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Can Cystic Fibrosis Cause Osteoporosis and Osteopenia?

Now that people with cystic fibrosis are living into middle age, complications normally associated with aging are becoming more common. Bone disease such as osteoporosis and osteopenia are two of those complications because lung disease, bone disease, and nutrition are all connected.1-3

  • Osteoporosis means the bones are less thick or less dense, and weak.
  • Osteopenia means the bones have fewer minerals and are weak and brittle.

Both osteoporosis and osteopenia make a person’s bones more likely to break or fracture.

Osteoporosis and osteopenia are rare in children with CF. It becomes more common in the late teens and adulthood. Bone disease is also a frequent side-effect of a lung transplant.

Bone disease reported in people with CF 20172

Condition
Under age 18
Age 18 and older
Osteopenia
1.4%
19%
Osteoporosis
0.5%
7%


How does cystic fibrosis contribute to osteoporosis and osteopenia?

Several of the complications of cystic fibrosis contribute to bone disease, including low body weight, malabsorption of fat-soluble vitamins, lower pancreatic function, CF-related diabetes, chronic infections, and low sex hormones.

Many of the medicines that people with CF take to control their disease can impact bone health too. These include steroids, antacids, and immune suppression drugs used after transplant.

All five mutation classes of CF seem to be affected by bone disease at equal rates.2

How are osteoporosis and osteopenia diagnosed?

A bone density test measures the density and mineral content of the bones. This test is called a dual-energy X-ray absorptiometry (DEXA) scan.

Your medical team may also run a lab test to check your Vitamin D levels. The CF Foundation recommends that all people with cystic fibrosis get a DEXA scan by age 18 and then again every one to five years.1,2

What are ways to manage and treat osteoporosis and osteopenia?

There are many steps you can take to improve bone health. These steps include:

  • Get regular, load-bearing exercise such as walking, jogging and weight-lifting.
  • Eat a well-balanced, high-calorie diet.
  • Take the right amount of pancreatic enzymes to maximize nutrient absorption.
  • Avoid alcohol, caffeine, carbonated drinks, and tobacco products.
  • Take calcium and Vitamin D supplements and eat plenty of dairy products which are rich in Vitamin D and calcium.3

Medicines called bisphosphates may be given to help stop osteoporosis or reverse it in people who have had fractures or an organ transplant.2

Written by: Jessica Johns Pool | Last reviewed: September 2019
  1. Cystic Fibrosis Foundation. Nutrition: Bone Health and Cystic Fibrosis. Available at: https://www.cff.org/PDF-Archive/Bone-Health-and-Cystic-Fibrosis. Accessed 5/6/2019.
  2. Cystic Fibrosis Foundation. Patient Registry Annual Data Report 2017. Available at: https://www.cff.org/Search.aspx?topic=230. Accessed 5/6/2019.
  3. Cystic Fibrosis Foundation. What Are the Causes of Bone Disease in CF? Available at: https://www.cff.org/Life-With-CF/Daily-Life/Fitness-and-Nutrition/Nutrition/Protecting-and-Maintaining-Bone-Health/What-Are-the-Causes-of-Bone-Disease-in-CF. Accessed 5/6/2019.