Osteoporosis (Bone Loss)

Osteoporosis causes bones to become weak and brittle. It is so fragile that even mild stress such as falling or bending over or coughing can cause breakage. Osteoporosis-related fractures most commonly occur in the hip, wrist, or spine.

Bone is a living tissue that is constantly broken down and renewed. Osteoporosis occurs when new bone formation cannot keep up with the loss of old bone.

Osteoporosis affects men and women of all races. But white and Asian women, especially older menopausal women, are at higher risk. Medications, a healthy diet, and exercise can help prevent bone loss or strengthen already weak bones.

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Symptoms

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There are typically no symptoms in the early stages of bone loss. But when your bones are weakened by osteoporosis, you may have signs and symptoms that include:

• back pain caused by a broken or collapsed vertebra

• neck shortening over time

• an oblique stance

• A bone that breaks much more easily than expected

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Reasons

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Osteoporosis weakens the bone

Your bones are in a state of constant renewal – new bone is made and old bone is broken down. When you're young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. After the early 20s, this process slows down and most people reach peak bone mass by age 30. 

Your odds of developing osteoporosis depend in part on how much bone mass you achieved as a teenager. Bone mass is partially hereditary and also varies by ethnic group. The higher your peak bone mass, the more bone you have in the "bank" and the less likely you are to develop osteoporosis as you age.

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Risk factors

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A number of factors can increase your odds of developing osteoporosis, including your age, race, lifestyle choices, and medical conditions and treatments.

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Irreplaceable risks

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Some risk factors for osteoporosis are out of your control, such as:

• Your gender. Women are much more likely to develop osteoporosis than men.

• Age. As you get older, your risk of osteoporosis increases.

• Race. If you are of white or Asian descent, you are at greatest risk of osteoporosis.

• family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mom or dad broke a hip.

• Body frame size. Small-bodied men and women have a higher risk as they may pull less bone mass as they age.

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Hormone levels

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Osteoporosis is more common in people who have more or less than normal hormones in their body. Examples include:

• sex hormones. Low sex hormone levels tend to weaken bone. The decline in estrogen levels in menopausal women is one of the strongest risk factors for developing osteoporosis. Prostate cancer treatments that reduce testosterone levels in men and breast cancer treatments that reduce estrogen levels in women are likely to accelerate bone loss.

• Thyroid problems. Too much thyroid hormone can cause bone loss. This can happen if your thyroid is overactive or if you take too much thyroid hormone medication to treat a thyroid with low levels.

• Other cloths. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.

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Dietary factors

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Osteoporosis is more likely to occur in people who have:

• Low calcium intake. Lifelong calcium deficiency plays a role in the development of osteoporosis. Low calcium intake contributes to decreased bone density, early bone loss and increased risk of fractures.

• Eating disorders. Severely restricting food intake and being underweight weakens bone in both men and women.

• Gastrointestinal surgery. Surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients, including calcium. While these surgeries may help you lose weight, other gastrointestinal ailments may also occur.

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steroids and other drugs

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Long-term use of oral or injected corticosteroid medications, such as prednisone and cortisone, interferes with the bone remodeling process. Osteoporosis has also been associated with medications used to combat or prevent:

• seizures

• stomach reflux

• Cancer

• transplant rejection

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medical conditions

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People with certain medical problems, including:

• celiac disease

• inflammatory bowel disease

• kidney or liver disease

• Cancer

• Multiple myeloma

• rheumatic joint inflammation

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lifestyle choices

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Certain bad habits can increase your risk of osteoporosis. Examples include:

• Sedentary lifestyle. People who spend a lot of time sitting down have a higher risk of osteoporosis than those who are more active. Any weight-bearing exercise and activity that promotes balance and good posture is beneficial for your bones, but walking, running, jumping, dancing and weightlifting seem to be particularly beneficial.

• Excessive alcohol consumption. Regular consumption of more than two glasses of alcoholic beverage per day increases the risk of osteoporosis.

• Tobacco use. The exact role tobacco plays in osteoporosis is not clear, but tobacco use has been shown to contribute to weak bones.

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Complications

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Compression fractures

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Bone fractures, especially in the spine or hip, are the most serious complications of osteoporosis. Hip fractures are often caused by a fall and can lead to an increased risk of disability and even death within the first year after injury.

In some cases, spinal fractures can occur even if you did not fall. The bones (vertebrae) that make up your spine can weaken to the point of collapse, causing back pain, loss of height, and a hunched posture.

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Prevention

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Good nutrition and regular exercise are essential to keeping your bones healthy throughout your life.

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Calcium

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Men and women ages 18 to 50 need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when women reach 50 and men 70.

Good sources of calcium include:

• low-fat dairy products

• dark green leafy vegetables

• Canned salmon or bone-in sardines

• Soy products such as tofu

• Calcium-fortified cereals and orange juice

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Calcium supplements can be taken if you have trouble getting enough calcium from your diet. However, calcium can cause kidney stones. While it's not clear yet, some experts suggest that too much calcium, especially in supplements, may increase the risk of heart disease.

It recommends that for people older than 50 years of age, the total calcium intake from a combination of supplements and diet should be no more than 2,000 milligrams per day.

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Vitamin D

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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, but it may not be a good source if you live in a high place, are homebound, or regularly use sunscreen or avoid the sun because of the risk of skin cancer. .

Dietary sources of vitamin D include cod liver oil, trout, and salmon. Many types of milk and cereals are fortified with vitamin D.

Most people need at least 600 international units (IU) of vitamin D per day. This recommendation increases to 800 IU per day after age 70.

People who do not have other sources of vitamin D and who have limited exposure, especially to the sun, may need additional treatment. Most multivitamin products contain between 600 and 800 IU of vitamin D. Up to 4,000 IU per day of vitamin D is safe for most people.

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To exercise

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Exercise can help you build strong bones and slow bone loss. No matter when you start exercising, it benefits your bones, but you can reap a lot of benefits if you start exercising regularly when you're young and keep exercising throughout your life.

Combine strength training exercises with weight bearing and balance exercises. Strength training helps strengthen the muscles and bones in your arms and upper spine. Weight-bearing exercises such as walking, running, jogging, climbing stairs, jumping rope, skiing, and impact-generating sports primarily affect the bones in your legs, hips, and lower spine. Balance exercises like tai chi can reduce your risk of falling, especially as you get older.

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