Osteoporosis is a degenerative bone disease characterized by porous, brittle bones that are prone to fractures. It affects approximately 10 million people in the United States alone, and its precursor, osteopenia, affects around another 34 million individuals. This disorder predominantly impacts people over 50 and is about four times more likely to strike women than men. In some cases, however, diseases, nutritional deficiencies, and medications can lead to osteoporosis, even in younger individuals.
Our skeletal systems are living things that are constantly regenerating, removing, and replacing cells in a process known as remodeling. Remodeling is how bones grow when we are younger, how they knit themselves back together after being broken, and how they maintain their strength when we are adults. When cells die off faster than they are regenerated, bones become less dense, making fractures both more likely to occur and less likely to heal properly.
Risk Factors
The drop in estrogen experienced by women after menopause increases the speed of bone loss, often leading to osteopenia or osteoporosis, but there are additional risk factors to consider. Reduced testosterone levels in men can also instigate bone loss, either due to aging or medical treatments. Individuals who don’t get enough calcium or vitamin D are also at greater risk of developing this condition, as are sedentary people, Asian and Caucasian people, smokers, heavy drinkers, and those with a family history of osteoporosis. Medical conditions, including hyperthyroidism, cancer, IBS, and celiac disease, can also contribute to bone loss. Treatment plans that involve steroids or corticosteroids, proton pump inhibitors and radiation are particularly hard on your bones.
Symptoms and Diagnosis
Osteoporosis is often referred to as a “silent” disorder as it often progresses with no external symptoms. Early symptoms that may indicate a loss of bone can include receding gums, weakened grip strength, and brittle fingernails. As it progresses, osteoporosis can cause additional symptoms, including:
- Back pain
- Easily Fractured Bones
- Neck pain
- Reduction in height (caused by compression fractures along the spine)
- Stooped posture
Unfortunately, a great deal of damage has already been done by the time symptoms are apparent. For that reason, medical professionals recommend bone density tests for women who have gone through menopause and men over 70. Your doctor may also recommend a bone density test if you have extenuating risk factors.
Preventing Osteoporosis
While many of the causes of osteoporosis are out of our control, there are steps you can take to strengthen your bones. Strategies you can use to help prevent bone loss and maintain bone strength include:
- Avoid smoking
- Eat a balanced diet
- Exercise every day
- Get 10-20 minutes of sun exposure per day
- Get at least 1,200 mg of calcium each day
- Get between 800 to 1,000 IU of vitamin D daily
- Limit alcohol use
Exercises that require the individual to bear their own weight, like walking, jogging, and dancing, are especially helpful for strengthening bones. Approximately 45-60 minutes per day of weight-bearing exercise is recommended at least three times a week. Strength resistance is also important for bone health. Strength resistance training 2-3 times a week places a moderate strain on the bones, strengthening them.
Treating Osteoporosis
According to the Office for Women’s Health, one in three women is likely to experience a fracture in their lifetime due to osteoporosis. These fractures often occur in bones that are critical for our ability to easily function on a daily basis, such as the wrists, the hips, and the spine. Fortunately, there are ways to improve bone strength even after osteoporosis has developed. The steps you can take to prevent bone loss will continue to reduce bone loss, although exercise may need to be altered to protect bones that are already fragile.
For women who have reached menopause, supplementary estrogen may help reduce bone loss, and calcitonin, a thyroid-based hormone that controls the level of calcium in your blood, may be recommended as well. Other medications that induce bone growth include:
- Bisphosphonates
- Parathyroid hormones
- Parathyroid hormone-related protein
- Raloxifene (Evista)
- Romosozumab (Evenity)
For collapsed vertebrae, a surgery called kyphoplasty may be helpful. During this procedure, a small balloon is inflated inside the collapsed vertebrae. The balloon is later replaced by bone cement to make the spine strong again.
Osteoporosis can be a debilitating disorder, especially when left untreated, and it affects the lives of around a quarter of all women in the United States over the age of 65. Fortunately, there are a number of lifestyle changes, medications, and therapies to help mitigate the damage. The best way to prevent bone loss is to get plenty of calcium, vitamin D, and bone-strengthening exercises.
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