Know All About Osteoporosis

What is osteoporosis?

If you have osteoporosis it means that you have lost some bone material. Your bones become less dense. This makes them more prone to break (fracture). ‘Thinning’ of the bones (osteoporosis) mainly affects older people but it can affect someone of any age. Osteoporosis is a situation that affects the bones. Its name comes from Latin for “porous bones.”

The inner side of a healthy bone has small spaces, like a honeycomb. Generally, osteoporosis increases the size of these spaces, causing the bone to lose strength and density. In addition, the outside of the bone grows weaker and thinner.

Alt text = Osteoporosis
Osteoporosis

Osteoporosis can occur in people of any age, but it’s more common in older adults, especially women. In the United States, more than 53 million people either have it or are at high risk of developing it.

People with osteoporosis are at a high risk of fractures, or bone breaks while doing routine activities such as standing or walking. Such as the most commonly affected bones are the ribs, hips, and the bones in the wrists and spine.

Symptoms of osteoporosis

Generally, the early stages of this disease don’t cause any symptoms or warning signs. In most cases, people with osteoporosis don’t know they have the condition until they have a fracture.

If symptoms do appear, some of the earlier ones may include:

  • receding gums
  • weakened grip strength
  • also weak and brittle nails

If you don’t have symptoms but have a family history of osteoporosis, it is essentially talking to your doctor that can help you assess your risk.

Severe osteoporosis

Generally, as bones get thinner and weaker, the risk of fracture increases.

Symptoms of severe osteoporosis can include a fracture from a fall or even from a strong sneeze or cough. They can also include back or neck pain or loss of height.

Back or neck pain or loss of height can be caused by a compression fracture. This is a break in one of the vertebrae in your neck or back, which is so weak that it breaks under the normal pressure in your spine.

If you do have a fracture from osteoporosis, how long it takes to heal will depend on many factors. These include where the fracture is, how severe it is, as well as your age and health history.

Cause of osteoporosis

Possible causes of this disease include specific medical conditions such as hyperthyroidism. They also include the use of certain medications.

Examples of these medications include long-term oral or injected corticosteroids such as prednisone or cortisone.

Risk factors of osteoporosis

Age

Generally, the biggest risk factor for osteoporosis is age. Throughout your life, your body breaks down old bones and grows new bones.

However, when you’re in your 30s, your body starts breaking down bone faster than it’s able to replace it. This leads to bones that are less dense and more fragile, and thus more prone to breakage.

Menopause

Menopause is another primary risk factor, which occurs in women around the ages of 45 to 55 years. Due to the change in hormone levels associated with it, menopause can cause a woman’s body to lose bone even more quickly.

Men continue to lose bone at this age, but at a slower rate than women do. However, by the time they reach the ages of 65 to 70, women and men are usually losing bone at the same rate.

Other risk factors for osteoporosis include:

  • being female
  • being Caucasian or Asian
  • having a family history of osteoporosis
  • poor nutrition
  • physical inactivity
  • smoking
  • low body weight
  • small-boned frame

You can improve your diet, and start an exercise program that can benefit your bone health. However, you can’t control other risk factors, such as your age or gender.

Senile osteoporosis

Such as you may have heard of senile osteoporosis. This isn’t a separate type — it’s simply osteoporosis that’s caused by aging when other possible secondary causes are excluded.

As mentioned above, age is a primary risk factor for osteoporosis. Unless proper prevention or treatment efforts are made, your body’s increasing breakdown of bone can lead to weakened bones and osteoporosis.

According to global statistics from the International Osteoporosis Foundation, about one-tenth of women aged 60 have osteoporosis, while two-fifths of women aged 80 have the disease.

Bone density test for diagnosis

To check for osteoporosis, your doctor will review your medical history and do a physical exam. They may also run tests of your blood and urine to check for conditions that may cause bone loss.

If your doctor thinks you may have osteoporosis or that you’re at risk of developing it, they’ll likely suggest a bone density test.

This test is called bone densitometry, or dual-energy X-ray absorptiometry (DEXA). It uses X-rays to measure the density of the bones in your wrists, hips, or spine. Accordingly, these are the three areas most at risk of osteoporosis. This painless test can take from 10 to 30 minutes.

Treatment for osteoporosis

If your testing shows that you have osteoporosis, your doctor will work with you to create a treatment plan. Your doctor will likely prescribe medications as well as lifestyle changes. These lifestyle changes can include increasing your intake of calcium and vitamin D, as well as getting appropriate exercise.

There’s no permanent cure for osteoporosis, but proper treatment can help protect and strengthen your bones. Therefore these treatments can help slow the breakdown of bone in your body, and some treatments can spur the growth of new bone.

Osteoporosis medications

The most common drugs used to treat osteoporosis are called bisphosphonates. Bisphosphonates are used to prevent the loss of bone mass. They may be taken orally or by injection. They include:

  • alendronate (Fosamax)
  • ibandronate (Boniva)
  • risedronate (Actonel)
  • zoledronic acid (Reclast)

Additional medications may be used to prevent bone loss or stimulate bone growth. They include:

Testosterone

In men, testosterone therapy may help increase bone density.

Hormone therapy

For women, the estrogen used during and after menopause can help stop bone density loss. Unfortunately, estrogen therapy has also been associated with an increased risk of blood clots, heart disease, and certain types of cancer.

Raloxifene (Evista)

This medication has been found to provide the benefits of estrogen without many of the risks, although there is still an increased risk of blood clots.

Denosumab (Prolia)

This drug is taken by injection and may prove even more promising than bisphosphonates at reducing bone loss.

Teriparatide (Forteo)

This drug is also taken by injection and stimulates bone growth.

Calcitonin salmon (Fortical and Miacalcin)

Generally, this drug is taken as a nasal spray and reduces bone reabsorption. In a short talk to your doctor about any increased risk of cancer with this drug.

Romosozumab (Evenity)

Such as this medication was approved by the FDA in April of 2019 to treat women who have gone through menopause and are at a high risk of having fractures.

The medicine is given in two injections under the skin (in the same sitting) once a month for 12 months or less. It has a “black box” warning because the Evenity may increase the risk of heart attacks or strokes, so it’s not recommended for people with a history of either.

Minerals or Diet for osteoporosis

Calcium and vitamin D are important for bone health. Your body needs adequate supplies of vitamin D in order to take up (absorb) the calcium that you eat or drink in your diet. The recommended daily intake for calcium in adults over the age of 50 is at least 1000 mg per day.

Calcium – you can get 1000 mg of calcium most easily by:

  • Drinking a pint of milk a day (this can include semi-skimmed or skimmed milk); plus
  • Eating 50 g (2 oz) of hard cheese such as Cheddar or Edam, or one pot of yoghurt (125 g), or 50 g of sardines.

Bread, calcium-fortified soya milk, some vegetables (curly kale, okra, spinach and watercress) and some fruits (dried apricots, dried figs and mixed peel) are also good sources of calcium. Butter, cream, and soft cheeses do not contain much calcium.

There is a possibility that taking calcium supplements when you have enough calcium in your diet might cause other problems such as heart disease. Therefore, it is best not to take calcium supplements without first discussing this with your doctor.

Vitamin D – there are only a few foods that are a good source of vitamin D. Approximately 115 g (4 oz) of cooked salmon or cooked mackerel provide 400 IU of vitamin D. The same amount of vitamin D can also be obtained from 170 g (6 oz) of tuna fish or 80 g (3 oz) of sardines (both canned in oil). Vitamin D is mainly made by your body after exposure to the sun. The ultraviolet rays in sunshine trigger your skin to make vitamin D. This may not provide as much vitamin D as you need. In the UK it is advised that everyone should consider vitamin D supplements in the winter, and some people should have them all year round.

Especially nutrients that promote bone health include protein, magnesium, vitamin K, and zinc.

Avoid smoking and drinking

Chemicals from tobacco can get into your bloodstream and can affect your bones, making bone loss worse. If you smoke, you should try to make every effort to stop. Also, you should try to cut down on your alcohol intake if you drink more than fourteen units of alcohol per week.

Lifestyle changes matters a lot

Medication will not restore all lost bone. Also, medication may not be suggested for all people with ‘thinning’ of the bones (osteoporosis). So, there are a number of lifestyle measures that are also important in treating osteoporosis. They include:

  • Weight-bearing exercise.
  • Muscle strengthening exercises.
  • Not smoking.
  • Keeping any alcohol drinking to within the levels as described earlier.

Preventing falls

You can also take measures to help prevent yourself from falling and breaking a bone.

  • Check your home for hazards such as uneven rugs, trailing wires, slippery floors, etc.
  • Regular weight-bearing exercise may help to prevent falls (as described above).
  • Are your vision and hearing as good as possible? Do they need checking? Do you need glasses or a hearing aid?
  • Beware of going out in icy weather.
  • Do you take any medicines that can make you drowsy or that may lower your blood pressure too much and increase your risk of falls? Can they be changed? You can discuss this with your doctor.
  • Hip protectors may also possibly help in some people in nursing homes or residential care settings. These are special protectors that you wear over your hips that aim to cushion your hips if you do have a fall.

If you have had a fall, or have difficulty walking, you may be advised to have a formal falls risk assessment. This involves various things such as:

  • A physical examination.
  • Checking your vision, hearing and ability to walk.
  • Reviewing your medication.
  • Reviewing your home circumstances.

Following this, where appropriate, some people are offered suggestions such as a muscle strengthening and balance programme, or recommendations on how to reduce potential hazards in their homes.

Natural treatments of osteoporosis

Because osteoporosis medications can have side effects, you may prefer to try other treatments instead of medication.

Several supplements, such as red clover, soy, and black cohosh, may be used to help promote bone health. However, before using these supplements, be sure to talk to your doctor or pharmacist. This is for two main reasons:

  1. There are few, if any, studies supporting the use of these supplements for treating osteoporosis. As a result, we don’t have proof that they work.
  2. These supplements can cause side effects, as well as interact with medications you’re taking. You’ll want to make sure you know what side effects could occur, and if you’re taking any medications that could interact with the supplement.

Therefore all of that said, some people report good results with natural treatments.

Exercise for osteoporosis

Besides eating right isn’t the only thing you can do to support the health of your bones. In particular, exercise is very important as well, especially weight-bearing exercises.

Weight-bearing exercises are performed with either your feet or your arms fixed to the ground or another surface. Examples include:

  • resistance training
  • climbing stairs
  • leg presses
  • squats
  • pushups
  • weight training
  • resistance bands
  • dumbbells
  • resistance exercise machines

For older people, a regular walk is a good start. However, the more vigorous the exercise, the better. For most benefit you should exercise regularly – aiming for at least 30 minutes of moderate exercise or physical activity at least five times per week. 

Exercise has many positive effects on weight and heart health, exercise can also improve your balance and coordination, which can help you avoid falls.

Always check with your doctor before starting any new exercise program.

Prevention for osteoporosis

Besides, there are many risk factors for osteoporosis that you cannot control. Such as these include being female, getting older, and having a family history of osteoporosis. There are some factors, however, that do fall within your control.

Some of the best ways to prevent osteoporosis include:

  • getting recommended daily amount of calcium and vitamin D
  • also doing weight-bearing exercises
  • stopping smoking
  • for women, weighing the pros and cons of hormone therapy

For the most part, if you’re at risk of developing osteoporosis, talk to your doctor about the best way to prevent it.

Osteopenia vs osteoporosis

If your doctor tells you that you have osteopenia, you may think you misheard the word “osteoporosis.” However, osteopenia is a separate condition from osteoporosis.

Unlike osteoporosis, osteopenia is not a disease. Rather, it’s the state of having low bone density. With osteopenia, your bones aren’t as dense as normal, but they’re not as weakened as they are if you have osteoporosis.

The main risk factor for osteopenia is older age. Your bone density peaks at age 35, and after that, it can lessen as you get older.

In many cases, osteopenia can lead to osteoporosis, so if you have osteopenia, you should take steps to strengthen your bones.

Point of view

The good news is, there’s a lot you can do both to prevent and to treat osteoporosis, from eating right and exercising to taking appropriate medications.

If you think you’re at risk of osteoporosis, or if you’ve been diagnosed with it, talk to your doctor. They can work with you to put together a prevention or treatment plan that can help improve your bone health and reduce your risk of complications.