Osteoporosis in Multiple Sclerosis:
Risks, relations and influencing factors

Around six million people in Germany suffer from osteoporosis. The number of unreported cases may be higher, as osteoporosis often goes undetected. A 10-fold increase in the incidence of osteoporosis and osteopenia has been observed in multiple sclerosis patients. Osteopenia is a preliminary form of osteoporosis in which the density of the bones is reduced.

It is assumed that various influences such as a genetic link, lack of exercise, diet, long-term glucocorticoid therapy or low vitamin D levels in the blood can be responsible for an increased risk of osteoporosis. 60% of MS patients suffer a fall within 6 months. 60% of these falls are associated with injuries. Among other things, this is due to the limited mobility of MS patients and a corresponding

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There is also an increased risk of side effects from medications such as benzodiazepines, anticonvulsants or different antidepressants.

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Osteoporosis and Menopause

Oestrogen helps to promote bone formation in the body. Oestrogen production decreases during the menopause in women. If less oestrogen is produced during the menopause, there is also an increased risk of osteoporosis. Hormone replacement therapy is often used during the menopause. This contributes to bone health with an anti-ageing effect.

Which factors impact osteoporisis ?

There are several different factors that can contribute to the development of osteoporosis. Even those who do not suffer from osteoporosis can make preventative changes to these factors in order to promote a healthy lifestyle. These factors include:

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Smoking

As we all know, smoking triggers a number of negative processes in our bodies. It also negatively affects Multiple Sclerosis and the risk of osteoporosis. Smoking has an osteoporosis-promoting effect, as the blood vessels constrict and the bones are no longer supplied with sufficient nutrients.

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Alcohol

‍Alcohol should only be consumed in healthy quantities. The focus should always be on enjoyment. Excessive alcohol consumption harms your body and promotes osteoporosis by preventing specific cells (“osteoblasts”) from helping to build bone. Alcohol and nicotine are the two most common legal drugs in Germany with a high addictive potential.‍

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Exercise

‍We tend to move less and less. Starting with office jobs where we sit all day - after which we often lack the time and motivation for a walk or exercise. Yet it is important for everyone to incorporate regular exercise into their daily routine. Among other things, exercise and sport stimulate bone metabolism and maintain our mobility. It is also a proven factor in preventing osteoporosis and the risk of fractures.‍

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Vitamin D deficiency

‍In our latitudes, almost everyone suffers from a vitamin D deficiency. This not only affects MS patients. Especially in the fall and winter months, when it is often gray and rainy outside, people have a vitamin D deficiency. Over time, this also leads to a calcium deficiency, as vitamin D ensures that we can absorb calcium from food. Calcium is involved in bone formation and provides the skeleton of the bone, which ensures stability. Vitamin D can be absorbed through sunlight (15-20 minutes a day with free arms) or through the diet.

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Drug therapy options

‍In addition to including more calcium and vitamin D in your diet to counteract osteoporosis, there are of course also drug therapy options. However, these should always be discussed with your doctor.