Mount Carmel Health Partners Clinical Guidelines Osteoporosis

Table E: Conditions, Diseases, and Medications that Cause or Contribute to Osteoporosis and Fractures Lifestyle Factors Alcohol abuse Excessive thinness Excess Vitamin A Frequent falling High salt intake Immobilization Inadequate physical activity Low calcium intake Smoking (active or passive) Cystic fibrosis Ehlers-Danlos Gaucher’s disease Hypophosphatasia Marfan syndrome Menkes steely hair syndrome Osteogenesis imperfecta Parental history of hip fracture Porphyria Androgen insensitivity Anorexia nervosa Athletic amenorrhea Hyperprolactinemia Panhypopituitarism Premature menopause (less than 40 yrs) Central obesity Cushing’s syndrome Diabetes mellitus (Types 1 & 2) Hyperparathyroidism Thyrotoxicosis Vitamin D insufficiency Genetic Diseases Riley-Day syndrome Hypogonadal states Turner’s & Klinefelter’s syndromes Endocrine Disorders Gastrointestinal Disorders Celiac disease Gastric bypass Gastrointestinal surgery Inflammatory bowel disease Malabsorption Pancreatic disease Hemophilia Leukemia and lymphomas Monodonal gammopaties Multiple myeloma Sickle cell disease Systemic mastocytosis Primary biliary cirrhosis Hematologic Disorders Thalassemia Rheumatologic and Autoimmune Diseases Ankylosing spondylitis Other rheumatic and autoimmune diseases Rheumatoid arthritis Systemic lupus Neurological and Musculoskeletal Risk Factors Epilepsy Multiple sclerosis Muscular dystrophy Parkinson’s disease Spinal cord injury Stroke Aids/HIV Alcoholism Amyloidosis Chronic metabolic acidosis Chronic obstructive lung disease Congestive heart failure Depression End stage renal disease Hypercalciuria Idiopathic scoliosis Post-transplant bone disease Sarcoidosis Aluminum (in antacids) Anticoagulants (heparin) Anticonvulsants Aromatase inhibitors Barbiturates Cancer chemotherapeutic drugs Depo-medroxyprogesterone (premenopausal contraception) Glucocorticoids (≥ 5 mg/d prednisone or equiva- lent for ≥ 3 months) GnRH (Gonadotropin releasing hormone) agonists Methotrexate Parental nutrition Miscellaneous Conditions and Diseases Weight loss Medications Lithium Cyclosporine A and tacrolimus This clinical Proton pump inhibitors guide- Tamoxifen® (premenopausal use) Selective serotonin reuptake inhibitors Thiazolidinediones (such as Actos® and Avandia®) Osteoporosis - 4 Thyroid hormones (in excess)

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