What is the Difference Between Primary and Secondary Osteoporosis

The key difference between primary and secondary osteoporosis is that primary osteoporosis is a type of osteoporosis where bone loss occurs during normal human aging, while secondary osteoporosis is a type of osteoporosis where bone loss occurs as a result of well-defined clinical disorders or the usage of some medications.

Osteoporosis is a bone condition that occurs when bone mineral density and mass decrease gradually. In osteoporosis, the quality or structure of bone changes as well. Osteoporosis falls into one of two categories: primary and secondary. Primary osteoporosis is associated with the normal process of aging, while certain medical conditions cause secondary osteoporosis.

CONTENTS

1. Overview and Key Difference
2. What is Primary Osteoporosis
3. What is Secondary Osteoporosis
4. Similarities – Primary and Secondary Osteoporosis
5. Primary vs. Secondary Osteoporosis in Tabular Form
6. Summary – Primary vs Secondary Osteoporosis

What is Primary Osteoporosis?

Primary osteoporosis is due to the progressive loss of bone density and bone mass by the normal aging process. People who suffer from primary osteoporosis are at an increased risk of fractures, even through minor bumps and falls. Primary osteoporosis is known as a silent disease as it usually does not cause any symptoms. Bone fractures in this condition can occur in the hips, wrist, and spine and in other bones as well. However, when symptoms do occur, they may include severe back pain, loss of height, postural problems like hunched or stooped over posture, and spinal fractures. The risk factors for this condition include sex (women are more likely to develop), age (aging), race (Caucasian and Asian people have a higher prevalent, body type (people with slender, small, thin bones are at higher risk), family history, menopause, smoking, poor diet, and sedentary lifestyle.

Moreover, primary osteoporosis can be diagnosed through medical history, fracture risk assessment tool (FRAX), bone density tests, and dual-energy X-ray absorptiometry (DEXA) tests. Furthermore, treatment options for primary osteoporosis may include hormone replacement therapy, medications such as bisphosphonates, calcitonin, estrogen receptor modulators, prolia, anabolic steroids, lifestyle choices (regular exercises, quitting smoking, etc.), and alternative therapy (relaxation techniques, such as stretching, meditation, or yoga).

What is Secondary Osteoporosis?

Secondary osteoporosis is characterized by the loss of bone density leading to increased fragility and susceptibility to fractures arising from an underlying medical condition or medication side effects. Symptoms may encompass fractures of the hip, wrist, and vertebrae, as well as seemingly innocuous actions such as sneezing or coughing, causing fractures and a stooped posture resulting from spinal bone fractures.

The risk factors for secondary osteoporosis include certain medical conditions such as hyperparathyroidism, hyperthyroidism, diabetes mellitus, inflammatory bowel disease, rheumatoid arthritis, lupus, celiac disease, chronic kidney disease, liver disease, ankylosing spondylitis, multiple myeloma, multiple sclerosis and anorexia nervosa, hormones and medications that affect the endocrine system (thyroid hormone, glucocorticoids, etc.), medications that affect the immune system (antiretroviral therapy), medications that act on the central nervous system (antidepressants), and medications that affect the gastrointestinal tract (proton pump inhibitors).

Secondary osteoporosis can be diagnosed through medical history, physical examination, blood tests to assess thyroid function, and DEXA or ultrasound scans. Furthermore, the treatment options for secondary osteoporosis may include treating the underlying medical cause, reducing medication dosages, Vitamin D supplementation, testosterone replacement, treating glucocorticoid-induced osteoporosis, bisphosphonates, parathyroid hormone (PTH) antagonists, and weight-bearing exercise.

What are the Similarities Between Primary and Secondary Osteoporosis?

• Primary and secondary osteoporosis are two types of osteoporosis.
• Both types may have similar symptoms, such as bone fractures, mobility issues, etc.
• They can be diagnosed through physical examination and bone scans.
• They are mainly treated through lifestyle changes and specific medications.

What is the Difference Between Primary and Secondary Osteoporosis?

Primary osteoporosis is a type of osteoporosis where bone loss occurs during the normal human aging process, while secondary osteoporosis is a type of osteoporosis where bone loss occurs as a result of well-defined clinical disorders or usage of some medications. Thus, this is the key difference between primary and secondary osteoporosis. Furthermore, primary osteoporosis is more common in women, whereas secondary osteoporosis is more common in men.

The infographic below presents the differences between primary and secondary osteoporosis in tabular form for side-by-side comparison.

Summary – Primary vs Secondary Osteoporosis

Osteoporosis makes bones become weak and brittle. Therefore, bone fractures can be caused by a fall or even mild stress, such as bending over, coughing, etc. Osteoporosis occurs when the creation of new bone does not match the speed of the loss of old bone. Primary and secondary osteoporosis are two types of osteoporosis. Primary osteoporosis is the bone loss that occurs during the normal human aging process, while secondary osteoporosis is the bone loss that occurs due to underline medical conditions or medications. So, this summarizes the difference between primary and secondary osteoporosis.

Reference:

1. “Primary Osteoporosis – An Overview.” ScienceDirect Topics.
2. “Secondary Causes of Osteoporosis.” Mayo Clinic Proceedings.

Image Courtesy:

1. “Depiction of an Osteoporosis patient” By Myupchar (CC BY-SA 4.0) via Commons Wikimedia