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Causes Of Osteoporosis

As a matter of fact, there are a few causes of osteoporosis, usually mentioned in the literature as risk factors:

– being elderly

– females are at a higher risk than males

– lack of exercise

– drinking too many soda drinks

– eating too much red meat

– sugar and starchy foods (starchy foods like pasta, rice, potatoes and bread are digested into sugar within 30 minutes)

– drinking too much coffee and alcohol

-too little vitamin D3, vitamin K2 and vitamin E

(more publications on the importance of vitamin K2)

Fractures in postmenopausal women

It is important to realize that according to Dr. Murray (Ref. 11) 15 to 20% of all hip fractures in postmenopausal women are due to osteoporosis. Notably, one third of women with hip fractures have normal bone density. The other risk fractures are listed in the table below. For one thing, one or more of these factors can cause osteoporosis or a fracture. For example, at age 90 about 50% of females have osteoporosis whereas only 15% of males have it. To point out, one of the effects of smoking is to develop osteoporosis and in women this also contributes to an early menopause. To clarify, this is in itself a higher risk for osteoporosis (loss of progesterone and estrogen production). Indeed, high alcohol consumption such as more than 14 beer for women and more than 21 beer for men per week are an independent risk factor for osteoporosis.

It is low hormones, not age that is the cause of osteoporosis

In this case  hypogonadism may contribute to osteoporosis as it is associated with heavy drinking leading to lower testosterone and progesterone production. For the same reason hypogonadism from starvation (anorexia nervosa) or excessive athletic exercise is also a cause of osteoporosis. There is a strong hereditary factor in about 2/3 of all cases, but this may be an inherent tendency to produce too little progesterone. On the other hand Dr. Lee has tested bone mineral density (BMD) in 70 and 80 year old women on progesterone cream replacement and found that their BMD was NOT reduced (Ref.10). To put it another way, this turns the dogma of conventional medicine upside down that age would be a risk factor for osteoporosis.

Primary and secondary osteoporosis

Osteoporosis is usually divided into primary and secondary osteoporosis. As can be seen, with secondary osteoporosis there is another primary cause as shown in the table, which causes the osteoporosis. In other words, osteoporosis is only a symptom of another underlying disease, which affects bone metabolism. Primary osteoporosis means that this is the primary disease. Primary osteoporosis can be divided again into two osteoporosis types, type I and type II osteoporosis (see table below, modified from Ref. 1).

Causes of Osteoporosis


Primary Osteoporosis:

Type I : postmenopausal (low progesterone, low estrogen in women) or with andropause (low testosterone in men)

Type II : senile, possible lack of vitamin D utilization

idiopathic : age less than 50, possibly genetically caused

Secondary Osteoporosis:

endocrine : hyperthyroidism, hyperparathyroidism, hypogonadism, Cushing syndrome, diabetes

gastrointestinal : celiac disease, partial gastrectomy, liver disease like primary biliary cirrhosis

rheumatological : ankylosing spondylitis, rheumatoid arthritis

cancerous : multiple myeloma, bone metastases from cancer

drugs : heparin, corticosteroids, alcohol abuse

other : small frame, low BMI, conditions with poor balance and muscular weakness (MS, Parkinson’s, after stroke etc.)


Type I and type II osteoporosis

Type I osteoporosis is due to postmenopausal (or andropausal) bone changes. In this case osteoporosis occurs because of a lack of progesterone and also estrogen in women or a lack of testosterone in males. This affects the ages of 50 to 75 and leads to fractures of the radius close to the wrists (Colles’ fractures) or the tibia (ankle fractures).

Type II osteoporosis is the senile type, occurs beyond age 60 and usually affects the femoral neck (hip fractures), upper arm and upper tibia bones, the vertebral bodies and the pelvic bone. Interesting to note that men have a mortality from hip fractures of 30% at the age of 75 years. Women in that age have a mortality from hip fractures of only 9% (Ref.9).

Premarin versus bioidentical estrogen

While in North America Premarin was given for menopause, in many other countries including Europe women insisted on bio-identical estrogen replacement. These women were found to have only 50% of bone loss compared to North American women over the past 50 years, particularly when this was combined with bioidentical progesterone (Ref.8). In short, the real news is that the dogma of estrogen loss after menopause being the “cause” of osteoporosis in postmenopausal women is not true. Papers published in the 1980’s and early 1990’s have shown that it is a lack of progesterone that is the culprit: in short, progesterone stimulates osteoblasts in the female and testosterone stimulates osteoblasts in males, which leads to remodelling of bone all of our lives. Estrogen slows down bone resorption by osteoblasts, the other cells in the bone that are essential for bone remodelling.

Clinical trial done by Dr. John Lee regarding hormone supplementation

Dr. Lee has done a 3 year study in post menopausal women where he checked their bone marrow density following progesterone supplementation, estrogen supplementation and he also had a control group without any supplementation (Ref. 10, p. 76). In brief, the progesterone group who was treated with bio-identical progesterone cream had a 14% increase in bone marrow density, the estrogen group had a 3% increase and the control group with no treatment lost 4% bone density. Dr. Lee concluded that the cause of osteoporosis is a lack of progesterone production, which starts already 5 to 10 years before menopause; other factors are poor nutrition and a lack of exercise. Regardless, the synthetic hormones do not stimulate the cells involved in the remodelling process of bone.

Women need progesterone cream, men need testosterone cream to prevent osteoporosis

In essence, only bio-identical hormones will stimulate the natural receptors of the osteoblasts (building bone up)and osteoclasts (removing aged bone that would be brittle). As has been noted, women with osteoporosis need natural progesterone creams, men with osteoporosis need natural testosterone creams. However, nonetheless, attention needs to be paid to the other nutritional factors and to a regular exercise program.

Sugar, salt, caffeine and alcohol are causing osteoporosis

According to Ref. 9 the chief danger substances are sugar, salt, caffeine and alcohol. In like manner, we are filling our food baskets with empty calories and unknowingly deplete our food of vitamin B12, folic acid, copper, zinc, magnesium, manganese and calcium. Equally, excess cortisol from stress in our lives, and lack of testosterone, estrogen and progesterone all can contribute to osteoporosis. Moreover, vitamin D and calcium are important for normal bone matrix formation. In contrast, cola beverages are the worst combination to ruin your bones as there is sugar, caffeine and phosphoric acid in it.

Sugar, high protein diets, phosphorus can cause osteoporosis

According to Ref. 9 sugar depletes the body of calcium. The body excretes calcium in the urine. Surely, sugar also increases cortisol levels, the stress hormone that it known to cause osteoporosis in excess. In addition, high protein diets cause organic acids to accumulate in the body that are neutralized (buffered) by calcium having been mobilized from the bone. Another key point, phosphorus in colas is doing the same thing. With this in mind, caffeine from colas, coffee or tea increases calcium excretion in the urine.  It is important to realize that caffeine mobilizes calcium from bone as does does too much alcohol. To summarize, a healthy diet with fresh, unprocessed fruit and vegetables and whole grains will protect your bones.

Causes Of Osteoporosis

Causes Of Osteoporosis

Anabolic effects of progesterone, testosterone and growth hormone

Altogether, the anabolic effects of progesterone, testosterone and growth hormone help build up bone via stimulation of the osteoblast cells in the bone. With aging in the male and in the female the sex hormones decline (menopause and andropause) and cytokines such as interleukin-6 will stimulate osteoclast cells to destroy bone. It is only through careful saliva hormone test analysis with subsequent replacement using natural bio-identical hormones that the hormone balance normalizes and osteoporosis undergoes successful treatment (balancing of osteoblast and osteoclast activity in the bone).

Read more about hormone replacement in women and men under this link.

Significantly, researchers found that another hormone, melatonin has bone restoring properties:


1. ABC of rheumatology, second edition, edited by Michael L. Snaith M.D., BMJ Books, 1999.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 57.

3. B. Sears: “The age-free zone”.Regan Books, Harper Collins, 2000.

4. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper Collins, 1997.

5. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

7. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

8. Dr. Uzzi Reiss on page 100 of: Suzanne Somers:”The Sexy Years; discover the hormone connection: the secret to fabulous sex, great heralth, and vitality, for women and men”, Three Rivers Press, NY, 2004

9. Dr. Eugene Shippen and William Fryer: “The Testosterone Syndrome, the critical factor for energy, health & sexuality – Reversing the male menopause”. M. Evans, NY/USA, 2007.

10. Dr. John R. Lee: Natural Progesterone- The remarkable roles of a remarkable hormone”, Jon Carpenter Publishing, 2nd edition, 1999, Bristol, England.

11. Michael T. Murray, N.D.: “What the drug companies won’t tell you and your doctor doesn’t know” – The alternative treatments that may change your life – and the prescriptions that could harm you. Atria Books (subsidiary of Simon & Schuster Inc.), 2009.

Last modified: June 30, 2021

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.