Osteoporosis is a disease that causes an individual’s bones to become increasingly brittle. This causes an increased risk of fractures. In fact, even moderate accidents or falls can produce fractures. In severe cases, even a fit of coughing or sneezing can result in a fracture. The fractures tend to mainly occur in the hip, spine or wrist.
This is a bone disease that can affect anyone of any race. However, women tend to be more affected by it than men. Additionally , white and Asian women tend to be more affected than those of other races.
Treatment of osteoporosis usually involves use of special medications as well as lifestyle changes. The latter include dietary modifications and taking up weight bearing exercise. The goal of treatment is to prevent bone loss or to strengthen bones that have become too weak.
What Causes Osteoporosis?
Most of us do not realize that our bone tissues are in fact in a constant state of renewal. Old bone tissue is constantly being lost and new tissue is always being created.
At younger ages, new tissue is created at a faster rate than the rate of loss of old tissue. As a result, the overall bone density increases.
However, as we age, the rate of bone tissue creation decreases and the rate of loss increases. By the early 30s, the rate of bone tissue loss starts to exceed the rate at which new tissue is created. This means that our overall bone density starts to decrease and our bones become more brittle.
The chances of developing osteoporosis depends on how much bone density we have accumulated at our peak. This itself tends to vary with inherited factors as well as ethnicity. The more bone density we have accumulated at our peak, the lower the likelihood of developing osteoporosis and vice versa.
The chances of developing osteoporosis have been observed to be correlated with a large range of factors. Some of these may be outside the control of the individual. However, others are controllable and should form part of an osteoporosis prevention strategy.
The following have been found to influence the risk of developing osteoporosis in advanced age:
Gender – women are more likely to develop the condition than men;
Ethnicity – whites and Asians have the highest risk;
Genetics – those with family histories (for example in parents) that include osteoporosis are at highest risk of developing it themselves;
Build – Individuals with small body frames are more at risk. This is because such a frame tends to indicate lower overall bone density and mass;
Hormone levels – the risk of osteoporosis is correlated with the levels of certain hormones in the body. Lower sex hormone levels tend to increase the risk. Higher levels of thyroid hormone can also increase the propensity to develop the disease. Early menopause increases the risk because it is associated with lower levels of oestrogen;
Diet – Osteoporosis risk is higher among individuals whose diets include less calcium and vitamin D.
Osteoporosis is also elevated among individuals whose food intake is lower and who are underweight as a result.
Individuals who have undergone surgery to reduce stomach size may partially lose the ability to absorb calcium and other important nutrients. This in turn can increase the risk of developing osteoporosis;
Certain types of medications have been shown to reduce the body’s ability to build new bone mass. For example, medications to reduce seizures or treat cancer have been observed to have this effect;
Co-existing medical conditions. Individuals with certain medical conditions may be unable to build sufficient new bone mass to replace that being lost. As a result, they may face a higher risk of osteoporosis. Some of these conditions would be cancer, lupus, rheumatoid arthritis, inflammatory bowel disease, malabsorption, chronic liver disease and chronic kidney disease;
Some lifestyle choices can also increase osteoporosis risk. Leading a sedentary lifestyle (with too little weight bearing or resistance exercise in particular) can increase osteoporosis risk.
Excessive consumption of alcohol or tobacco can also increase the risk of developing osteoporosis.
Complications Of Osteoporosis
Osteoporosis can lead to many other health problems as one grows older. Bone fractures (and hip fractures in particular) can lead to long term disability among the aged.
Spinal compression fractures are another potential health risk faced by those with osteoporosis. The spinal vertebrae can become so weak that they start to crumble under their own weight. The result is usually back pain, a “hunched” and forward leaning posture and loss of height.
About 25% of caucasian women over age 60 will develop this posture due to osteoporosis of the spine. It causes rounding of the shoulders due to vertebral fracture/collapse.
If you think you may be at higher risk of developing osteoporosis, talk to your doctor about lifestyle changes. You should also discuss with her any medications that may help you.
Here are some of the steps to prevent the development of osteoporosis or at least to reduce its risk:
Eat plenty of protein. It is one of the building blocks of the most important bodily tissues, including bone.
Vegetarians and older adults may especially be at risk of not consuming enough of this vital nutrient. They need to take conscious steps to ensure an adequate intake.
Make sure you consume enough calcium and vitamin D. These are both essential to forming strong and healthy bones. Good sources of calcium include dairy, salmon or sardines (with bones), soy, dark green leafy vegetables and orange juice.
The best source of vitamin D is sunlight. The ultraviolet rays in the sun trigger the skin to make vitamin D.
However, sunlight may not be easy to get if one lives in far northern or southern regions of the world. In those areas, the days can be short. To make up, one should consider taking a vitamin D supplement.
Try to lead an active lifestyle with plenty of exercise. It’s best to develop these habits when you are young and bone loss has not yet started to occur. Strength training and weight bearing exercise (walking, jogging, running, etc.) is beneficial. It will help you develop good bone density in the legs, hips and spinal areas.
Only weight-bearing exercise is beneficial in preventing osteoporosis. This means exercise where your feet and legs are bearing the body’s weight. Because swimming is not weight-bearing exercise, it is not so beneficial in preventing osteoporosis. Strength training includes exercises like press-ups and weight lifting.
Balance training exercises can also be useful. They will help you reduce your risk of falling as you get older
Smoking and drinking
Chemicals from the tobacco in cigarettes can get into the bloodstream and affect the bones, making osteoporosis worse;
Excessive alcohol intake has a similar effect. You should therefore make every effort to stop smoking. Alcohol intake should also be limited to no more than 14 units per week.
If you are known to have osteoporosis and have suffered a fragility fracture, treatment with medications should be started early.
In other cases, osteoporosis may be present but a fragility fracture has not occurred. Doctors will then use certain criteria to determine when to start medications.
These criteria include age, bone density measurements on a DXA scan and family history of a hip fracture. Other factors are alcohol consumption, whether you smoke, your BMI and presence of medical conditions like rheumatoid arthritis.
The medications used to prevent and treat osteoporosis include the following:
Bisphosphonates : These are the most commonly used group of medicines and are available as tablets, liquid or an injection;
Denosumab. This may be considered for women who have been through the menopause when a bisphosphonate is not suitable or not tolerated. It is given twice a year by injection;
Raloxifene : This is another option for some women with osteoporosis. It works by mimicking the natural effects of oestrogen. It is usually only used if a woman has already had a fragility fracture;
Calcium and vitamin D tablets : The body needs an adequate supply of calcium and vitamin D for bone synthesis. Patients with osteoporosis should take a calcium and vitamin D supplement in addition to one of the above medications.
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