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There are two types of osteoporosis:

• Primary osteoporosis - bone loss that occurs as a consequence of the normal aging process.
• Secondary osteoporosis - bone loss that occurs as a consequence of other factors such as a chronic medical condition, nutritional deficiency, or certain types of medications.

Primary Osteoporosis

Normal bone metabolism involves achieving a delicate balance between bone formation by cells called osteoblasts and bone resorption (removal) by cells called osteoclasts. This phenomenon is known as "bone remodeling" and is vital to enable the skeleton to increase in size during growth and development. Any factor that disrupts the delicate balance between bone formation and bone resorption can result in bone loss and, therefore, can increase the risk for developing osteoporosis.

In primary osteoporosis, increased bone loss and low bone density are due to the normal aging process. This type of osteoporosis is most often observed in women who have reached the age of menopause. In postmenopausal women, the rate of bone resorption increases dramatically with the onset of menopause and continues at a high rate throughout their lifetime leading to progressive bone loss. In men, primary osteoporosis is also associated with advancing age primarily due to loss of gonadal function.

Secondary Osteoporosis

Bone loss that due to secondary factors such as chronic medical conditions, nutritional deficiencies, or certain medications is known as secondary osteoporosis. Secondary osteoporosis may be caused by a variety of conditions including:

• Rheumatological disorders

  • rheumatoid arthritis
  • lupus
  • ankylosing spondylitis

• Endocrine disorders

  • Cushing's disease
  • hypogonadism
  • hyperthyroidism
  • hyperparathyroidism

• Gastrointestinal disorders

  • Crohn's disease
  • celiac disease

• Chronic liver or kidney disease

• Multiple myeloma
• Vitamin D deficiency
• Anorexia
• Alcohol abuse

• Medications

  • glucocorticoids
  • anticonvulsants
  • immunosuppressive drugs
  • some chemotherapeutic drugs used for the treatment of cancer
  • high doses of thyroxine
  • lithium
  • aluminum
  • heparin