Osteoporosis is a condition that weakens bones and makes them more prone to fracture. It affects millions of women around the world, especially older women. Osteoporosis can lead to serious complications such as chronic pain, disability, and loss of independence. Fortunately, osteoporosis can be prevented and reversed with proper nutrition, exercise, and medication. In this article, we will explain what osteoporosis is, what causes it, how to prevent it, and how to treat it.
What is osteoporosis?
Osteoporosis means “porous bone.” It is a disease that reduces the density and quality of bone tissue. Normally, bone is constantly being broken down and rebuilt by specialized cells called osteoclasts and osteoblasts. This process keeps the bone strong and healthy. However, when bone loss exceeds bone formation, osteoporosis occurs. The bones become thin, fragile, and easily broken.
Osteoporosis can affect any bone in the body, but it is most common in the hip, spine, and wrist. A fracture in these areas can have serious consequences, such as chronic pain, deformity, reduced mobility, and increased risk of infection. Osteoporosis can also affect the height and posture of a person, causing them to shrink and stoop.
Osteoporosis is often called a “silent disease” because it usually has no symptoms until a fracture occurs. Many people are unaware that they have osteoporosis until they suffer a fall or a minor injury that causes a broken bone. Therefore, it is important to get screened for osteoporosis regularly, especially if you have risk factors for the disease.
What causes osteoporosis?
Osteoporosis is caused by a combination of genetic and environmental factors. Some of the main causes of osteoporosis are:
- Age: As we age, our bones naturally lose density and strength. This is because the rate of bone formation slows down while the rate of bone resorption increases. Women lose bone mass faster than men after menopause due to the decline in estrogen levels. Estrogen is a hormone that protects bone health by inhibiting bone resorption and stimulating bone formation.
- Sex: Women are more likely to develop osteoporosis than men because they have smaller and thinner bones than men. Women also lose more bone mass during pregnancy and breastfeeding due to the increased demand for calcium by the fetus and infant.
- Family history: Osteoporosis tends to run in families. If you have a parent or sibling with osteoporosis or a history of fractures, you are more likely to inherit genes that predispose you to low bone density and quality.
- Lifestyle factors: Certain habits and behaviors can increase your risk of osteoporosis by affecting your bone metabolism. These include:
- Smoking: Smoking reduces blood flow to the bones and interferes with the absorption of calcium and vitamin D. Smoking also increases the production of free radicals that damage bone cells.
- Alcohol: Excessive alcohol consumption can impair the function of osteoblasts and osteoclasts and reduce the absorption of calcium and vitamin D. Alcohol also increases the risk of falls and injuries that can lead to fractures.
- Diet: A diet that is low in calcium, vitamin D, protein, and other nutrients that are essential for bone health can contribute to osteoporosis. Calcium is the main mineral that makes up bone tissue. Vitamin D helps the body absorb calcium from food and supplements. Protein provides amino acids that are needed for bone formation.
- Physical activity: A sedentary lifestyle can lead to muscle loss and reduced bone stimulation. Physical activity helps maintain muscle mass and strength, which support the bones and prevent falls. Weight-bearing exercises such as walking, jogging, dancing, or lifting weights also stimulate bone formation by applying stress on the bones.
How to prevent osteoporosis?
The best way to prevent osteoporosis is to start taking care of your bones when you are young. Building strong bones during childhood and adolescence can help you maintain your bone mass throughout adulthood. However, it is never too late to start taking steps to improve your bone health at any age. Here are some tips on how to prevent osteoporosis:
- Eat a balanced diet: Make sure you get enough calcium, vitamin D, protein, and other nutrients that support bone health from your diet or supplements. The recommended daily intake of calcium for adults is 1,000 to 1,200 milligrams (mg) per day. The recommended daily intake of vitamin D for adults is 600 to 800 international units (IU) per day. You can get calcium from dairy products, green leafy vegetables, nuts, seeds, and fortified foods. You can get vitamin D from sunlight exposure, fatty fish, egg yolks, and fortified foods.
- Exercise regularly: Aim for at least 30 minutes of moderate physical activity on most days of the week. Include a combination of weight-bearing exercises and resistance training to strengthen your bones and muscles. You can also do balance and flexibility exercises to improve your posture and coordination and prevent falls.
- Quit smoking and limit alcohol: Smoking and drinking too much alcohol can harm your bones and increase your risk of fractures. If you smoke, quit as soon as possible. If you drink alcohol, limit your intake to no more than one drink per day for women and two drinks per day for men.
- Get screened for osteoporosis: If you are a woman over 65 or a man over 70, you should get a bone mineral density (BMD) test to measure your bone mass and diagnose osteoporosis. You may also need a BMD test earlier if you have risk factors for osteoporosis or a history of fractures. A BMD test uses a special X-ray machine called a dual-energy X-ray absorptiometry (DEXA) scan to measure the density of your bones in different areas of your body, such as your hip, spine, or wrist. The results are expressed as a T-score, which compares your bone density with that of a healthy young adult of the same sex. A T-score of -1.0 or above is normal, a T-score between -1.0 and -2.5 indicates low bone mass or osteopenia, and a T-score of -2.5 or below indicates osteoporosis.
How to treat osteoporosis?
If you have osteoporosis, you can still take steps to slow down or stop bone loss and prevent fractures. The treatment of osteoporosis depends on your age, sex, medical history, fracture risk, and personal preferences. The main goals of treatment are to:
- Reduce pain: If you have pain from a fracture or spinal deformity, you may need pain medication, anti-inflammatory drugs, or nerve block injections to relieve your discomfort. You may also need physical therapy, braces, or surgery to stabilize your spine or repair your fracture.
- Prevent further bone loss: You may need medication to inhibit bone resorption and increase bone formation. There are different types of drugs that can help treat osteoporosis, such as:
- Bisphosphonates: These drugs slow down the activity of osteoclasts and reduce bone loss. They can be taken orally or by injection. Examples include alendronate, ibandronate, and zoledronic acid.
- Denosumab: This drug is a monoclonal antibody that blocks a protein called RANKL that stimulates osteoclasts. It is given by injection every six months.
- Raloxifene: This drug is a selective estrogen receptor modulator (SERM) that mimics the effects of estrogen on bone without affecting other tissues. It is taken orally and is usually prescribed for postmenopausal women.
- Testosterone: This hormone can help increase bone density in men with low testosterone levels due to aging or other causes. It can be given by injection, gel, or patch.
- Parathyroid hormone: This hormone stimulates bone formation by activating osteoblasts. It is given by injection daily or twice weekly. Examples include teriparatide and abaloparatide.
- Prevent falls and injuries: You should take precautions to avoid falls and injuries that can cause fractures. Some tips include:
- Wear low-heeled shoes with rubber soles and warm boots in winter
- Use support while using steps Avoid walking on slippery floors
- Install handrails and grab bars in your bathroom and stairs
- Remove rugs and cords that can cause tripping
- Use adequate lighting in your home
- Keep your vision checked regularly
- Review your medications with your doctor to avoid side effects that can impair your balance or coordination.
Osteoporosis is a serious condition that affects millions of women around the world. It can cause pain, disability, and loss of independence. However, osteoporosis can be prevented and reversed with proper nutrition, exercise, and medication. You should get screened for osteoporosis regularly, especially if you have risk factors for the disease. You should also follow your doctor’s advice on how to treat osteoporosis and prevent fractures. By taking care of your bones, you can enjoy a healthy and active life.