Osteoporosis

Approximately,  50% of women and 25% of men over the age of 50 have osteoporosis and 1 in 3 people have reduced bone density (osteopenia), which can become osteoporosis. Most people don’t know they have osteoporosis until it causes them to break a bone. 

 

Osteoporosis occurs when the creation of new bone doesn't keep up with the loss of old bone.  Bones become weak and brittle — so brittle that a fall or even mild stresses such as bending over or coughing can cause a break and serious consequences. Osteoporosis-related breaks most commonly occur in the hip, wrist, or spine.

 

Risk Factors

Use this Bone Health Assessment or review the many  factors that can contribute to osteoporosis.  

• Family history of hip fractures

• Small body frame and lack of bone mass obtained in youth

• White and Asian women, especially past menopause or who experienced early menopause

• Too much or too little of estrogen and testosterone, common with breast and prostate cancer treatments

• Overactive thyroid or too much thyroid hormone medicine to treat an underactive thyroid

• Overactive parathyroid and adrenal glands

• Long-term use of corticosteroid medicines, such as prednisone and cortisone

• Use of medications for seizures, gastric reflux, cancer, and transplant rejection

• Medical problems such as celiac disease, inflammatory bowel disease, kidney or liver disease, cancer, multiple myeloma, and rheumatoid arthritis

• Dietary factors such as low calcium intake, eating disorders, being underweight, and gastrointestinal surgery 

• Lifestyle choices such as a sedentary lifestyle, excessive alcohol consumption, and tobacco use

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Signs and Symptoms

There typically are no symptoms in the early stages of bone loss, but once weakened the following can occur:

• Lower back pain, caused by a broken or collapsed bone in the spine

• Loss of height over time (an inch or more)

• Changes in posture such as stooping or bending forward

• Shortness of breath due to compression of spinal disks 

• A bone that breaks much more easily than expected

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Prevention and Treatment to prevent bone loss and strengthen already weak bones

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Calcium: People aged 18 to 50 need 1,000 milligrams of calcium a day and 1,200 milligrams for women over  50 and men over 70. Total calcium intake, from supplements and diet combined, should be no more than 2,000 milligrams daily.  Good sources include: low-fat dairy products, dark green leafy vegetables, canned salmon or sardines with bones, soy products, calcium-fortified cereals, and orange juice.

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Vitamin D improves the body's ability to absorb calcium and improves bone health in other ways. People can get some of their vitamin D from sunlight. Dietary sources of vitamin D include cod liver oil, trout, salmon,and  fortified milk and cereal. Most people need at least 600 international units (IU) of vitamin D a day and 800 IU a day after age 70.

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Exercise can help build strong bones and slow bone loss. Combine strength training exercises with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in the arms and upper spine. Weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope,  and impact-producing sports — affect mainly the bones in the legs, hips and lower spine. Balance exercises such as tai chi can reduce risk of falling.

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Medications prescribed by healthcare providers. Some of the most common medications include hormone therapies . People with severe osteoporosis or a high risk of fractures might need medications, including parathyroid hormone (PTH) analogs, denosumab and romosozumab. These medications are usually given as injections.

 

Fall Prevention Measures can reduce the chance of injury and breaking a bone.  Review these tips to lessen the risk of falls. 

 

Diagnosis 

A healthcare provider will diagnose osteoporosis with a bone density test, which uses X-rays to measure the calcium and other minerals in the bones to determine their strength.  

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