Osteoporosis

Osteoporosis, the most common metabolic bone disease globally, is characterized by a decrease in bone mineral density and mass, or a change in bone structure and strength. This decrease in bone strength significantly heightens the risk of fractures, underscoring the importance of maintaining bone health.

Certain risk factors may lead to the development of osteoporosis or can increase the likelihood that you develop the disease. You may have many risk factors or none at all to develop osteoporosis:

• Sex: Women have a greater chance of developing osteoporosis than men. Women have lower peak bone mass and smaller bones than men. However, men are still at risk, especially after the age of 70.

• Race: Osteoporosis is most common in non-Hispanic white women and Asian women. African American and Hispanic women have a lower risk of developing osteoporosis, but they are still at significant risk. Among men, osteoporosis is more common in non-Hispanic white men.

• Age: As you age, bone loss happens more quickly, and new bone growth is slower. Over time, your bones can weaken, and your risk of osteoporosis increases.

• Body Size: Slender, thin-boned women and men are at greater risk of developing osteoporosis because they lose less bone than larger-boned individuals.

• Family History: Researchers are finding that your risk for osteoporosis and fractures may increase if one of your parents has a history of osteoporosis or hip fracture.

• Changes to hormones: Low levels of certain hormones can increase your chances of developing osteoporosis. For example

  • Low estrogen levels in women after menopause

  • Low levels of estrogen from the abnormal absence of menstrual periods in premenopausal women due to hormone disorders or extreme levels of physical activity.

  • Low levels of testosterone in men. Men with conditions that cause low testosterone are at risk for osteoporosis. However, the gradual decrease of testosterone with aging is probably not a major reason for the loss of bone.

• Diet: Beginning in childhood and into old age, a diet low in calcium and vitamin D can increase your risk for osteoporosis and fractures. Excessive dieting or poor protein intake may increase bone loss and osteoporosis risk.

• Other Medical Conditions: Some medical conditions that you may be able to treat or manage can increase the risk of osteoporosis, such as other endocrine and hormonal diseases, gastrointestinal disease, rheumatoid arthritis, certain types of cancer, HIV/AIDS, and anorexia nervosa.

• Medications: Long-term use of certain medications may make you more likely to develop bone loss and osteoporosis, such as:

  • Glucocorticoids and adrenocorticotropic hormone treat various conditions, such as asthma and rheumatoid arthritis.

  • Antiepileptic medicines, which treat seizures and other neurological disorders.

  • Cancer medicines, which treat seizures and other neurological disorders.

  • Cancer medications use hormones to treat breast and prostate cancer.

  • Proton pump inhibitors, which lower stomach acid.

  • Selective serotonin reuptake inhibitors treat depression and anxiety.

  • Thiazolidinediones, which treat type II diabetes.

• Lifestyle: A healthy lifestyle can be important for keeping bones strong. Factors that contribute to bone loss include:

  • Low levels of physical activity and prolonged periods of inactivity can contribute to an increased rate of bone loss. They also leave yo u in poor physical condition, which can increase your risk of falling and breaking a bone.

  • Chronic heavy drinking of alcohol is a significant risk factor for osteoporosis.

  • Studies indicate that smoking is a risk factor for osteoporosis and fracture. Researchers are still studying if the impact of smoking on bone health is from tobacco use alone or if people who smoke have more risk factors for osteoporosis.

Prevention:

• Staying physically active by participating in weight-bearing exercises such as walking.

• Drinking alcohol in moderation.

• Quitting smoking, or not starting if you don't smoke.

• Taking your medications, if prescribed, can help prevent fractures in people who have osteoporosis.

• Eating a nutritious diet rich in calcium and vitamin D helps maintain good bone health.

Symptoms: Osteoporosis is called a "silent" disease because there are typically no symptoms until a bone is broken. Symptoms of vertebral (spine) fracture include severe back pain, loss of height, or spine malformations such as a stooped or hunched posture (kyphosis).

Bones affected by osteoporosis may become so fragile that fractures occur spontaneously or as the result of:

• Minor falls, such as a fall from standing height, would not normally cause a break in a healthy bone.

• Normal stresses such as bending, lifting, or even coughing.

Diagnosis: Your bone density can be measured by a machine that uses low levels of X-rays to determine the proportion of minerals in your bones. During the painless test, you lie on a padded table as a scanner passes over your body. In most cases, only certain bones are checked - usually in the hip and spine. According to the U.S. Preventative Services Task Force, women 65 and older should be screened for osteoporosis, as well as younger women who have a higher-than-normal risk of fractures. Men may want to consider screening if they are over 70 or have risk factors for thinning bones.

Treatment: Treatment recommendations are often based on an estimate of your risk of breaking a bone in the next 10 years using information such as the bone density test. If your risk isn't high, treatment might not include medication and might focus instead on modifying risk factors for bone loss and falls.

Osteopenia: The initial stage of bone loss and is less severe than osteoporosis. If left untreated, it can develop into osteoporosis. Lifestyle changes are often the first step, such as:

• Weight-bearing exercises

• Exercises using weights

• Eating a balanced diet with enough calcium and vitamin D

• Quitting smoking

• Moderating alcohol consumption

• Taking over-the-counter or prescription supplements

• Sometimes prescription medications, such as those used to treat osteoporosis

For more information on osteoporosis, click here

For more information on treatments of osteoporosis, click here