Table 1 Proposed mechanisms contributing to AED induced bone disease.

   • Hepatic enzyme induction

   • PXR activation

• Altered calcium metabolism (DPH)

   • ↓ Intestinal absorption

   • ↓ vitamin D mediated absorption

   • ↓ intestinal cation transport

• ↑ PTH

   • Vitamin D insufficiency

   • ↓ cellular response to PTH

• Vitamin K deficiency

• ↓ Calcitonin

• Osteoblast Inhibition

• Altered sex-steroid & SHBG metabolism

• Possible modulation of Aromatase activity