Bone thinning: what are its causes? Can it be influenced by diet?

Bone thinning occurs when there is a loss of bone mass. If this bone mass is not renewed and new bone is not added, a disease condition occurs.

During a person's lifetime, gradual bone remodelling and regeneration is normal. Some of the old bone mass is continuously broken down and new bone tissue is formed to replace it.

As a result of disease or ageing, this renewal may be impaired. The most common cause of bone thinning is old age.

Age and gender

In old age, old bone tissue is replaced by new tissue only in very limited quantities, especially in people over 70 years of age. Bone thinning also makes bones more susceptible to fracture or other injury.

Fractures can occur even with seemingly innocuous bumping. In women, excessive bone thinning can also occur due to the absence of the hormone estrogen after the transition (menopause).

Bone diseases

Bone thinning is also typical of a musculoskeletal disease called osteoporosis, a metabolic disease of the bone tissue in which the amount of bone mass and the quality of the bone is reduced.

Osteoporosis most often affects women and is typically manifested by back pain and a reduction in height. Osteoporosis can also be caused by a calcium deficiency. Often osteoporosis is accompanied by scoliosis.

It can be primary or secondary. Primary is divided into type I and type II. The first type occurs after the menopause and is also determined by age. It most often occurs between 55 and 65 years of age.

The second type is senile osteoporosis, which occurs after the age of 70. The other type is idiopathic osteoporosis. This occurs at any age and its cause is unknown.

Secondary osteoporosis is caused by disease. It can be endocrine, hereditary, diabetes, malabsorption, tumour. One of the causes is long-term immobilisation.

Osteoporosis manifestations may not be observable. They are often encountered incidentally, during X-ray examination. Its main features include:

• deformation of the figure
• distortion of the curvature of the spine
• reduction in height (even more than 10 cm)
• pain, which is aggravated by movement and strain
• pain in the spine, especially when standing for long periods, walking, changing position
• sudden, sharp pain in the lower thoracic and upper lumbar spine
• frequent fractures of the femur, humerus, wrist and vertebrae

What other diseases still affect thinning?

Also, several types of kidney disease or rheumatic diseases have an influence on the development of osteoporosis. Some diseases of the digestive system also have an influence on bone thinning. This is the case, for example, in hemochromatosis.

This is a disease of the liver caused by excessive deposition of iron in the tissues in the form of ferritin and hemosiderin. Subsequently, toxic damage to these tissues also occurs. Thus, deposition can also occur in the joints and bones and damage them.

Another problem is celiac disease, which is a disorder of the digestive system in which the gut cannot process a mixture of proteins called gluten. It is a chronic autoimmune disease of the gut.

There is bone pain, joint pain, impaired absorption of vitamins from the gut into the bone marrow, and there is also a breakdown of calcium from the bones. So there is a metabolic predisposition for thinning of the bones.

Crohn's disease and ulcerative colitis are examples of the same. In this case, there is even talk of separate diseases in the form of metabolic osteopathy or osteomalacia.

Even in some endocrinological diseases, there are problems with bone thinning and the quality of the bone tissue itself, for example in Cushing's syndrome.

This disease is characterised by an increased production of cortisol. Cortisol is a steroid hormone that is required for the regulation of carbohydrate metabolism. However, as a result of increased cortisol levels, there are also problems with calcium metabolism, which in turn results in thinning of the bones.

Osteoporosis can also be caused by thyroid or parathyroid disease, which is actually an endocrine disease.

Kidney disorders

The kidneys can also have an effect on bone thinning and bone quality. For example, kidney inflammation can also cause this bone quality disorder in the body. The kidneys have the task of cleaning the blood of waste substances and products. If they become inflamed and fail, they cannot perform this function fully. If the kidneys are chronically failing, other diseases such as anaemia or bone problems can also be associated in the body.

Bone thinning even in anorexia

Bone thinning problems also occur in eating disorders, such as anorexia. These are psychological eating disorders in which a person tries to lose weight. For this reason, he or she either refuses food and nourishment or tries to exercise excessively or otherwise expel digested food from the body. Due to the restriction of the quantity but also the quality of food, various nutritional disorders occur. Dehydration, metabolic disorders and a decrease in bone density are manifested.

Drugs with a negative effect

Some drugs also have an effect on bone thinning. These are mainly representatives of glucocorticoids. They are used because of their anti-inflammatory effect.

Some antiepileptics and antidepressants have a negative effect on bones. Some drugs used in cancer and also immunosuppressants are similarly affected.

Lifestyle and bones

Lifestyle also has a negative impact on bone quality. Reduced physical activity contributes negatively. Dietary deficiencies of calcium and vitamin D are equally serious. So are alcohol and smoking.