Sjögren’s syndrome is an autoimmune disease that mainly affects middle-aged and older women, causing dry eyes and dry mouth. Researchers have discovered that people with Sjögren’s syndrome are much more likely to also develop osteoporosis, a condition where bones become weak and break easily. This review examines why these two conditions often happen together and what doctors can do about it. Understanding the connection between these diseases helps doctors create better treatment plans that protect both eye and mouth health while keeping bones strong.

The Quick Take

  • What they studied: Why people with Sjögren’s syndrome (a disease causing dry eyes and mouth) often develop weak bones, and how doctors should treat both conditions together
  • Who participated: This is a review article that examined existing research rather than conducting a new study with participants. It focused on middle-aged and older women, who are most commonly affected by Sjögren’s syndrome
  • Key finding: Between one-third and half of people with Sjögren’s syndrome also develop osteoporosis, which is much higher than in people without the disease. This happens because both conditions affect the body’s immune system, vitamin D processing, and bone-building processes in similar ways
  • What it means for you: If you have Sjögren’s syndrome, your doctor should check your bone health regularly. You may need extra vitamin D, calcium, and specific exercises to keep your bones strong. This is especially important because treating one condition shouldn’t make the other worse

The Research Details

This is a narrative review, which means researchers looked at many existing studies about Sjögren’s syndrome and osteoporosis to understand how they’re connected. Instead of doing their own experiment with patients, they gathered information from published research and organized it to show patterns and relationships. This type of review is helpful for understanding complicated topics where two diseases interact with each other. The researchers examined how both conditions develop in the body, what causes them, and what treatments work best.

A review approach is perfect for this topic because Sjögren’s syndrome and osteoporosis are complex diseases with many overlapping causes. By looking at all the existing research together, doctors can see the bigger picture of how these conditions affect each other. This helps create better treatment plans that address both problems without making either one worse. Understanding these connections is especially important because treating one disease might accidentally harm bone health or eye health if doctors don’t know about the connection.

This review was published in a peer-reviewed medical journal, meaning other experts checked the work before publication. However, because it’s a review rather than a new study, it depends on the quality of the research it examines. The strength of the conclusions depends on how well the original studies were done. Readers should know that this summarizes current understanding but doesn’t provide new experimental evidence. The findings represent what doctors currently believe based on available research.

What the Results Show

The research shows that people with Sjögren’s syndrome have a much higher chance of developing osteoporosis compared to healthy people their age. Studies found that between 33% and 52% of Sjögren’s patients also have weak bones, while this only happens in a small percentage of healthy older adults. This high rate suggests the two diseases are connected, not just coincidental.

The connection happens through several body systems. First, both diseases involve problems with how the body processes vitamin D, which is essential for strong bones. Second, both conditions cause the immune system to attack the body’s own cells in ways that weaken bones. Third, hormonal imbalances that occur with Sjögren’s syndrome also affect bone strength. Finally, both diseases can make the body too acidic, which pulls calcium out of bones to balance the acid.

The review identified that the RANKL/RANK/OPG system—a complex signaling pathway in the body—plays an important role in both diseases. This system controls how bone-building cells and bone-breaking-down cells work. When this system is out of balance, bones become weak. Additionally, the widespread immune system problems in Sjögren’s syndrome directly damage bone-building cells and activate bone-breaking-down cells. The review also noted that treating one condition can sometimes create challenges for treating the other, so doctors need coordinated strategies.

This review builds on previous research showing that autoimmune diseases often come with bone problems. What makes this work important is that it specifically examines how Sjögren’s syndrome and osteoporosis are connected through multiple pathways, rather than treating them as separate problems. Previous research identified some of these connections, but this review brings them together in one place and emphasizes that doctors need to manage both conditions as an integrated problem rather than treating them separately.

This is a review of existing research rather than a new study, so it cannot prove cause-and-effect relationships. The conclusions depend on the quality of the studies reviewed. Some of the mechanisms described are still being researched, so our understanding may change as new evidence emerges. The review focuses mainly on women, so the findings may not apply equally to men with Sjögren’s syndrome. Additionally, treatment recommendations are based on current evidence but may evolve as new therapies are developed.

The Bottom Line

People with Sjögren’s syndrome should have their bone density checked regularly (moderate confidence). Vitamin D and calcium supplementation appears beneficial for protecting bones in these patients (moderate confidence). Weight-bearing exercise and strength training may help maintain bone health (moderate confidence). Doctors should coordinate treatment plans to avoid therapies that might weaken bones while treating Sjögren’s syndrome (high confidence). Some medications used for Sjögren’s may need adjustment if osteoporosis develops (moderate confidence).

This research is most relevant for women over 40 with Sjögren’s syndrome, as they have the highest risk. Doctors treating Sjögren’s syndrome should use this information to screen for bone problems. People with a family history of either condition should discuss screening with their doctor. Men with Sjögren’s syndrome should also be aware, though the research focuses less on them. People already diagnosed with osteoporosis who develop Sjögren’s symptoms should tell their doctor about both conditions.

Bone density changes happen slowly, so improvements from vitamin D, calcium, and exercise typically take 6-12 months to show up on bone density scans. However, you may feel better and have fewer fractures within weeks to months of starting treatment. Preventing further bone loss is often the first goal, with actual bone strengthening taking longer. Regular monitoring every 1-2 years helps track progress.

Want to Apply This Research?

  • Track daily vitamin D and calcium intake (target: 1000-1200mg calcium and 600-800 IU vitamin D daily for adults over 50). Log weekly weight-bearing exercise sessions (goal: 150 minutes per week). Record any falls, injuries, or bone pain to share with your doctor.
  • Set daily reminders to take vitamin D and calcium supplements with meals. Schedule 30-minute walks or strength training sessions 3-4 times per week. Create a checklist for bone-healthy foods (dairy, leafy greens, fortified foods). Set a reminder to schedule annual bone density screening appointments.
  • Use the app to track supplement adherence over months to identify patterns. Monitor exercise consistency week-to-week and adjust goals based on ability. Log any new symptoms or medication changes to discuss with your healthcare provider. Review quarterly summaries to see progress toward bone health goals and share results with your doctor at annual appointments.

This review summarizes current medical research but is not a substitute for professional medical advice. If you have Sjögren’s syndrome or osteoporosis, consult your doctor before making changes to your treatment plan, starting supplements, or beginning an exercise program. Bone density screening and treatment decisions should be made with your healthcare provider based on your individual health status. This information is educational and should not be used for self-diagnosis or self-treatment.