Osteoporosis is a degenerative disease of the bones that is characterized by a decrease in bone density. And, according to the National Osteoporosis Foundation, it is quite common, too. In fact, about 10 million Americans are living with osteoporosis and another 34 million more are at risk for this disease.
The National Osteoporosis Foundation also reports that about half of all women and a quarter of all men over the age of 50 will break a bone due to osteoporosis. It may be more than a broken bone, however, as it is estimated that about 20 percent of all seniors who break a hip will die within a year due to complications (pneumonia, blood clots, and pulmonary embolism due to prolonged bed rest) or from the surgery often needed to repair them.
Causes of Osteoporosis
Osteoporosis causes bones to degenerate or become “porous.” In fact, a bone affected by osteoporosis actually looks like a honeycomb underneath a microscope. Although all bones are formed in this way, a bone with osteoporosis will have larger holes, thereby leading to a loss of density or mass.
Normal, healthy bone is composed of three, major minerals: protein, calcium, and collagen, all of which help it keep its strength and mass. However, a bone affected by osteoporosis, because it is lacking the mass necessary to maintain its structure, may fracture, either through cracking or collapsing (compression fracture).
There are a number of causes (risk factors) of osteoporosis:
- Thin or small frame
- Caucasian or Asian race
- Family history
- A diet lacking calcium
- Poor health or nutrition
- Cigarette smoking
- Excessive alcohol use
- Lack of exercise
- Certain disease that inhibit the absorption of nutrients, such as celiac sprue
- Menopausal women or those with low estrogen levels
- Low testosterone levels in men
- Chemotherapy in women
- Diseases that cause chronic inflammation, such as liver disease or rheumatoid arthritis
- Hyperthyroidism or hyperparathyroidism
- Lack of Vitamin D
- Certain medications, such as anti-seizure medications, blood thinners or oral corticosteroids
Signs and Symptoms of Osteoporosis
Osteoporosis is a silent disease, as it is often present without displaying any signs or symptoms. In fact, most people are unaware they are suffering from osteoporosis until they break a bone. Further, many smaller fractures caused by osteoporosis go undiagnosed when they don’t cause any discomfort or display any symptoms.
Advanced osteoporosis may appear in the form of a dowager hump, a noticeable, hunchbacked appearance that results from the collapse of the vertebrae. Fractures of the vertebrae may present themselves as band-like pain that radiates from the back and around to the sides of the body.
Osteoporosis is often diagnosed through an x-ray after an individual has experienced a fracture. However, many national associations, including the National Osteoporosis Foundation and the American Medical Association, have recommended that all individuals at an increased risk for osteoporosis receive a dual-energy x-ray absorptiometry scan, most commonly known as a DXA or DEXA scan. This painless diagnostic test, which takes just minutes to complete and exposes patients to very little radiation, is a very accurate way to diagnose osteoporosis. A DEXA scan can diagnose osteoporosis, as well as osteopenia (somewhere between normal bone density and osteoporosis).
In general, the National Osteoporosis Foundation recommends bone density screening for:
- All women over the age of 65
- All postmenopausal women who have risk factors for osteoporosis
- Postmenopausal women with fractures
Treatment/Prevention for Osteoporosis
The goal of treating osteoporosis is to prevent bone loss or increase bone density. Therefore, a combination of lifestyle changes and medications is often used.
Lifestyle changes may include quitting smoking, cutting down on alcohol consumption, getting regular exercise, and eating a balanced diet rich in calcium and Vitamin D (Vitamin D is essential for calcium absorption). Calcium and Vitamin D supplements are also often encouraged for individuals who have risk factors for osteoporosis.
Some of the current medications used to stop bone loss and increase bone density include: alendronate, risedronate, raloxifene, ibandronate, calcitonin, zoledronate, and denosumab. Brand names include: Fosamax, Actonel, Evista, Boniva, Calcimar, Reclast, and Prolia.
Resources for Osteoporosis
- National Osteoporosis Foundation
- Natural Osteoporosis Association
- Academy of Nutrition and Dietetics