Is your Child or Teenager at risk of Osteoporosis?

Most people are shocked to hear that children can be affected by osteoporosis. At present, there are no statistics available regarding children, however, no child should be left at risk of this disease.

Anyone under 21 years of age who breaks bones easily or has risk factors for bone loss, should be investigated. A child being on a medication that causes bone loss, for example, a steroid asthma inhaler, should have a DXA scan done, so a plan can be put in place to reduce their risk of fracturing. Children at risk can only be scanned on a DXA machine that has the additional software for children. They will also need an X-ray of their non-dominant hand, as it is necessary to check their chronological age with their bone age. This is because their hips will not be fully developed, so only the bones in their spine are analysed in the results. It is important that parents seek advice and treatment, from a specialist who deals with children with bone disorders.

The following are a list of risk factors that can place a child at risk of developing osteoporosis. Some are the secondary effects of a disease and/or the treatment for a disease that can place a child at risk, others are genetics or lifestyle.

  • Genetics, a family history, especially if combined with a second risk factor.
  • Metabolic disorders
  • Osteogenesis imperfecta: a genetic abnormality that affects the collagen in the bone, characterised by bones that break easily, often from no apparent cause.
  • Idiopathic juvenile osteoporosis (IJO) if no cause of bone loss can be found
  • Marfan’s and other collagen abnormalities.
  • Cerebral Palsy if mobility (walking-weight bearing exercise) is affected.
  • Wheelchair-bound, or bed-bound for 6 weeks or permanently.
  • Muscular Dystrophy if the secondary effects of mobility (walking) is affected.
  • Juvenile arthritis or Rheumatoid arthritis. The disease itself and steroids which are used to treat these diseases, can affect bone and/or if the child’s walking is impaired.
  • Asthmatics being treated with steroids – low dose, long-term, or high dose short-term, can cause bone loss and place a child at risk.
  • Malabsorption problems such as Coeliac disease (Gluten and wheat sensitivity) and irritable bowel syndrome (IBS), can mean calcium, vitamin D, and other nutrients are not properly absorbed from the intestine which affects bone.
  • Ulcerative Colitis and Chron’s disease, as treatments are usually steroid-based which cause bone loss.
  • Corticosteroid medications cause bone loss.
  • Chemotherapy and/or Radiation both cause bone loss.
  • Anorexia Nervosa and/or Bulimia, past or present history causes significant bone loss in children.
  • Over-exercising with and without being associated with inadequate nutrition, resulting in loss of periods or no period for more than 3 months (other than pregnancy,) or periods not starting in the first place, causes bone loss.
  • Amenorrhea is when an athlete who has an eating disorder and over trains loses their periods, which causes bone loss.
  • Thyrotoxicosis, which is an overactive thyroid gland increases bone loss.
  • Cushing’s Syndrome is a condition in which your body makes too much of the hormone cortisol, which cause’s bone loss.
  • Hyperparathyroidism; Primary or secondary Hyperparathyroidism results in increased loss of bone.
  • Rickets (osteomalacia) is a severe vitamin D deficiency that affects bone.
  • Diabetes, those who are Insulin dependent are at higher risk of bone loss.
  • Smoking or drinking excess alcohol in teenagers