Osteoporosis Explained

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Osteoporosis literally means “porous bones”. It occurs when bone density decreases and the body stops producing as much bone as it did before. It can affect both men and women, but due to the sudden decrease in estrogen after menopause, it is most likely to occur in older women.

Due to its prevalence worldwide, osteoporosis is considered to be a serious public health concern. It is estimated that over 200 million people worldwide suffer from this disease. While it is some times referred to as a “silent disease” because you can not feel your bones changing, 30% of women in the United States are effected.

What Is Osteoporosis?

“Osteoporosis” literally translates to “porous bones”. The weakening of the bones occurs when your body stops producing as much new bone tissue. Since your bone tissue is constantly being renewed, the decrease in production causes weakness and increased chance of fracture, especially in the hips, spine and wrists.

Bone density peaks when a person is in their late 20s. After the age of around 35 years, bone starts to become weaker. As we age, bone breaks down faster than it builds. If this happens excessively, osteoporosis results.

Signs and Symptoms

Bone loss that leads to osteoporosis developes slowly. There are often no symptoms or outward signs, and a person may not know they have it until they experience a fracture after a minor incident, such as a fall, or even a cough or sneeze.

How Is Osteoporosis Diagnosed?

Because bone loss typically happens gradually and painlessly, the first sign of osteoporosis can be breaking a bone, often more easily than you’d expect. But it is possible to determine if you have osteoporosis, even before a bone is broken, by getting a bone density test. The test can also detect if your bone density is lower than normal for a person of your age and sex.

Bone Density Testing

A bone density test is as close as your doctor can come to predicting your future bone health. The test results will show if you have osteopenia or osteoporosis, and how susceptible your bones are to fracture. A bone density test is the best way to predict fracture risk.

The test uses X-rays to measure how many grams of calcium and other bone minerals are in a square centimeter of bone. Generally, the higher the mineral content, the denser the bone is. And the denser bones are, the less likely they are to fracture.

Bone density testing uses a device called a bone densitometer. Most densitometers measure how much of a low-energy X-ray beam is absorbed as it passes through bone, in comparison to the absorption as the beam passes through the soft tissues next to the bone. The amount of X-ray energy that enters the bone is also compared with the amount of energy that leaves the bone. Denser bone absorbs more of the X-ray beam.

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Causes and Risk Factors

Risk factors include:

  • Age: Risk increases after the mid-30s, and especially after menopause.
  • Reduced sex hormones: Lower estrogen levels appear to make it harder for bone to reproduce.
  • Ethnicity: White people and Asians are more susceptible than other ethnic groups.
  • Bone structure: Being tall (over 5 feet 7 inches) or slim (weighing under 125 pounds) increases the risk.
  • Genetic factors: Having a close family member with a diagnosis of hip fracture or osteoporosis makes osteoporosis more likely.
  • Fracture history: Someone who has previously experienced a fracture during a low-level injury, especially after the age of 50 years, is more likely to receive a diagnosis.
  • Some medications and/or diseases may increase your risk of bone loss. Talk to your doctor if you have an conerns.

How Is Osteoporosis Treated?

Osteoporosis treatment may involve medication along with lifestyle changes.

The most common medications used in the treatment of osteoporosis are:

  • Denosumab (Prolia)
  • Alendronate (Fosamax)
  • Risedronate (Actonel)
  • Ibandronate (Boniva)
  • Zoledronic acid (Reclast)
  • Calcium and Vitamin D Supplements

Some lifestyle changes may help to improve bone density or slow down the loss process. These include:

  • Exercise. Weight-bearing physical activity and exercises that improve balance and posture can strengthen bones and reduce the chance of a fracture. The more active and fit you are as you age, the less likely you are to fall and break a bone.
  • Good nutrition. Eat a healthy diet and make certain that you’re getting enough calcium and vitamin D.
  • Quit smoking. Smoking cigarettes speeds up bone loss.
  • Limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy women, that means up to one drink a day.

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