Osteoporosis
Osteoporosis Facts
Osteoporosis is a disease of the bones that causes the bones to decrease in density and in mass. This means that the bones become weakened and brittle, and more likely to break. Sometimes bones become so brittle that even mild stress on them, such as coughing or a change in position can cause a fracture. These fractures related to Osteoporosis are most likely to occur in the spine, wrist or the hip.
Prevalence
Risk factors
Some of the factors that increase your risk of developing Osteoporosis are out of your control. These include:
- Gender: If you are a woman, you are more likely than a man to develop Osteoporosis.
- Age: Your chance of developing Osteoporosis increases with your age.
- Race: If you are Caucasian or of Asian descent, you are at greater risk of the disease than other races.
- Family history: If you have a sibling or a parent with Osteoporosis, especially if you also have a history of hip fractures in your family, you are at an increased risk for having the disease.
- Frame structure: People who have small frames tend to be at increased risk for Osteoporosis, both women and men, due to the fact there is less bone tissue for the body to draw from as a resource during the aging process.
Hormone levels
Hormone levels also have a lot to say about Osteoporosis, and this is a risk factor that is beyond our control when it occurs. In some cases, medication is available to correct hormonal dysfunction. Examples of hormones that can affect the risk of Osteoporosis include:
- Sexual hormones: The reduction in estrogen production at the time of menopause greatly increases a woman's risk for Osteoporosis. Certain cancer therapies may also decrease estrogen production. Testosterone levels decrease as men age and certain prostate cancer treatments may also lower the level of this sex hormone. Decreased levels of sexual hormones weaken bone tissue leading to Osteoporosis.
- Thyroid hormones: An excess of the hormone produced by the thyroid or by taking too much medication to correct a thyroid deficiency can lead to an increased risk of Osteoporosis due to bone loss.
- Other hormones: Hormones produced by other glands have also been associated with an increased chance of Osteoporosis. These glands include the adrenal and the parathyroid glands.
Calcium intake
Your risk for Osteoporosis is increased if not enough calcium is available for the production and replacement of bone mass. Low calcium levels are more likely to occur include people who have:
- A calcium-poor diet: Without adequate calcium, bone density diminishes and early bone loss occurs which leads to Osteoporosis. A diet lacking in calcium throughout life plays a major role in this.
- Eating disorders: A reduced intake of food like is found in anorexia can decrease the amount of calcium intake. Anorexia can also stop the menstrual cycle in women which lead to early bone loss and Osteoporosis.
- Gastrointestinal surgery: When weight loss surgery to limit the surface area of the stomach or the removal of part of the intestine is required, fewer nutrients such as calcium are available to be absorbed. This can increase the risk for Osteoporosis.
Medications
Certain medications interfere with the way the body rebuilds bone tissue. The use of these increases the chance of developing Osteoporosis. Some of these include corticosteroids when they are used long-term. Examples of corticosteroids include cortisone and prednisone.
The disease has also been linked to medications used to treat or to prevent:
- Seizures
- Rejection of transplanted organs
- Cancer
- Epigastric reflux
- Depression
Lifestyle
There are also some lifestyle factors and behaviors that are associated with an increased chance of developing Osteoporosis. Examples of these include:
- Lack of exercise: A sedentary lifestyle is associated with an increased risk of osteoporosis. Weight-bearing exercise has been shown to be especially helpful for creating and maintaining healthy bones, for example running, walking, dancing and weight-lifting.
- Excessive use of alcohol: More than two alcoholic drinks per day on a regular basis has been associated with an increased risk for Osteoporosis. This may be due to decreased calcium absorption in the presence of alcohol.
- Smoking and tobacco use: While it isn't known exactly why it is known that the use of tobacco leads to the weakening of bones and Osteoporosis.
Reasons
Osteoporosis is a polyetiological condition, this means it can be caused by a number of different conditions. Some of these include:
- Hormone imbalances or deficiencies
- A lack of calcium
- A lack of vitamin D
- A sedentary lifestyle is associated with Osteoporosis
- Other medical conditions like thyroid disease or certain digestive disorders
- Tobacco use can lead to Osteoporosis
- Excessive consumption of alcohol
- Use of certain medications can lead to Osteoporosis
- There is also a genetic risk factor that has been linked to the development of Osteoporosis
Classification
Osteoporosis Symptoms
A bone fracture after a fall is frequently the main Osteoporosis symptom. In the event that you have Osteoporosis, the power of a stumble to the ground is frequently enough to fracture a bone. A stumble to the ground, for example, does not, for the most part, cause a fracture in somebody without Osteoporosis. A broken bone after minor damage like this is known as a fragility fracture.
The most widely recognized fragility fractures happen in the hip, wrist, and the bones that make up the spine (vertebrae). A broken bone in a more established individual can have genuine outcomes in a few people.
Having weaker bones does not in itself give you any osteoporosis symptom. Unless you have had a fracture, a throbbing pain is NOT an osteoporosis symptom. It doesn't cause pain other than the after-effect of a fracture. On the off chance that you have not had a fracture and you have felt pain, this will be because of another issue and is not an osteoporosis symptom. Having said that, we don’t frequently get fractures in the vertebrae. So, on the off chance that you have another serious back pain and you know you have osteoporosis symptoms, you should tell your specialist. An X-ray would then be able to get organized to check if you have a fracture.
Loss of height, back pain, and a stooping pose are osteoporosis symptoms that can happen on the off chance that you have at least one broken vertebrae. A vertebra influenced by osteoporosis symptoms may fracture even without a fall or noteworthy force to cause. The vertebrae can end up noticeably squashed after a fracture. In the event that a bowed forward stance, which is an osteoporosis symptom may influence your capacity to approach your typical day to day exercises. It can likewise influence your breathing, as your lungs will have less space to expand your chest.
In the early stages of bone loss that occur in osteoporosis, there are typically no osteoporosis symptoms. Once the bones begin to become weak, some osteoporosis symptoms may start to appear. These can include:
- A stooped over posture, and a loss in height due to this is an osteoporosis symptom
- Pain occurring in the back due to vertebrae that have collapsed or have been fractured
- A bone fracture which occurs unexpectedly, especially in the wrist, spine or hip is a classic osteoporosis symptom
- A loss of bone mass signaling osteoporosis may be evident on dental x-rays
- Lack of Vitamin D
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Trouble getting up from a seat without using your arms to push
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Muscle and joint pain
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Bone mineral density is at -2.5 or lower.
Diagnostic procedures
The diagnosis of osteoporosis symptoms is made by measuring your bone mineral density or BMD. This measurement is related to the strength of your bones and can help your doctor predict how likely you are to have a fracture of one of your bones.
- In order to measure your BMD, a test called a DXA scan, or a bone density scan is completed. It's important to not get this mixed up with a "bone scan" which is used to look for certain types of tumors and cancers, infections or fractures rather than detecting conditions like osteoporosis.
The results of your DXA scan can tell whether your bones are healthy, whether your bone mass is low and beginning to a show bone loss, which is a condition called osteopenia, or whether you have osteoporosis.
The scan doesn't take long and it is painless. You will lie down on an examination table and the scanner will pass over the surface of your body.
- A standard X-ray can uncover osteoporosis of the bone on the grounds that the bones seem substantially more slender and lighter than typical bones. However, when X-rays have successfully recognized osteoporosis symptoms, no less than 30% of the bone has already been lost. What's more, X-rays are not exact pointers of bone thickness. In this manner, the presence of the bones on X-rays regularly is influenced by varieties in the level of presentation of the X-ray film.
- Bone densitometry is a test like an X-ray test that rapidly and precisely measures the thickness of the bone. It is utilized essentially to identify osteopenia or osteoporosis, sicknesses in which the bone's mineral and thickness are low and the danger of breaks is expanded.
On the off chance that you figure you might be pregnant, tell your specialist before getting a bone densitometry test.
You don't need to change your day to day routine before this test. Eat, drink, and take any medication as you regularly would. In any case, don't take calcium supplements or medications that contain calcium for 24 hours before your bone densitometry test.
Osteoporosis Treatment
The most widely used medications for osteoporosis treatment in both men and women are those known as bisphosphonates. Examples of these medications for osteoporosis treatment are:
- Risedronate (Actonel, Atelvia)
- Zoledronic acid (Reclast, Zometa)
- Alendronate (Fosamax, Binosto)
- Ibandronate (Boniva)
Side effects of these osteoporosis treatments and medication include difficulty swallowing, abdominal pain, nausea and an increased risk of inflammation of the esophagus or ulcers of the esophagus. When the medication is taken properly, these side effects are less likely. Injected forms of these osteoporosis treatment drugs do not cause an upset stomach, but the injectable form is more expensive.
Long-term use of these osteoporosis treatment drugs has been associated with an uncommon problem of cracking and possible breaking of the thighbone. They can also affect the bone of the jaw. This is most likely to happen after the extraction of a tooth. A patient should always have a dental examination prior to starting bisphosphonate osteoporosis treatment.
Hormone-related therapy
If estrogen replacement therapy is started fairly quickly after the onset of menopause, it can help maintain bone strength and density and reduce the risk of osteoporosis and serve as an osteoporosis treatment. Estrogen therapy also has side effects including blood clots, heart disease, and breast and endometrial cancer.
Raloxifene (Evista) is an alternative to estrogen which can assist in preventing the loss of bone density and decrease the risk of osteoporosis in postmenopausal women but does not have some of the side effects of estrogen. This osteoporosis treatment medication can also help reduce the chance of some kinds of breast cancer. It can increase the risk of blood clots and hot flashes is a frequent side effect.
In men, testosterone replacement therapy can help with bone density, but usually, other medications are recommended to decrease the risk of osteoporosis.
Other osteoporosis treatment medications
For people who cannot tolerate the common medications for osteoporosis, or for those who need more extensive osteoporosis treatment, doctors may recommend:
- Teriparatide (Forteo): This medication actually stimulates the growth of new bone for osteoporosis treatment. It is injected under the skin.
- Denosumab (Prolia): This medication is also given by injection and works better than bisphosphonates for osteoporosis treatment. Side effects may include muscle and back pain.
Prevention
There are three very important and very easy ways you can keep your bones healthy and help reduce your risk of osteoporosis. They are:
- Make sure you get enough calcium
- Make sure you get enough vitamin D
- Make sure you get regular exercise
Calcium
Both men and women need calcium to keep their bones healthy and reduce the risk of osteoporosis. If you are between 18 and 50 years old, you need 1,000 milligrams per day. If you are a woman, when you turn 50, you need 1,200 milligrams daily and if you are a man, increase your daily intake to 1,200 milligrams when you turn 70. The best sources of calcium to include in your diet are:
- Cereals and orange juice fortified with calcium
- Soy products, like tofu
- Canned sardines or salmon, including bones
- Dark green leafy vegetables
- Low or no-fat dairy products
If you can't get enough calcium from the foods you eat, ask your doctor to recommend a supplement. Be careful, because taking too much calcium has been linked to kidney stones and heart problems. The total daily calcium intake daily, including diet and supplements, should not exceed 2,000 milligrams for people who are over the age of 50.
Vitamin D
In order for your body to absorb calcium, vitamin D is needed. The sunlight is a good source of this vitamin, but many people do not get enough, especially those living in northern climates, those who are confined to the home or those who use sunscreen or who avoid the sun due to skin cancer.
The exact daily dose of vitamin D required has not been established, but most physicians recommend adults get 600 to 800 IU (international units) per day from diet and supplements combined. If blood studies show you are low in vitamin D your doctor may recommend a higher daily dose. Up to 4,000 IUs per day are safe for adults and teenagers.
Exercise
Regular exercise helps lower the loss of bone tissue and builds strong bones and it provides the most benefits when it is started at a young age. Strength training can benefit you by strengthening the bones and muscles in the upper part of the spine and your upper arms. Weight-bearing activity like running, stair climbing, skiing, walking, jogging mainly help the bones in the lower spine, legs and hips. Prevention is still considered an osteoporosis treatment.
Low impact activities like cycling, swimming, working out on machines and training on elliptical machines are great at providing a workout for the cardiovascular system, but they don't provide as much benefit to the bones as weight-bearing exercises.
Pathological changes
All types of osteoporosis are caused by the imbalance between the amount of bone being formed and the amount of bone is lost. Under normal circumstances, new bone is constantly being formed, in fact up to 10% of all the body's bone mass may be being replaced at one time. This process takes place through the work of special cells called osteoclasts and osteoblasts.
Osteoporosis develops either because as the bones grow and develop, they don't lay down a strong foundation, too much bone tissue is reabsorbed, or not enough bone tissue is formed or any of these factors working together.
Hormones greatly influence the rate at which bone is reabsorbed. Calcium and vitamin D also have an impact on this. The structure and makeup of the bones also change with the process of aging and have an effect on the development of osteoporosis.
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