What Is Osteoporosis?
Osteoporosis is a brittle bone condition that is more prone to fractures. Osteoporosis weakens the bones and increases the risk of fractures. Bone mass (bone density) declines after age 35, and bone loss occurs more rapidly in women after menopause.
Important risk factors for osteoporosis include genetics, lack of exercise, calcium and vitamin D deficiencies, personal history of adult fractures, smoking, excessive alcohol consumption, history of rheumatoid arthritis, low body weight, and a family history of osteoporosis.
Patients with osteoporosis do not have symptoms until bone fractures occur. The diagnosis can be made using X-rays and tests to measure bone density.
Treatments include prescription drugs for osteoporosis, such as quitting alcohol and cigarettes and ensuring adequate exercise, calcium, and vitamin D supplements. This is a condition that affects the bones. Its name comes from the Latin “porous bones”. The body reabsorbs more bone tissue and makes less to replace it.
In people with osteoporosis, the bones become porous and weak, especially when there is an increased risk of fractures in certain peripheral joints such as the hips, spine, and wrist.
The inside of a healthy bone has tiny holes like a honeycomb. Osteoporosis increases the size of these areas, which leads to a loss of strength and bone density. Also, the outside of the bone becomes weak and thin.
It can occur at any age, but it is more common in adults, especially women. More than 53 million people in the United States have or are at risk of developing osteoporosis.
People with osteoporosis are at risk for fractures or fractures when they perform normal activities such as standing or walking. The most commonly affected bones are the ribs, hips, and wrist and spine bones.
Why is osteoporosis a major public health problem?
- In, 44 million had low bone density (10 million had osteoporosis and 34 million had osteoporosis). This is 55% of the American population aged 50 and over.
One in two Caucasian women will break a bone in her lifetime due to osteoporosis.
The direct health care costs of osteoporosis fractures are in the billions of dollars, not even indirect costs such as days lost from work and productivity. About 20% of those who experience a hip fracture die within a year after the fracture. One-third of hip fracture patients are discharged from a nursing home within a year after the fracture. Only one-third of hip fracture patients regain their pre-fracture level function.
As America ages, the number of people with osteoporosis-related fractures increases exponentially. The pain, suffering, and the overall impact on health and financial costs are immense.
Bone fractures after a minor fall are a sign of osteoporosis.
Osteoporosis develops slowly, and a person may not realize it until they experience a fracture or fracture after a minor event, such as a fall. Coughing or sneezing can also cause osteoporosis.
Frequent tears occur in the hip, wrist, or spinal cord in people with osteoporosis.
If there is a fracture in the vertebrae of the spine, it can lead to changes in the posture, curvature, and curvature of the spine. People may also notice a decrease in height or their clothes may not fit as they used to.
The early stages of osteoporosis do not cause any symptoms or warning signs. In most cases, people with osteoporosis do not know they have the condition until they have a fracture.
If symptoms appear, some of the above may be:
- Shrink gums
- Gripping force weakens
- Weak and brittle nails
Even if you don’t have symptoms and have a family history of osteoporosis, talking with your doctor can help you assess your risk.
When to see a doctor
Severe discomfort in any common area of osteoporosis indicates an unexpected back or inadvertent fracture. People should seek a medical evaluation as soon as they notice this type of pain.
Causes of osteoporosis
The causes are certain medical conditions such as hyperthyroidism. Some of them also include drug use.
Examples of these actions are chronic oral or injectable corticosteroids, such as prednisone or cortisone.
Your bones are in a constant state of restoration: new bone is formed and old bone is broken. When you are a child, your body makes your bone faster than it breaks an old bone, and your bone mass increases. This process slows down in their early 20s, and most people reach their peak bone mass in their 30s. As people age, bone mass is lost faster than it was created.
How likely you are to develop osteoporosis depends on the amount of bone mass you have achieved in your youth. Peak bone mass is somewhat inherited and the species group also varies. At your peak bone mass, you have more bone on the “bank” and are less likely to develop osteoporosis as you age.
Many factors, including your age, race, lifestyle choices, and medical conditions and treatments, increase your chances of developing osteoporosis.
Some risk factors for osteoporosis are beyond your control, including:
- Your gender Women are more likely to develop osteoporosis than men.
- Age. The risk of developing osteoporosis increases with age.
- Race. If you are white or of Asian descent, you are at risk of developing osteoporosis.
- Family history. Having parents or siblings with osteoporosis puts you at higher risk, especially if your mother or father has a hip fracture.
- Body size. Men and women with smaller body build are at higher risk because bone mass decreases with age.
Osteoporosis is more common in people who have more or less certain hormones in their bodies. Examples:
- Sex hormones. Low levels of sex hormones can weaken bones. Reduced estrogen levels in menopausal women are one of the most important risk factors for developing osteoporosis.
- Men gradually reduce testosterone levels as they age. Prostate cancer treatments that lower testosterone levels in men and breast cancer treatments that lower estrogen levels in women have the potential 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 are taking too many thyroid hormone medications to treat an underactive thyroid.
- Other glands. Osteoporosis is also associated with overactive parathyroid and adrenal glands.
Osteoporosis is more likely to occur in people with:
- Low calcium intake. Lifelong calcium deficiency plays a role in the development of osteoporosis. Low calcium intake contributes to reduced bone density, early risk of bone loss, and fractures.
- Eating disorders. Highly restricted food intake and low weight can lead to bone loss in both men and women.
- Gastrointestinal surgery. Surgery to reduce the size of your stomach or remove a part of the intestine limits the surface area available to absorb nutrients, including calcium. These surgeries can help you lose weight and other gastrointestinal disorders.
Steroids and other drugs
Long-term use of oral or injected corticosteroids, such as prednisone and cortisone, can interfere with the bone remodeling process. It is also associated with medications that are used to combat or prevent osteoporosis:
- Gastric reflux
- Rejection of the exchange
People with certain medical problems are at higher risk for osteoporosis:
- Celiac Disease
- Inflammatory bowel disease
- Kidney or liver disease
- Multiple myeloma
Some bad habits increase your risk of osteoporosis. Examples:
Sedentary lifestyle. People who sit more time are more likely to develop osteoporosis than those who are more active. Weight-bearing exercises and activities that promote balance and good posture are beneficial for your bones while walking, running, jumping, dancing, and lifting weights are especially helpful.
Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases the risk of osteoporosis.
Tobacco use. The exact role that tobacco plays in osteoporosis is unclear, but tobacco use has been shown to contribute to weakness.
To check for osteoporosis, your doctor will review your medical history and perform a physical exam. They may also perform blood and urine tests to detect conditions that can lead to bone loss. If your doctor thinks you have or are at risk for osteoporosis, he or she may recommend a bone density test.
Bone density scanning uses a type of x-ray called dual-energy x-ray absorptiometry (DEXA). DEXA indicates the risk of osteoporosis. It also helps monitor individual response to treatment. DEXA can scan two types of devices:
- Central device: this is a hospital examination that measures the mineral density of the hip and spine, while the person is on the table.
- Peripheral device: This is a mobile machine that examines the bone of the wrist, heel, or finger.
DEXA test results
Doctors give the test results as a DEXA T score or Z score.
The T-score compares the bone mass of a person with the bone mass of a small person.
Shows a bone strength of -1.0 or higher
- -1.1 to -2.4 indicates mild bone loss (osteoporosis)
- -2.5 or less indicates osteoporosis
The Z score compares bone mass with that of other individuals of similar structure and age.
Generally, a doctor will repeat the test every 2 years, as this will allow the results to be compared.
Osteoporosis ultrasound is another method used by physicians to diagnose osteoporosis and may be performed in the primary care setting. It is less common than DEXA, and clinicians cannot compare measurements with DEXA T scores.
Treatment recommendations are based on an estimate of your fracture risk over the next 10 years using information such as a bone density test. If your risk is not high, your treatment may not include medications and may focus on modifying your risk factors for bone loss and falls.
Bisphosphonates are osteoporosis medications that are widely prescribed for both men and women at risk of fracture. Examples:
- Alendronate (Binosto, Fosamax)
- Risedronate (Octonel, Atelvia)
- Ibandronate (Boniva)
- Zoledronic acid (regeneration, zomato)
Side effects include nausea, abdominal pain, and heartburn. They are less likely to occur if the medicine is taken correctly.
Intravenous forms of bisphosphonates do not cause abdominal pain but can cause fever, headache, and muscle aches for up to three days. It may be easier to schedule a quarterly or yearly injection than to remember to take a weekly or monthly pill, but doing so can be very costly.
Monoclonal antibody drugs
Compared to bisphosphonates, denosumab (Prolia, Exageva) provides similar or better bone density results and reduces the chance of all types of fractures. Denosumab is given as an injection under the skin every six months.
If you take denosumab, you will need to continue it indefinitely. Recent research suggests that there is an increased risk of spinal breakage after discontinuation of the research.
A very rare problem with bisphosphonates and denosumab is a break or fracture in the middle of the femur.
The second rare problem is delayed healing of the jaw bone (osteoporosis of the jaw). It occurs after a dental procedure such as tooth extraction.
You should have a dental exam before you start taking this medicine, and you should continue to take good care of your teeth and visit your dentist regularly. Make sure your dentist knows you are taking these medications.
Estrogen, especially when started after menopause, helps maintain bone density. However, estrogen therapy increases the risk of blood clots, endometrial cancer, breast cancer, and heart disease. Therefore, estrogen is often necessary for young women’s bone health or even for menopausal symptoms.
Raloxifene (Evista) mimics the beneficial effects of estrogen on bone density in postmenopausal women, without some of the risks associated with estrogen. Taking this medicine can reduce the risk of certain types of breast cancer. Hot flashes are a common side effect. Raloxifene also increases the risk of blood clots.
In men, osteoporosis can be associated with a gradual decline in testosterone levels related to age. Testosterone replacement therapy can help improve symptoms of low testosterone levels, but osteoporosis medications in men for the treatment of osteoporosis have been well studied and are therefore recommended alone or in combination with testosterone.
If you can’t tolerate the common treatments you receive for osteoporosis, or if they don’t work well enough, your doctor may suggest:
- Teriparatide (Forteo). This powerful drug is similar to parathyroid hormone and stimulates the growth of new bones. It is given as a daily injection under the skin. After two years of teriparatide treatment, another osteoporosis is taken to maintain new bone growth.
- Abaloparatide (Times). is another drug similar to parathyroid hormone. You can only take it for two years, after which there will be another osteoporosis drug.
- Romosozumab (Divinity). It is the newest bone-building drug to treat osteoporosis. It is given as an injection every month at your doctor’s office. It was limited to one year of treatment, followed by other drugs for osteoporosis.