Is Osteoporosis Genetic? Doctors Reveal Risk Factors That May Weaken Your Bones

You know that certain things are passed along through genes, such as personality traits, abilities or eye color. But what about your bone health? Is osteoporosis genetic, too? Unfortunately, the answer is yes.

“Osteoporosis is a polygenic disorder, meaning that there are several genes which contribute to bone mass and fracture risk,” says Rubina A. Malik, MD , a geriatrician and osteoporosis expert with the Montefiore Health System, and an associate professor of medicine at Montefiore’s Albert Einstein School of Medicine in Bronx, NY.

In fact, “there are actually more than 50 genes [linked to osteoporosis], and many possible combinations of these can lead to low bone density ,” says endocrinologist Roberto Pacifici, MD , a professor of medicine and the director of the division of endocrinology at the Emory University School of Medicine in Atlanta, GA.

Here’s everything you need to know about genetic risk factors for osteoporosis, plus other factors that may up the odds of weak or brittle bones.

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Osteoporosis is genetic: Here’s who’s most at risk

The parental gene connection is especially strong when it comes to genetic risk for osteoporosis, says Dr. Pacifici. “Parents are the number one predictors, and the genetic transmission can come from either parent,” he says. But if your mother in particular has osteoporosis, you’re more likely to develop it, he adds. And the more severe your mother’s osteoporosis was, the more likely it will be for you, too.

“Women are also at an increased risk of osteoporosis if she has two or more relatives with the bone disease,” adds Dr. Malik.

Your family history of osteoporosis is so important that a study in The Journal of Rheumatology suggests that genes may account for 50 to 85 percent of postmenopausal women’s osteoporosis risk.

In general, a family history of fractures in a first-degree relative (parent, sibling or child) increases your risk of developing a fracture three-fold, Dr. Malik adds.

How osteoporosis genes affect bone health

Your genes can influence your skeletal size, bone structure, cell formation in bones and your bones’ mineral content. “Some of the genes connect to the most important and abundant protein in the bone, which is collagen, and how much of it we produce,” says Dr. Pacifici.

Other genes control the way we metabolize and regulate vitamin D, adds Dr. Pacifici. Vitamin D helps the body absorb calcium, the main mineral needed to build and maintain strong, healthy bones.

Some genetic variants can disrupt the communication between cells involved in bone repair and maintenance, while other genes may affect muscle mass and activity levels (both of which impact bone health).

A bone density test helps determine osteoporosis risk

If you have any risk factors for osteoporosis, including a genetic connection, it may be a good idea to have your bone density tested as early as the age of 50. “It’s important for most women to have a bone density test around menopause because it’s a much easier way to prevent bone loss,” Dr. Pacifici says.

And remember: Just because you may have inherited genes associated with osteoporosis doesn’t mean you’re going to develop it. A family history simply means your risk is higher—not that osteoporosis is inevitable .

Additional osteoporosis risk factors

Half of women over the age of 50 will break a bone as a result of osteoporosis, the Bone Health and Osteoporosis Foundation reports. “Women are more at risk for developing osteoporosis than men because women generally have lower peak bone mass,” says Dr. Malik. Another key component is race: white and Asian women have the highest risk of osteoporosis, Dr. Malik notes.

Here we break down six other common osteoporosis risk factors (some preventable) to reduce your risk of developing the condition:

Menopause

Women can lose up to 20 percent of their bone density during the five to seven years after menopause. Why? “The drop in estrogen levels impacts bone cells,” says Dr. Malik. “These changes can result in increased bone turnover and bone loss leading to osteopenia (lower than normal bone density) and eventually osteoporosis. ”

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Taking certain medications

According to the International Osteoporosis Foundation , some medications have side effects linked to osteoporosis or an increased risk of fractures. These drugs include long-term glucocorticoid therapies such as prednisone, proton pump inhibitors, thyroid hormone treatment (L-thyroxine), anti-coagulants, some antidepressants and certain cancer and diabetes drugs.

Rapid weight loss

“Excessive dieting and excessive weight loss over a short period of time is detrimental to bone health because of the loss of bone nutrients,” says Dr. Malik. A study in the The Journal of Nutrition found that people who lost a greater amount of weight during a three to four month period had significant bone loss compared to those who lost weight more moderately over six months.

Smoking

Quitting smoking is vital to cut osteoporosis risk and keep your bones strong. Smoking reduces blood supply to your bones, slows the production of osteoblasts (bone-forming cells) and decreases calcium absorption in your diet.

Because smoking weakens bones and makes them more brittle, the habit nearly doubles the risk of hip fracture compared to risk in non-smokers, reports the International Osteoporosis Foundation .

Inflammatory health conditions

Any condition that causes chronic inflammation, such as lupus, rheumatoid arthritis and inflammatory bowel disease (IBD) can cause bone loss, says Dr. Pacifici.

Chronic inflammation can damage bones and reduce bone density, making bones more susceptible to fractures, found a study in Frontiers in Endocrinology . The researchers also found that autoimmunity can decrease bone-strengthening calcium levels in the body.

Other health conditions linked to a greater risk of osteoporosis and fractures include diabetes and hyperthyroidism , according to a study in the Best Practice and Research Clinical Endocrinology and Metabolism .

Being petite

Research has found bone mineral density and skeletal frame size are key predictors of future bone health. A petite frame and lower bone density are associated with an increased risk of fractures. Slimmer people with a slighter frame are more apt to develop osteoporosis because they have less bone mass to draw against as they age.

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This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan .