What to know about early onset osteoporosis

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Although osteoporosis mainly affects people over the age of 50, it can affect those of any age. If a person develops the condition before age 50, they have early onset osteoporosis.

However, research suggests that early onset osteoporosis is very rare.

Osteoporosis is a medical condition in which a person’s bones weaken and are more likely to break. The bones lose mass, change structure, and lose mineral density, meaning they gradually lose strength and become more fragile.

According to the United Kingdom’s National Health Service (NHS), people usually start gradually losing bone from about the age of 35. However, individuals with osteoporosis lose bone mass at a much faster rate.

People with osteoporosis may not know they have it until they experience falls or impacts that cause broken bones, or fractures. These individuals are more likeely to experience broken bones, most often in the:

• wrists
• forearms
• back
• hips

A person is unlikely to notice any pain or other symptoms of osteoporosis, such as spine malformations or a loss of height, until they experience a broken bone.

Conditions that may affect a person’s bone health and increase the risk of early onset osteoporosis include:

• inflammatory conditions, including:
  • inflammatory bowel disease
  • chronic obstructive pulmonary disease
  • rheumatoid arthritis
• endocrine disorders, such as:
  • hyperthyroidism
  • hypogonadism, which is when a person’s testes or ovaries do not function correctly
  • Cushing’s syndrome
  • type 1 diabetes
  • hyperparathyroidism
• cystic fibrosis
• celiac disease
• anorexia nervosa
• certain types of cancer

These conditions may directly affect bone fragility. Alternatively, their treatments may lead to bone fragility as a side effect. For example, one treatment for some inflammatory conditions is glucocorticoids. These medications may play a part in causing osteoporosis during childhood and adulthood.

Some individuals may have monogenic osteoporosis, in which a single variant in certain genes causes bone fragility.

Other osteoporosis risk factors may include:

• low calcium intake
• vitamin D deficiency
• low levels of exercise
• insufficient protein intake
• having a family history of osteoporosis or parents with a history of hip fractures
• heavy drinking
• smoking

Females are more likely to develop osteoporosis than males, particularly if they are white or Asian.

Healthcare professionals diagnose a person with early onset osteoporosis based on:

• low bone mineral density (BMD) test scores
• fracture (FRAX) risk score and bone fractures
• underlying conditions or secondary factors

Healthcare professionals use BMD testing to diagnose people with early onset osteoporosis. They often use a test called dual-energy X-ray absorptiometry (DXA). They use DXA testing to measure the BMD of a person’s overall skeleton and bodily areas that are more likely to fracture, such as their hips or spine.

DXA testing is quick and does not cause pain. Healthcare professionals assess two kinds of similar test results:

• T-scores, which compare a person’s BMD to young, healthy adults
• Z-scores, which compare a person’s BMD with the average BMD of those of the same age, sex, and body size

A T-score of -2.5 or less means a person has osteoporosis. If their Z-score is –2.0 or less, their BMD is low.

Treatments for osteoporosis usually include:

• medications to strengthen a person’s bones, such as bisphosphonates and biologics
• fall prevention methods to help prevent fractures
• lifestyle modifications, such as reducing alcohol intake, making dietary changes, and exercising regularly

Healthcare professionals will tailor treatments for each person, according to the severity of their osteoporosis and underlying conditions.

According to a 2021 study, early onset osteoporosis is rare, and scientists have not conducted many large studies into medication treatments. However, the studies that the research authors cited have indicated that addressing certain factors could reduce frequent fractures in children and adolescents. These factors include:

• levels of physical activity
• calcium intake
• vitamin D intake
• any underlying conditions associated with osteoporosis

Early onset osteoporosis is a rare condition, and there is a lack of studies into how it may affect a person’s life expectancy.

With early diagnosis and treatment, people with osteoporosis may have positive health outcomes. However, without treatment, they may develop chronic pain and hip or spinal fractures. These can lead to serious complications that affect their quality of life.

People with early onset osteoporosis develop the condition before the age of 50 and are more likely to have broken bones or fractures. This may lead to serious complications and reduced life expectancy.

Early onset osteoporosis is a rare condition.

Several conditions may increase a person’s risk of developing early onset osteoporosis, including inflammatory conditions, endocrine disorders, and anorexia nervosa.

Healthcare professionals use bone mineral density testing to diagnose early onset osteoporosis. Treatments include medications, fall prevention methods, and lifestyle changes.