Osteoporosis is a disease in which bones deteriorate or become brittle and fragile due to loss of bone tissue and low bone mass.
Osteoporosis 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, but it is most likely to occur in women after menopause. This is because of the sudden decrease in estrogen level.
Osteoporosis is often referred to as a “silent disease” because you cannot feel your bones getting weaker, and may not even know that you have the condition until after you break a bone.
Osteoporosis increases the risk of fractures, most of the hips, spine, and wrists. It causes an estimated 9 million fractures each year worldwide.
As the most common type of bone disease, osteoporosis affects approximately 10 million Americans. Another 44 million people have low bone density, which puts them at risk for the Osteoporosis.
Statistically, 1 in 2 women and up to 1 in 4 four men who are over the age of 50 years will break a bone due to osteoporosis.
Facts On Osteoporosis
- Osteoporosis affects the structure and strength of bones and makes fractures of the spine, hip, and wrists more likely.
- It is most common among females after menopause,
- smoking and poor diet increase the risk of osteoporosis
- There are often no clear outward symptoms, but there may be a stoop, and there may be bone pain.
- A special X-ray scan, known as DEXA, is used for identification or diagnosis of the condition.
- Treatments include drugs to prevent or slow bone loss, exercise, and dietary adjustments.
Symptoms of Osteoporosis
There are no symptoms in the early stages of bone loss, but once your bones have been weakened by osteoporosis, you may have the following signs and symptoms:
- Back pain, caused by a ruptured or collapsed vertebra
- Loss of height
- An arched posture
- A fracture of the bone that occurs much more easily than normal
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.
Risk Factors for Osteoporosis
A number of factors can increase the likelihood that you’ll develop osteoporosis. Such factors include; your age, race, lifestyle choices, and medical conditions, medications, and treatments.
Some risk factors for osteoporosis are out of your control. Such factors include:
- Your sex: women are much more likely to develop osteoporosis than the men.
- Age: the older you get, the higher your risk of osteoporosis.
- Race: white or people of Asian descent are at greatest risk of osteoporosis
- Family history: having a family member like a parent with osteoporosis puts you at greater risk, especially if either of your parents experienced a hip fracture.
- Body frame size: men and women who have small body frames tend to have a higher risk of the condition because they have less bone mass reserve to draw from as they age.
Furthermore, Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Such hormonal conditions include:
- Sex hormones: lowered sex hormone levels tend to weaken bone, and the reduction of estrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis.
- Thyroid problems: Too much thyroid hormone in the body system can cause bone loss, and this can occur if your thyroid is overactive or if you take too much thyroid hormone medication.
- Osteoporosis has also been linked with overactive parathyroid and adrenal glands.
Dietary Risk Factors for Osteoporosis
Osteoporosis is more likely to occur in the following group of people, in relation to diet:
- Low calcium intake: a lifelong lack of calcium plays a role in the development of osteoporosis, and it has been established that low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures.
- Eating disorders: severely restricting food consumption and being underweight weakens bones.
- Gastrointestinal surgery: surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients. Fewer nutrients you absorb, especially calcium, more risk of developing osteoporosis.
The risk of osteoporosis is higher in people who have certain medical problems, including:
- Celiac disease
- Inflammatory bowel disease
- Kidney or liver disease
- Multiple myelomas
- Rheumatoid arthritis
Medications and Steroids
Long-term use of certain oral or injected corticosteroid medications, such as prednisone and cortisone, can interfere with the bone-rebuilding process. Osteoporosis has also been associated with medications used to combat or prevent the following diseases:
- Gastric reflux
- Transplant rejection
- Men experience a gradual reduction in testosterone levels as they age, and the treatments for prostate cancer that reduce testosterone levels in men are likely to accelerate bone loss.
Some bad practices can increase your risk of osteoporosis.
- Sedentary lifestyle: people who spend a lot of time sitting have a higher risk of osteoporosis than those who are more active and mobile.
- Excessive alcohol consumption also increases your risk of osteoporosis.
- Tobacco use has been shown to contribute to weak bones. However, the exact role tobacco plays in osteoporosis isn’t clearly understood yet.
Any weight-bearing exercise and activities that promote balance and good posture are beneficial for your bones. Walking, running, jumping, dancing and weightlifting seem particularly helpful in preventing osteoporosis.
Risk Assessment for Bone Fractures
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.
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
- Hyperparathyroidism and Hyperthyroidism
- Multiple myelomas
- Metastatic bone diseases
Similarly, the following drugs or chemicals can also cause osteoporosis:
- Corticosteroid therapy
- Antacids, especially ones containing aluminum
- 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.
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 the diet, then protein supplementation becomes an option.
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 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.
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 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.