Medical Condition

Causes, Risk Assessment, Treatment and Prevention of Osteoporosis

Osteoporosis is a disease that happens when bone density decreases and the body stops producing as much bone as it used to do before. Osteoporosis can affect both males and females, and the bones deteriorate or become brittle and fragile due to loss of bone tissue and low bone mass.

Osteoporosis increases the risk of fractures, and causes an estimated 9 million fractures each year worldwide.

A tool called FRAX is normally used to assess a person’s probability of bone fracture for a period of 10 years.

The FRAX tool takes into consideration various risk factors associated with fracture, as well as a person’s bone mineral density at the hip, as measured with a dual-energy X-ray absorptiometry scan (DXA or DEXA scan).

The assessment tool is available online, but you need to know your bone mineral density at the hip to use it.

Causes of Osteoporosis

Our bones are in a constant state of renewal, where new bone is made and old bone is broken down. When we are young, our body makes new bone faster than it breaks down old ones and our bone mass generally increases.

But as we age, bone mass is lost faster than it’s created. Most people reach their peak bone mass by their early 20s.

Your rate of developing osteoporosis depends partly on how much bone mass you attained in your youthful age. The higher your peak bone mass, the more bone you have, and the less likely you are to develop osteoporosis as you get older.

Secondary Osteoporosis

Sometimes osteoporosis is caused by a medical condition or treatment that affects bone mass, and result in bone loss. This is known as secondary osteoporosis.

Some conditions can also cause the bone marrow cavity to expand at the expense of the inner layer of bone that has a spongy, honeycomb-like structure. When this happens, the inner layer bone (trabecular bone) loses some of its strength.

Diseases and disorders that can cause secondary osteoporosis include:

  • kidney failure
  • Cushing’s disease
  • Liver deficiency
  • Anorexia nervosa and bulimia
  • Rheumatoid arthritis
  • Celiac disease
  • Multiple sclerosis (MS)
  • Chronic obstructive pulmonary disease
  • Scurvy
  • Hyperparathyroidism and Hyperthyroidism
  • Diabetes
  • Hypercortisolism
  • Thalassemia
  • Multiple myeloma
  • Leukemia
  • Metastatic bone diseases

Similarly, the following drugs or chemicals can also cause osteoporosis:

  • Corticosteroid therapy
  • Lithium
  • Barbiturates
  • Antacids, especially ones containing aluminum
  • Tobacco
  • Alcohol (when used excessively)

Treatment for secondary osteoporosis may focus on treating the underlying condition or disease causing it.

Treatment for Osteoporosis

A variety of medication and lifestyle approaches can help slow the rate of bone loss that is typical in osteoporosis.

Some drugs can slow the breakdown of bone, while others promote bone formation.

You should consult an expert or your doctor about the best strategy for you, based on your bone mineral density, estimated fracture risk, lifestyle, and any other medical conditions you may have.

Prevention of Osteoporosis

Good nutrition and regular exercise are indispensable for keeping your bones healthy.

Nutrition

Protein is one of the building blocks of bone, and while most people get plenty of protein in their diets, some may not. Vegetarians can get enough protein in the diet if they intentionally seek suitable sources, such as soy, nuts, legumes, and dairy.

If you doubt that you are getting enough protein from diet, then protein supplementation becomes an option.

Calcium

Men and women need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when women turn 50+ and men turn 70+.

Good sources of calcium include:

  • Low-fat dairy products
  • Soy products, such as tofu
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Calcium-fortified cereals and
  • orange juice

If you find it challenging to get enough calcium from your diet, consider taking calcium supplements. However, be careful not to overdose on calcium as too much calcium has been linked to kidney stones.

Some experts also suggest that too much calcium especially in supplements can increase the risk of heart disease, and the Institute of Medicine recommends that total calcium intake, from supplements and diet combined, should not exceed 2,000 milligrams daily for people older than 50.

Vitamin D

Vitamin D improves your body’s ability to absorb calcium. This helps improve bone health. You can get adequate amounts of vitamin D from sunlight, but this may not be a good source because of the difficulty to enjoy the sun by some, and risk of skin cancer for others.

For people without other sources of vitamin D or with limited sun exposure, a supplement may be needed. Most multivitamin products contain between 600 and 800 IU of vitamin D, and you can safely ingest up to 4,000 IU of vitamin D a day.

Body Weight

While being underweight increases the chance of bone loss and fractures, excess weight is also known to increase the risk of fractures in your arm and wrist. Thus, maintaining an appropriate body weight is good for bones just as it is good for your general health and wellbeing.

Exercise

Exercise can help you build strong bones, while slowing bone loss. Exercise will benefit your bones no matter when you start, and you will gain the most benefits if you start young and if you exercise regularly and continue to exercise throughout your life.

You should combine strength training exercises with weight-bearing and balance exercises. While strength training helps strengthen muscles and bones in your arms and upper spine, weight-bearing exercises (such as walking, jogging, running, stair climbing, and skipping rope) affect mainly the bones in your legs, hips and lower spine.

Swimming, cycling and exercising on machines such as elliptical trainers can provide a good cardiovascular workout, but may not be as helpful for improving bone health.

 

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