Osteoporosis (OP) is a condition characterized by decreased bone strength, and loss of both density and structure, leading to an increased risk of fracture.  Many factors can contribute to bone loss:

• Sex: Women are more likely to develop osteoporosis.  Both estrogen and testosterone are essential for healthy bone tissue, but estrogen levels drop quickly during menopause, making women more susceptible to bone loss.  Nearly 20% women over the age of 50 are affected by bone loss, while about 5% of men over the age of 50 are affected.  About 55% of people over 50 are at significant risk of osteoporosis.  Once they reach age 70, men catch up with women in the rate they lose bone.

• Age: Your bone is living tissue that changes over time just like all the other tissues in your body, but before age 30 your body is efficient in the process of balanced bone remodeling, which means your body removes old, damaged bone tissues and replaces it with new bone every 7-10 years.  After age 30-40, the process may become unbalanced, and gradually your body removes more tissue than it can replace.  This decreases the quality of your bones as you age, making you more susceptible to fractures, especially of the spine, wrist, and hip.

• Health conditions and procedures may affect your bone health:

1. • Gastrointestinal and digestive disorders, including inflammatory bowel disease and celiac disease
   • Prostate or breast cancer
   • Chronic kidney disease or liver disease (including biliary cirrhosis)
   • Autoimmune disorders, including lupus, rheumatoid arthritis, multiple sclerosis, and ankylosing spondylitis
   • Hematologic disorders, including leukemia, lymphoma, multiple myeloma, and sickle cell disease
   • Neurological disorders, including stroke, spinal cord injury, and Parkinson’s disease
   • Endocrine disorders, such as hyperparathyroidism or hyperthyroidism, diabetes, Cushing’s syndrome, or premature menopause
   • Certain surgical procedures, including gastrointestinal bypass, gastrectomy, and organ transplantation

• Any of these medications taken on a regular basis:

1. • Corticosteroids, such as prednisone
   • Heparin, if taken chronically
   • Anti-seizure (epilepsy) drugs
   • Thyroid medications, if taken in larger doses than necessary
   • Drugs used to treat breast and prostate cancers
   • Methotrexate, given for inflammatory arthritis
   • Diuretics
   • Lithium
   • Depo-progesterone, used for birth control
   • Antacids that contain aluminum

• Diet and exercise: A diet rich in calcium and vitamin D, and regular exercise can help you maintain bone density.  A poor diet and sedentary lifestyle have been shown to have a negative effect on bone strength.  Low protein intake, significant weight loss, and eating disorders may also put your bone health at risk.

• Smoking and alcohol: Nicotine directly inhibits bone-forming cells (osteoblasts) from creating new bone tissue.  Alcohol can also interfere with bone growth and replacement.

• Genetics: Do you have a family history of osteoporosis?  Is there a history of fractures on your mother’s side of the family?  If so, you may be at increased risk of developing osteoporosis.

SYMPTOMS

There are seldom any signs or symptoms that bones are losing density or becoming more fragile, until a fracture occurs as a result of minor injury, yet by the age of 50, more than half of all Americans will have developed, or will be at risk for, osteoporosis.  Once your bones have been weakened by osteoporosis you may notice:

• Back pain, caused by a fractured or collapsed vertebra
• Loss of height over time
• A stooped posture
• A bone that breaks much more easily than expected

TREATMENTS AND PREVENTION

Current treatments focus primarily on preventing further bone loss, as we don’t yet have reliable means of restoring lost bone.  This is why it’s so important to do what you can to keep your bones healthy and strong and prevent bone loss from happening.

Women over the age of 65 and men over the age of 75 are more prone to serious fractures due to OP. Hip, spine and wrist fractures can cause significant life impact, but there are steps you can take to reduce your risk:

• Change your diet.  Eating foods rich in calcium and vitamin D help keep your bones healthy, and a balanced diet full of fresh fruits and vegetables and quality low-fat proteins will keep you healthier overall.
• Take supplements — especially calcium and vitamin D
• Make lifestyle modifications, such as developing a sustainable exercise plan.  Weight-bearing exercise is the most important type of exercise for preventing osteoporosis.  When your body supports its own weight against gravity, the load on your bones activates bone cells to strengthen weaker areas.
• Quit smoking and limit alcohol consumption. Nicotine directly impacts osteoblasts (bone-making cells), slowing and preventing their production of new bone tissue.  Alcohol is not only not good for bone health, but it may also affect your balance, causing you to fall.
• Your doctor may recommend medications to lower your risk of fractures by increasing bone density, preventing bone loss, or building new bone:
  • Bisphosphonates
  • Selective estrogen receptor modulators (SERMs)
  • Calcitonin
  • Denosumab
  • Anabolic agents
  • Estrogen replacement therapy
• Prevent falls. Physical therapy and exercise can increase your strength and improve your balance.  Remove trip-hazards in your home, such as loose rugs, and electrical cords.  Use caution, and handholds, on slippery surfaces (floors, shower, icy pavement, etc.).
• Prevent or control diabetes
• Prevent or control high blood pressure
• Lower disease risk, including the risk of breast and prostate cancer, multiple sclerosis, rheumatoid arthritis, and osteoarthritis
• Start estrogen replacement therapy if you are postmenopausal

If you are experiencing pain, or have questions about your bone health, contact your orthopedic specialist to learn more.

Sources:

https://orthoinfo.org/en/diseases–conditions/osteoporosis/

https://www.webmd.com/osteoporosis/guide/strong-bones