Osteoporosis

What is Osteoporosis?

Osteoporosis is a bone disease characterized by decreased bone density and strength, which makes bones more fragile and prone to fractures. It often progresses without symptoms until a fracture occurs.

Causes of Osteoporosis

• Bone remodeling imbalance: With age, the rate of bone breakdown exceeds the rate of new bone formation.
• Hormonal changes: Reduced estrogen levels in women (especially post-menopause) and testosterone levels in men contribute to bone loss.
• Calcium and vitamin D deficiency: Essential nutrients for bone health; low levels can accelerate bone loss.
• Genetics: Family history of osteoporosis increases risk.
• Medical conditions: Such as hyperthyroidism, celiac disease, and rheumatoid arthritis.
• Medications: Long-term use of corticosteroids and certain other drugs can weaken bones.

Risk Factors

• Age: Risk increases as you get older, especially after 50.
• Gender: Women are more likely to develop osteoporosis than men.
• Family history: Higher risk if a parent or sibling has osteoporosis.
• Body frame size: Smaller body frames have less bone mass to draw from as they age.
• Diet: Low intake of calcium and vitamin D contributes to bone loss.
• Lifestyle choices: Sedentary lifestyle, smoking, and excessive alcohol use increase risk.

Symptoms of Osteoporosis

Osteoporosis is often called a “silent disease” because bone loss occurs without symptoms. When symptoms do appear, they may include:

• Back pain: Caused by a fractured or collapsed vertebra.
• Loss of height over time
• Stooped posture
• Bone fractures: Occur more easily, especially in the hip, spine, or wrist.

Diagnosis

• Bone density test (DEXA scan): The most common test to measure bone mineral density (BMD).
• Physical examination: Review of medical history and risk factors.
• Laboratory tests: To rule out other medical conditions that could cause bone loss.

Prevention Strategies

• Calcium-rich diet: Include dairy products, leafy greens, and fortified foods to maintain bone strength.
• Vitamin D intake: Sun exposure and foods like salmon and fortified milk help the body absorb calcium.
• Regular exercise: Weight-bearing and strength-training exercises can improve bone density.
• Avoid smoking: Smoking accelerates bone loss.
• Limit alcohol consumption: Excessive drinking can interfere with bone formation.

Treatment Options

• Medications:
  • Bisphosphonates: Reduce bone loss and fracture risk (e.g., alendronate, risedronate).
  • Monoclonal antibodies: Such as denosumab, which helps slow bone breakdown.
  • Hormone-related therapy: Estrogen therapy can maintain bone density in postmenopausal women.
  • Anabolic agents: Medications like teriparatide and abaloparatide that stimulate new bone formation.
• Calcium and vitamin D supplements: Ensure sufficient intake to support bone health.
• Lifestyle changes: Incorporating more physical activity and balanced nutrition into daily routines.

Complications of Osteoporosis

• Fractures: Most common and serious complication, especially in the hip and spine.
• Loss of mobility: Hip fractures can lead to reduced mobility and independence.
• Chronic pain: Can result from spinal fractures or bone damage.
• Height loss and spinal deformities: Fractures in the spine can lead to a curved or stooped posture.
• Increased risk of mortality: Especially after hip fractures in older adults.