Osteoporosis: Symptoms, Causes, Treatment and Prevention

Osteoporosis:

Because osteoporosis weakens bones, they are more prone to sudden, unforeseen fractures. The condition frequently advances painlessly, and it is not discovered until bones break. This illness is preventable, and there are therapies available.

Describe osteoporosis:

Osteoporosis translates to "porous bone." Since the condition weakens bones, having it increases your chance of sudden, unforeseen bone fractures. If you have osteoporosis, your bones are weaker and have less mass. The condition frequently progresses without any warning signs or discomfort, and it is typically not recognized until the weakening bones result in excruciating fractures. The majority of these involve hip, wrist, and spine fractures.

How common is osteoporosis?

Globally, osteoporosis is thought to affect about 200 million individuals. The number is approximately 54 million in the United States. Both men and women can get osteoporosis, although women are four times more likely to get it than men. Approximately two million American males presently have osteoporosis, and an additional 12 million are at risk of getting the disease.

One in every two women and one in every four males will get an osteoporosis-related fracture after the age of 50. Another 30% of people have low bone mass, which increases their risk of osteoporosis. The name of this condition is osteopenia.

More than two million fractures occur each year as a result of osteoporosis, and this number keeps rising.

Causes:

Even without knowing the precise cause of how osteoporosis arises, researchers are aware of how it does. Living, expanding tissue makes up your bones. Healthy bones have a sponge-like appearance on the inside. Trabecular bone is the term for this region. The spongy bone is encased in a tough outer layer of bone. Cortical bone is the name of this robust covering.

Osteoporosis weakens the inside of the bone by causing the "holes" in the "sponge" to enlarge and multiply. Bones support and shield the body's critical organs. Calcium and other minerals are also stored in bones. The body breaks down and rebuilds bone when it requires calcium. This procedure, known as bone remodeling, maintains the strength of the bones while supplying the body with the calcium it requires.

You typically gain more bone than you lose up until the age of roughly 30. After age 35, bone mass gradually decreases because bone deterioration outpaces bone formation. You lose bone density more quickly if you have osteoporosis. The rate of bone deterioration increases after menopause.

Symptoms:

Osteoporosis typically shows no symptoms. It is sometimes referred to as a silent sickness for this reason. 

• Adaptation of posture (stooping or bending forward).
• Breathing difficulty (smaller lung capacity due to compressed disks).
• Broken bones.
• Vertebral fracture or collapse resulting in back pain.
• Height declines with time.
• A hunched position.
• A bone that fractures far more quickly than is typical.

Who is susceptible to osteoporosis?

Two of the most important risk factors for osteoporosis are gender and age, which together account for a wide range of risk variables.

Age raises everyone's risk for osteoporosis fractures. However, the risk of getting osteoporosis is highest in postmenopausal women over the age of 50. Because menopause inhibits the production of estrogen, a hormone that prevents excessive bone loss, women experience accelerated bone loss in the first 10 years after menopause.

Both osteoporosis and aging affect males. You might be startled to learn that men over 50 are more likely to suffer a bone fracture brought on by osteoporosis than to develop prostate cancer. Men are predicted to break their hips at a rate of about 80,000 each year, and they are more likely than women to pass away a year after a hip fracture.

Ethnicity is a factor in your osteoporosis risk as well. Asian and Caucasian women are more prone to osteoporosis development. Black and Hispanic women are still at risk, though. In actuality, after a hip fracture, African-American women are more likely to die than white women.

Bone structure and body weight are further factors. Because they have less bone to shed than persons with more body weight and larger frames, those who are petite and skinny are more likely to develop osteoporosis.

Risk factors for osteoporosis also include family history. You may be at a higher risk of having osteoporosis if your parents or grandparents have displayed any symptoms of the condition, such as a hip fracture following a minor fall.

Last but not least, certain medical problems and drugs raise your risk. You and your healthcare provider might think about earlier osteoporosis screening if you currently have or formerly had any of the illnesses listed below, some of which are connected to abnormal hormone levels.

• Thyroid, parathyroid, overactive adrenal glands.
• Previous organ transplantation or bariatric (weight loss) surgery.
• Hormone therapy for prostate or breast cancer, or if you've skipped periods in the past.
• Inflammatory bowel illness or celiac disease.
• Blood conditions like multiple myeloma.

Osteoporosis and bone deterioration from several drugs' adverse effects are possible. Steroids, breast cancer therapies, and seizure control drugs are a few of these. The impact of your medications on your bones should be discussed with your doctor or pharmacist.

Although every risk factor is linked to an element outside of your control, this is untrue. You can talk to your doctor about pharmaceutical concerns. And you are responsible for your

Eating habits:

 If your body doesn't get enough calcium and vitamin D, you're more likely to get osteoporosis. Despite being risk factors, eating disorders like bulimia and anorexia can be treated.

Lifestyle:

 Sedentary (inactive) people are more likely to develop osteoporosis.

Smoking:

 Smoking raises the possibility of fractures.

 Diagnosis:

To find out about your bone health before problems arise, your doctor may conduct a test. Dual-energy X-ray absorptiometry, often known as a DEXA or DXA scan, is another name for bone mineral density (BMD) examinations. The strength of the spine, hip, and wrist bones can be examined using these X-rays, which emit very modest doses of radiation. Only highly advanced osteoporosis will be shown on routine X-rays.

For females who have osteoporosis risk factors, the DEXA scan may be performed sooner. Consider obtaining a bone density test if you're a man over 70 or a younger man with risk factors.

Treatment:

Exercise, vitamin and mineral supplements and pharmaceuticals are all possible treatments for osteoporosis that have already progressed. You may benefit from taking supplements and engaging in physical activity to avoid osteoporosis. Exercises including weight bearing, resistance, and balance are all crucial.

Which drugs are prescribed to treat osteoporosis?

There are numerous drug classes used to treat osteoporosis. To find the ideal fit, your healthcare provider will collaborate with you. It's difficult to say which drug is the best for treating osteoporosis. The therapy that is most effective for you is the "best" therapy.

hormones and treatments connected to hormones

Estrogen, testosterone, and the selective estrogen receptor modulator raloxifene (Evista®) are all members of this class. Estrogen therapy is likely to be utilized in younger women and women who need to treat menopause symptoms due to the risk of blood clots, certain malignancies, and heart disease.

Bisphosphonates

Treatments for osteoporosis with bisphosphonates are regarded as antiresorptive medications. They prevent bone tissue from being reabsorbed by the body. There are numerous formulas with varied brands and dosing regimens (monthly, daily, weekly, and even yearly). After three to five years of use, you might be able to stop taking bisphosphonates and continue to reap the benefits. These medications are also offered in generic form. Only women should use Boniva and Atelvia, although both sexes are permitted to use the other products.

The flu-like symptoms (fever, headache), heartburn, and reduced renal function are all potential side effects of bisphosphonates. Atypical femur fractures and the uncommon occurrence of jaw bone deterioration (osteonecrosis of the jaw) are just two examples of the potentially catastrophic adverse effects (low trauma fractures of the thigh). With continued medication use (>5 years), the chance of these uncommon occurrences rises.

Biologics

Both men and women can receive an injection of denosumab (Prolia®)once every six months. When other therapies have failed, it is frequently utilized. Even in some cases of impaired kidney function, denosumab can be administered. Although the long-term implications are unknown, there could be some very serious adverse effects. Among them are potential issues with the jaw or thigh bones.

Anabolic substances

People with osteoporosis can build bone density with these products. There are now three of these goods that are authorized:

For postmenopausal women who have a high risk of fracture, romosumab-aqqg (Evenity®) has been approved. The substance both promotes the growth of new bone and lessens bone deterioration. Once a month, you will receive two injections, one immediately after the other. These injections can only be given for a year.

For two years, injectable medications teriparatide (Forteo®) and baloparatide (Tymlos®) are administered daily. They are parathyroid hormones or substances that resemble hormones in many aspects.

When should medicine be used to treat osteoporosis?

Women should start therapy to lessen their risk of fracture if their T-scores on the bone density test are -2.5 or lower, such as -3.3 or -3.8. If a woman has osteopenia, a milder form of osteoporosis, she is likely to need medical attention. Based on your risk factors and bone density results, your doctor may use the World Health Organization's fracture risk assessment tool, or FRAX, to determine if you need therapy. Treatment should also be given to people who have experienced a classic osteoporosis fracture, such as one of the wrist, spine, or hip (sometimes even if the bone density results are normal).

Supplements

It's crucial to keep in mind that nutritional supplements aren't subject to the same regulations as prescription drugs, despite being widely accessible over-the-counter and online. Additionally, just because something is "natural" doesn't necessarily mean that it is always safe for use.

Your healthcare professional might advise you to consume enough calcium and vitamin D. If you have osteoporosis or are attempting to prevent it, this is crucial. The ideal situation is if you can satisfy those needs with a meal plan, but you might not be able to. There are calcium supplements made from plants, some of which are based on algae

1,000 mg to 1,200 mg of calcium should be consumed every day, either through diet or supplements. It has not been demonstrated that consuming more calcium will boost bone strength, but it may be linked to a higher risk of kidney stones, calcium buildup in the blood vessels, and constipation.

Different theories exist on the optimal levels of vitamin D, but it is known that many people do not have sufficient levels and may require supplements. Your doctor may check your blood sugar levels and then base his or her advice on the results.

Prevention:

Two significant risk factors for osteoporosis that you may manage are your food and way of living. In postmenopausal women, hormone therapy that replaces lost estrogen offers a powerful barrier against osteoporosis.

Diet

You need a diet high in calcium to maintain strong, healthy bones throughout your life. The amount of calcium in one cup of skim or 1 percent fat milk is 300 milligrams.

       Among the food sources are:

• Dairy products like yogurt, cheese, and milk
• Green veggies with leaves, like kale and broccoli
• Fish having fragile bones, like canned tuna and salmon
• Breakfast cereals fortified
• A person can take supplements if their calcium intake is insufficient.

Due to its ability to facilitate the body's absorption of calcium, vitamin D is also essential in preventing osteoporosis. Saltwater fish, liver, and fortified meals are other dietary sources.

Remember that the body can only absorb 500 mg of calcium at a time if you need supplements. Since more than 500 mg of calcium supplementation won't be absorbed, you should take it in staggered doses.

recommended daily intake of calcium

Age and gender Number

Adults, aged 19 to 50, 1,000 mg

Men aged 51 to 70, 1,000 mg

Adult women, ages 51 to 70, 1,200 mg

Adults aged 71 and beyond 1,200 mg

Adolescents who are expecting or nursing 1,300 mg

Pregnant women who are also nursing

Because it helps the body absorb calcium, vitamin D is very crucial. The following is a list of the recommended daily intakes for vitamin D. Additionally, a few weekly sessions of exposure to sunlight and the consumption of fortified milk also provide vitamin D.

Daily recommended intake of vitamin D

Number of people by age

0 to 6-month-old babies: 400 IU

6 to 12-month-old infants  400 IU

1-3 years of age  600 IU

4–8 years of age  600 IU

ages 9 to 70  800 IU

800 IU over 70 years old

14 to 50 years old, breastfeeding or pregnant 600 IU

Discuss these figures with your healthcare physician. You could be advised to take additional vitamin D in specific circumstances. The calcium type may also be suggested by your healthcare professional; for example, you may be instructed to take calcium citrate rather than calcium carbonate. 

Calcium is crucial for healthy bones. Make careful you get enough calcium each day.

Lifestyle

The amount of bone loss can be decreased by leading a healthy lifestyle. Start a routine fitness regimen. The best exercises for building stronger bones are those that require your muscles to work against gravity, like weightlifting, jogging, and aerobics.

 Avoid consuming too much caffeine. Never, ever use tobacco.

Other strategies for reducing the risk include:

• Avoid smoking as it can inhibit the formation of new bone and lower a woman's estrogen levels.
• Minimizing alcohol consumption to promote strong bones and stop falls
• Regular weight-bearing exercise, such as walking, supports strong, healthy bones and strengthens the muscles that support them.
• Yoga and other flexibility and balance-enhancing workouts help lower the incidence of falls and fractures.
• Nutrition, exercise, and fall prevention strategies are essential for minimizing the risk of fracture and the rate of bone loss in persons who already have osteoporosis.

Outlook:

Osteoporosis is a disease that can have negative consequences. Fractures that result from it can be painful, difficult to heal, and cause other problems.

A hip fracture, for example, may require prolonged bed rest, which increases your risk of blood clots, pneumonia, and other infections.

The good news is that there are many things you can do to both prevent and cure osteoporosis, from maintaining a healthy diet and exercising regularly to using the right drugs.

Speak to your doctor if you believe you may have osteoporosis or if you have already received a diagnosis. They can collaborate with you to develop a preventative or therapeutic strategy that will help you maintain good bone health and lower your risk.