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Osteoporosis causes bones to become weak and brittle, so fragile that even minor stressors like bending over or coughing can result in a fracture. Most osteoporosis-related fractures occur in the hip, wrist, or spine.
Bone is a living tissue that is constantly breaking down and being rebuilt. When the formation of new bone does not keep up with the loss of old bone, osteoporosis develops.
Men and women of all races are affected by osteoporosis. However, white and Asian women, particularly older women who have passed menopause, are most vulnerable. Medications, a nutritious diet, and weight-bearing exercise can help prevent bone loss or strengthen bones that are already weak.
WHAT ARE THE SYMPTOMS OF OSTEOPOROSIS?
In the early phases of bone loss, there are usually no symptoms. However, if your bones have been compromised by osteoporosis, you may experience the following indications and symptoms:
- Back discomfort as a result of a fractured or collapsed vertebra
- Height loss over time
- A hunched posture
- A bone that fractures far more easily than expected
WHAT ARE THE CAUSES OF OSTEOPOROSIS?
Your bones are constantly being renewed - new bone is formed and old bone is broken down. When you're young, your body produces new bone faster than it degrades old bone, so your bone mass grows. This process slows after the early twenties, and most people reach their peak bone mass by the age of thirty. Bone mass is lost faster than it is formed as people age.
The amount of bone mass you had when you were younger influences your risk of developing osteoporosis. Peak bone mass is inherited in part and varies by ethnic group. The more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age, the higher your peak bone mass.
WHAT ARE THE RISK FACTORS FOR OSTEOPOROSIS?
A variety of factors, including age, race, lifestyle choices, and medical conditions and medications, can raise your risk of developing osteoporosis.
Unchangeable risks
Some osteoporosis risk factors are beyond your control, such as:
- Your gender: Women are far more prone than men to acquire osteoporosis.
- Age: The older you get, the more likely you are to get osteoporosis.
- Race: You are most likely to get osteoporosis if you are white or of Asian heritage.
- Family history: Having an osteoporotic parent or sibling increases your chances, especially if your mother or father shattered a hip.
- Size of the body frame: Men and women with petite physical frames are more vulnerable because they may have less bone mass to draw from as they age.
Hormone levels
People who have too much or too little of particular hormones in their body are more likely to develop osteoporosis. Here are several examples:
- Sex hormones: Low sex hormone levels are known to damage bones. The decline in estrogen levels in women throughout menopause is one of the most significant risk factors for osteoporosis. Prostate cancer treatments that lower testosterone levels in males and breast cancer treatments that lower estrogen levels in women are likely to hasten bone loss.
- Thyroid issues: Thyroid hormone excess might result in bone loss. This can happen if your thyroid is overactive or if you use too much thyroid hormone therapy to treat a thyroid that is underactive.
- Other glands: Overactive parathyroid and adrenal glands have also been linked to osteoporosis.
Dietary factors
Osteoporosis is more common in those who have:
- Calcium deficiency: A lifelong calcium deficiency contributes to the development of osteoporosis. Low calcium consumption leads to decreased bone density, early bone loss, and an increased risk of fractures.
- Eating disorders: Food restriction and being underweight both deteriorate bone in men and women.
- Gastrointestinal surgery: Surgery to reduce the size of your stomach or remove a portion of your intestine reduces the surface area available to absorb nutrients, including calcium. These procedures include those used to help you lose weight and those used to treat gastrointestinal issues.
Steroids and other drugs
Long-term usage of corticosteroid drugs, such as prednisone and cortisone, either orally or intravenously, disrupts the bone-rebuilding process. Medication used to treat or prevent osteoporosis has also been linked to the disease.
- Gastric reflux
- Seizures
- Cancer
- Transplant rejection
Medical problems
People with specific medical conditions are more likely to develop osteoporosis, including:
- Cancer
- Multiple myeloma
- Rheumatoid arthritis
- Celiac disease
- Inflammatory bowel disease
- Kidney or liver disease
Your Lifestyle choices
Some unhealthy habits can put you at risk for osteoporosis. Here are several examples:
- Sedentary way of life: People who spend a lot of time sitting are more likely to develop osteoporosis than those who are more active. Any weight-bearing activity and activities that promote balance and good posture are excellent for your bones, but walking, jogging, jumping, dancing, and weightlifting appear to be especially beneficial.
- Drinking too much alcohol: Drinking more than two alcoholic beverages every day raises the risk of osteoporosis.
- Tobacco consumption: The precise effect of tobacco in osteoporosis is unknown, although it has been demonstrated that tobacco usage contributes to weak bones.
WHAT ARE THE COMPLICATIONS OF OSTEOPOROSIS?
The most significant effects of osteoporosis are bone fractures, particularly in the spine or hip. Hip fractures are frequently caused by falls and can result in disability and possibly an increased risk of death within the first year.
Even if you haven't fallen, you can sustain a spinal fracture. The vertebrae (the bones that make up your spine) might deteriorate to the point of collapsing, resulting in back pain, loss of height, and a hunched forward posture.
HOW IS OSTEOPOROSIS DIAGNOSED?
A system that employs low doses of X-rays to assess the quantity of mineral in your bones can measure your bone density. You lie on a padded table as a scanner travels over your body during this painless test. In most situations, only a few bones are examined, mainly those in the hip and spine.
WHAT ARE THE TREATMENTS FOR OSTEOPOROSIS?
Treatment suggestions are frequently based on an estimate of your risk of breaking a bone in the next ten years based on data such as a bone density test. If your risk is low, treatment may not entail medication and may instead focus on reducing risk factors for bone loss and falls.
Bisphosphonates
Bisphosphonates are the most commonly recommended osteoporosis drugs for both men and women who are at high risk of fracture. Here are several examples:
- Alendronate (Binosto, Fosamax)
- Ibandronate (Boniva)
- Risedronate (Actonel, Atelvia)
- Zoledronic acid (Reclast, Zometa)
Nausea, abdominal pain, and heartburn-like symptoms are among the side effects. These are less likely if the medication is taken correctly. Bisphosphonates used intravenously do not induce gastrointestinal trouble, but they can cause fever, headache, and muscle aches.
A break or crack in the centre of the thighbone is an extremely unusual side effect of bisphosphonates. A second uncommon consequence is delayed jawbone healing (osteonecrosis of the jaw). This can happen after an invasive dental operation, such as tooth extraction.
Denosumab
Denosumab (Prolia, Xgeva) produces comparable or better bone density outcomes and lowers the risk of all types of fractures when compared to bisphosphonates. Denosumab is administered every six months by an injection beneath the skin.
Denosumab, like bisphosphonates, can cause breaks or cracks in the centre of the thighbone as well as osteonecrosis of the jaw. If you take denosumab, you may need to do so indefinitely. According to recent studies, there may be a substantial chance of spinal column fractures after quitting the medicine.
Hormone-related treatment
Estrogen, especially when administered soon after menopause, can aid in bone density maintenance. However, estrogen therapy can raise the risk of breast cancer and blood clots, both of which can lead to strokes. As a result, estrogen is often utilized for bone health in younger women or in women who simultaneously require treatment for menopausal symptoms.
Raloxifene (Evista) replicates estrogen's positive effects on bone density in postmenopausal women while avoiding some of estrogen's dangers. This medication may lower the risk of certain forms of breast cancer. Hot flashes may occur as a side effect. Raloxifene may potentially raise your chances of developing blood clots.
In males, osteoporosis may be associated with a steady reduction in testosterone levels as they age. Testosterone replacement therapy can help relieve symptoms of low testosterone, however osteoporosis drugs have been examined more thoroughly in males to treat osteoporosis and are thus suggested alone or in conjunction with testosterone.
Bone-building medications
If you have severe osteoporosis or if the more typical osteoporosis therapies are ineffective, your doctor may advise you to try:
- Teriparatide (Bonsity, Forteo): This potent medication works similarly to parathyroid hormone in stimulating new bone development. It is administered through daily injections under the skin for up to two years.
- Abaloparatide (Tymlos): This is a comparable medication to parathyroid hormone. This medication is only effective for two years.
- Romosozumab (Evenity): This is the most recent bone-building medicine approved to treat osteoporosis. It is administered as a monthly injection at your doctor's office and is only effective for one year.
When you stop taking any of these bone-building medications, you will usually need to take another osteoporosis prescription to keep the new bone growth going.
HOW CAN OSTEOPOROSIS BE PREVENTED?
Good nutrition and regular exercise are critical to maintaining bone health throughout your life.
Calcium
Men and women aged 18 to 50 require 1,000 mg of calcium every day. When women reach the age of 50 and males reach the age of 70, the daily dose climbs to 1,200 milligrams.
Calcium-rich foods include:
- Dairy products with low fat
- Dark green leafy vegetables
- Salmon or sardines in cans with bones
- Tofu and other soy products
- Cereals with calcium and orange juice
Consider taking calcium supplements if you have trouble getting enough calcium from your diet. However, excessive calcium consumption has been linked to kidney stones. Although the exact cause is unknown, some experts believe that too much calcium, particularly in supplements, may increase the risk of heart disease.
The National Academies of Sciences, Engineering, and Medicine's Health and Medicine Division recommends that persons over the age of 50 consume no more than 2,000 mg of calcium per day through supplements and diet.
Vitamin D
Vitamin D helps bone health by increasing the body's ability to absorb calcium. Sunlight can provide some vitamin D, but it may not be a useful source if you live in a high latitude, are housebound, or habitually use sunscreen or avoid the sun due to the danger of skin cancer.
Cod liver oil, trout, and salmon are all good sources of vitamin D. Many types of milk and cereal are vitamin D enhanced.
The majority of people require at least 600 international units (IU) of vitamin D each day. After the age of 70, the dosage increases to 800 IU per day.
People who do not have access to other sources of vitamin D, particularly those with restricted sun exposure, may require a supplement. The majority of multivitamins contain 600 to 800 IU of vitamin D. Most people can tolerate up to 4,000 IU of vitamin D per day.
Exercise
Exercise can help you strengthen your bones and slow bone loss. Exercise benefits your bones regardless of when you begin, but you will get the greatest benefits if you begin exercising consistently while you are young and continue to exercise throughout your life.
Combine strength training, weight-bearing, and balance exercises. Arm and upper spine muscles and bones are strengthened through strength training. Walking, jogging, running, stair climbing, skipping rope, skiing, and impact-producing sports mostly influence the bones in your legs, hips, and lower spine. Tai chi and other balance activities can help lower your chance of falling, especially as you get older.