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Bone quality is a significant factor that affects the development of osteoporosis. This parameter is determined by bone mass (as measured by bone density) and also by the micro-architecture of bone. Bone density at any given time depends on both the peak bone density achieved during development and subsequent adult bone loss. Collectively, these affect the relative intactness of bones, with respect to tensile strength, fragility and freedom from fatigue damage. Many studies demonstrate the ability of bone density to predict fractures, especially fragility fractures (those caused by minor trauma). The risks vary depending on the populations studied and on the technique of measuring the bone density.
Nonmodifiable risk factors
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Advanced age : Bone density increases dramatically during puberty in response to gonadal hormone release and eventually reaches values in young adults that are nearly double those of children. After peak bone density is reached, bone density remains stable for years and then declines. |
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Gender : Considerable evidence suggests that bone loss begins before menses cease in women and in the third to fifth decade in men. In women, once the menopause is established, the rate of bone loss is accelerated several-fold. The chances of developing osteoporosis are greater for woman because they have less initial bone tissue and lose it more rapidly because of the changes involved in the menopause. |
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Family history and personal history of fractures as an adult : Susceptibility to fracture may be, in part, hereditary. Young women whose mothers have a history of vertebral fractures also seem to have reduced bone mass. A personal history of a fracture as an adult also increases fracture risk. |
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Race : Caucasian and Asian women are more likely to develop osteoporosis.. |
Potentially modifiable risk factors
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Bone structure and body weight : Small-boned, fair-skinned, and thin women are at greater risk. |
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Estrogen deficiency : Normal or early menopause (brought about naturally or because of surgical removal of the ovaries) increases the risk of developing osteoporosis. A menstrual history of late-onset menses, or of amenorrhea (absence of menstrual periods) also increases risk. |
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Lifestyle : Stress, smoking, excess alcohol consumption, and a sedentary lifestyle are associated with the development of osteoporosis. |
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Diet : A high intake of caffeine, phosphorous, or protein, and a diet poor in calcium and vitamin D affect bone formation. |
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Poor eyesight : Impaired eyesight despite adequate correction can lead to falls. |
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Poor health/frailty Medications : A number of drugs taken for other conditions can have an affect on osteoporosis, either because they interfere with bone formation or accelerate its loss. |
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Chronic health problems : Diseases such as chronic liver disease, chronic liver failure, endocrinopathies (eg, diabetes, hyperthyroidism), malabsorption syndromes, rheumatoid arthritis, and chronic anorexia can also be risk factors for osteoporosis. |
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From TCM's viewpoint, osteoporosis is caused by a kidney deficiency. As people get older, the essential qi (jing) of the kidney gradually declines and results in a lack of nutrients for the bones to grow and function properly. This causes the bones to become fragile and break or deform easily. Bone fractures can be hard to heal due to the lack of nourishment and kidney deficiency.
Click here to see cause of osteoporosis from a TCM perspective.
The causes of kidney deficiency leading to osteoporosis are as follows:
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Exhaustion of kidney essence.
Kidney essence may be depleted in one of three ways:
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A congenital deficiency (a deficiency you are born with) and the aggravation of external factors, such as excessive sexual activities and frequent childbirth, cause the kidney essence to become severely depleted. This leads to loss of bone nutrients. |
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The elderly are especially vulnerable to osteoporosis if they do not take good care of their bodies because the depletion of kidney essence accelerates with age. |
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Exogenous pathogens can easily invade and damage the kidney when vital qi (energy) is insufficient. This causes the development of osteoporosis. . |
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Acquired Deficiency
Under normal conditions, the spleen and stomach are responsible for changing digested nutrients into qi, blood, and acquired (postnatal) jing. Over-consumption of alcohol and food can damage the spleen and stomach and reduces the amount of jing available to nourish the bone, bone marrow and muscle. Additionally, when the stomach and spleen dysfunction, a decline in formation of qi and blood results and this can contribute to osteoporosis development. |
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Invasion of exogenous pathogens
Osteoporosis can occur when external cold and dampness evils, which are exogenous pathogens, invade the body and impair the vital qi (energy) and kidney qi. This leads to a deficiency of kidney essence (jing) and a failure in the bone marrow to replenish the nutrients needed to retain bone strength. Other symptoms such as lumbago (back pain) and arthralgia (joint pain) can occur when cold and dampness evils stagnate in the tendons and joints, blocking the circulation of qi and blood in that area.
TCM followers believe that external cold and dampness pathogens can invade the body under the following conditions:
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Living in cold and moist areas for a long time |
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Exposure in a windy place while drinking alcohol |
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Bathing or taking a shower while sweating |
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Eating too much cold food and |
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Lying in damp and moist open areas such as wet grassy fields. |
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