other for absorption if taken together.