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Osteoporosis: Causes, Symptoms, Diagnosis, Treatment, and Prevention

The condition osteoporosis results in weak and brittle bones which are more prone to breaking or cracking. Osteoporosis can affect any bone in the body, but it is more common in the spine, hips, and wrists.

Causes of Osteoporosis

Normally, the body constantly renews the bone by removing old bone and replacing it with new bone, but osteoporosis is caused by an imbalance between bone formation and breakdown. However, as we age, this process slows down and we lose more bone than we gain. As a result, our bone mass and density decrease.

Some factors that can increase the risk of developing osteoporosis are:

  • Age: Osteoporosis is more common in older people, especially women after menopause. This is because the hormone estrogen, which helps maintain bone density, decreases after menopause.

  • Gender: Women are more likely to develop osteoporosis than men, because they have less bone mass to begin with and lose bone faster after menopause.

  • Family history: Osteoporosis can run in families, so if you have a parent or sibling with osteoporosis, you may have a higher risk of developing it.

  • Lifestyle: Certain habits can affect your bone health, such as smoking, drinking too much alcohol, being physically inactive, or having a poor diet that lacks calcium and vitamin D.

  • Medical conditions: Some diseases or medications can interfere with bone formation or increase bone loss, such as thyroid disorders, rheumatoid arthritis, inflammatory bowel disease, diabetes, cancer, or steroids.

Symptoms of Osteoporosis

Initially, osteoporosis does not cause any symptoms. However, as the bones become weaker and more fragile, they can break or fracture easily. The most common signs of osteoporosis include:

  • Pain: You may experience pain in your back, hips, or ribs due to fractures or compression of the spine.

  • Height loss: You may lose some height due to fractures or curvature of the spine.

  • Posture changes: You may develop a stooped or hunched posture due to fractures or compression of the spine.

  • Fractures: You may suffer from fractures in your wrists, hips, or spine due to minor falls or injuries.

Diagnosis of Osteoporosis

By measuring your bone mineral density (BMD), which refers to how much calcium and other minerals are in your bones, osteoporosis can be diagnosed. You can check your BMD with a dual-energy X-ray absorptiometry (DEXA) scan, which uses low-dose X-rays to scan your spine and hips. As a result, your BMD is compared to the BMD of a healthy young adult of the same sex, which is expressed as a T-score. T-scores between -1.0 and -2.5 indicate low bone mass (osteopenia), while T-scores below -2.5 indicate osteoporosis.

Your doctor may also order blood tests or urine tests to check for other factors that may affect your bone health, such as vitamin D levels, thyroid function, or kidney function.

Treatment of Osteoporosis

Osteoporosis cannot be cured, but it can be treated to slow down the progression of bone loss and prevent fractures. The main goals of treatment are:

  • Medications: There are different types of drugs that can prevent or reduce bone loss and increase bone formation. The following are examples: bisphosphonates (such as alendronate or risedronate), hormone therapy (such as estrogen and raloxifene), denosumab (a monoclonal antibody that blocks a protein that stimulates bone breakdown), teriparatide (a synthetic form of parathyroid hormone that stimulates bone formation) and romosozumab (a monoclonal antibody that inhibits bone breakdown and stimulates bone formation).

  • Calcium and vitamin D supplements are essential for bone health. You should get enough calcium and vitamin D through your diet or by taking supplements if necessary. For women over 50 years old, 1200 mg is recommended per day, while 1000 mg is recommended for men under 50 years old. For adults under 70 years old, a daily intake of 600 IU of vitamin D is recommended, and for those over 70 years old, 800 IU is recommended.

  • Exercise strengthens your bones and muscles and improves your balance and posture. A healthy individual should engage in 150 minutes of moderate-intensity aerobic exercises (for example, walking, cycling, or swimming) per week, along with two sessions of strength training exercises (for example, lifting weights). The flexibility and coordination of your body should be improved by some exercises (such as yoga or tai chi).

  • Fall prevention: Osteoporosis patients are more likely to fracture their bones as a result of falls. A safe home (such as removing rugs, cords, or clutter that can cause tripping, installing handrails and grab bars, and using nonslip mats) is a good way to prevent falls, as is wearing appropriate footwear (such as shoes with low heels and good traction) and using assistive devices (such as a cane or walker) if necessary.

Prevention of Osteoporosis

Osteoporosis can be prevented or delayed by taking care of your bone health throughout your life. Some tips to prevent osteoporosis are:

  • Eat a balanced diet: You should eat foods that provide calcium, vitamin D, protein, and other nutrients for your bones. Calcium can be found in dairy, green leafy vegetables, nuts, seeds, beans, tofu, and fortified foods. Vitamin D can be found in fish, eggs, mushrooms, and fortified foods. Limit your salt, caffeine, alcohol, and soda intake, as they can interfere with calcium absorption or cause bone loss.

  • Exercise regularly: You should do weight-bearing exercises (such as walking, jogging, or dancing) and resistance exercises (such as lifting weights or using resistance bands) to stimulate your bones and muscles. Besides improving balance and posture, you should also practice yoga and tai chi to keep yourself from falling or breaking your bones.

  • Avoid smoking: Smoking can reduce your bone mass and increase your risk of fractures. If you smoke, you should quit as soon as possible.

  • Limit alcohol: Drinking too much alcohol can impair your bone formation and increase your risk of fractures. If you drink alcohol, you should limit your intake to no more than one drink per day for women and two drinks per day for men.

  • Get screened: Women and men should get a bone density test (DEXA scan) after the age of 65, or at an earlier age if they are at risk for osteoporosis.

By following these tips, you can protect your bones and prevent or treat osteoporosis, a serious condition that can affect your quality of life and increase your risk of fractures. Do not start any medication or supplement to treat osteoporosis without consulting your doctor.

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