A group of health conditions that negatively affect the bone mass, bone turnover, and bone growth is called metabolic bone disease. Normally, the bones grow and change constantly throughout our lives. Usually, new bone cells replace old ones every 10 years or so.
Commonly, people develop metabolic bone disease due to mineral imbalances (such as increased or decreased levels of Calcium, Phosphorus, or vitamin D), genetic conditions, vitamin deficiencies, and others. While metabolic bone disease can be present at birth (congenital), it can be acquired later in life.
In general, the frequency of these conditions is different. For example, osteoporosis affects about 12.6% people over 50 in the U.S. However, osteogenesis imperfecta (OI) occurs less commonly than osteoporosis. It affects about 25,000 to 50,000 people in the U.S.
Metabolic Bone Diseases Types
One of the most common metabolic bone diseases is osteoporosis. It affects about 200 million people in the world, and it causes a loss of bone mass. As a result, people who develop this condition may experience bone weakness and an increased risk of bone fractures. Sometimes, people may also develop osteopenia, which is a less serious form of low bone density. Check below for other types of metabolic bone diseases:
- Hypophosphatasia
- Osteogenesis imperfecta
- Osteomalacia (also known as rickets in children)
- Paget’s disease
- Cushing syndrome
Symptoms
Usually, people who develop metabolic bone diseases experience the following symptoms. Check some examples below:
- Broken bones
- Walking problems
- Posture changes (stooping or bending forward)
- Low back pain
- Weakness of the muscles
- Pain in the bones or hips
- Breathing problems (reduced lung capacity is often caused by compressed or pinched disks in the spine)
- Reduced height
If any of the previous symptoms occur, immediately visit a doctor. You should also know that osteoporosis is considered a silent disease because it does not cause pain.
Causes and Risk Factors
People often develop metabolic bone diseases due to reduced or a lack of minerals in the bones that gradually weaken or damage them. Thus, mineral imbalances that occur at birth or develop later in life negatively affect mineral homeostasis, which makes sure your body has enough Calcium, vitamin D, and Phosphorus. These minerals are stored in bones for rebuilding and growth.
However, some factors may put you at increased risk of developing these disorders. Check some examples below:
- Age – Older adults (over 65 years old) are more prone to metabolic bone diseases.
- Early menopause (before 45 years old)
- Smoking
- Hormone therapy for breast or prostate cancer
- Organ transplant
- Prolonged use of antiseizure medicines
- Family history – If you have a parent or sibling with a metabolic bone disease, your risk of developing it significantly increases.
- Lack of physical exercise
In addition, people who already have the following conditions are at higher risk of metabolic bone diseases. Check below some health conditions often related to metabolic bone disease:
- Hypophosphatemia (reduced Phosphorus in the blood)
- Hyperparathyroidism
- Vitamin D or Calcium deficiency
- Kidney disease
- Alcohol use disorder
- Malnutrition
- Malabsorption
Complications
Those who develop metabolic bone diseases may also experience some complications, especially if they leave it untreated. Check some complications below:
- Fragility fractures – this is one of the most common complications that causes fractures in the spine (vertebral compression fractures), hip, and wrist, even with minimal trauma.
- Bone pain and deformities
- Skeletal deformities and loss of height – Usually, people develop kyphosis (hunched posture) due to vertebral fractures.
- Reduced mobility and disability – These include loss of independence, reduced quality of life, and long-term (chronic) disability (in rare cases). The previous health problems often occur due to chronic pain and fractures.
- Cardiovascular and vascular calcification – In some cases, people with renal osteodystrophy (CKD-related metabolic bone disease) may have Calcium deposits in their blood vessels.
- Muscle weakness
- Kidney stones
The previous list does not contain a complete list of metabolic bone disease complications. In any case, you can consult with your physician about ways to reduce the risk of developing them.
How to Prevent Metabolic Bone Disease?
While genetics plays a role in multiple types of metabolic bone diseases, doctors may recommend some tips to reduce the risk of developing them. For example:
- Preventive screenings for bone conditions (such as osteoporosis)
- Quit smoking – Do not hesitate to see a doctor if you have problems with smoking cessation.
- Limit or avoid alcoholic drinks
- Regularly perform physical exercise
- Adopt a Calcium and vitamin D-rich diet
Diagnosis
Usually, metabolic bone disease is diagnosed by performing the following tests. For example:
- Blood tests – These tests are often done to check for the levels of Calcium, Phosphorus, and vitamin D in the blood. Sometimes, reduced levels of Calcium, vitamin D, or Phosphorus may indicate osteomalacia.
- X-rays – This is an imaging test used to check for cracks and fractures. It is often performed in people with osteoporosis.
- BMD (bone mineral density) test – Sometimes, this test is called a dual-energy X-ray absorptiometry (DEXA or DXA) scan. It also involves a small dose of radiation that helps show the strength of the wrist, hip, and spine bones. This test is often performed by doctors in people with an increased risk of bone loss and fractures.
Treatment
Fortunately, there are some treatments available. Doctors often recommend the following options to relieve the symptoms and prevent serious complications. For example:
- Vitamins and supplements
- Bisphosphonates
- Bone-building medicines (such as anabolic agents)
- Physical therapy
- Weight-bearing exercises
- Surgery
- Denosumab injections
- Hormone-related therapy (including Testosterone, calcitonin, and Estrogen)
The previous treatments may cause some adverse reactions, especially if they are used for long periods. Examples include heartburn, headaches, flu-like symptoms, muscle pain, impaired kidney function, and others. Discuss it with your doctor for more details.
Frequently Asked Questions
How soon after treatment will I notice improvements?
Usually, people notice improvements right after starting the treatment. However, the recovery of bone mass may take a longer time.
Is metabolic bone disease serious?
The only way to prevent serious complications is early diagnosis and proper treatment. Otherwise, this condition can be dangerous. For instance, if you develop osteoporosis, you are more prone to fractures.
Can you reverse metabolic bone disease?
Sometimes, doctors are able to reverse damage caused by this condition, but it often occurs when the condition is found early, and the affected person gets treatment as soon as possible. Ask your healthcare provider if you have any other questions.
