What is Osteoporosis
Osteoporosis is a disease which is characterized by low bone mass and weak bones that can lead to compromised bone strength and there is an increased risk of fractures.
It is called a silent disease with increased bone turnover and decreased bone mass. In this disease, bones become brittle and weak and with mild stress like bending over can cause a fracture. Fractures related to osteoporosis mostly occur in:
Bones are living tissue in our body and these are constantly being broken down and replaced. Osteoporosis occurs when the formation of new bones does not keep up with the old bone.
Osteoporosis, being a silent disease is often unrecognizable until the late stages when the fragility fractures occur. But early recognition of disease before the occurrence of fractures followed by timely and efficient initiation of appropriate treatment can reduce the risk of fractures.
Osteoporosis Causes :
In young age i.e., in early 20s bone density is greatest. But as you become older, you can lose the mass of bone from many factors. Osteoporosis or the early warning signs of osteoporosis i.e., osteopenia, signals the lack of balance in the remodeling process i.e., too much bone portion is broken down, and too little new bone is built up back. Brittle bones result in body prone to many fractures.
Probably you know that calcium is essential to building strong and healthy bones, but a diet low in calcium isn’t the only culprit in this matter. There are many causes of osteoporosis that are unknown. The researchers believe that a combination of many causes is blaming for bone loss i.e., osteoporosis.
Lack of estrogen in women
Most common cause of osteoporosis is lack of estrogen level in women. Older women have the quick drop in estrogen level, so bone loss accelerates after menopause. Over the time as the older women lose more bone than they replace, chances of osteoporosis and fracture increases.
Researches show that the younger women who stop menstruating — such as the thin athletes or the girls with anorexia — also have compromised bone density.
Having both ovaries surgically removed may also cause osteoporosis and low bone density in females. In one study, this surgery causes the increase in hip, spine, and wrist fractures in postmenopausal women.
Lack of calcium
Without calcium, our body can’t rebuild new bone during the lifelong process of bone remodeling in a body.
Bones in our body are the reservoir for two minerals — calcium and phosphorus. You need the constant level of calcium in the blood since many of your organs, especially the muscles, heart, and nerves, depend on calcium for proper functioning. When these organs demand calcium, they’ll steal it from the mineral storehouse present in your bones. Over time, as you deplete the mineral reservoir in your bones, you end up with thin, brittle bones which may lead to osteoporosis.
Throughout the youth, the body uses calcium and phosphorus for the formation of bones. If the intake of calcium is not sufficient or if the body is not absorbing enough calcium from the diet, it will cause osteoporosis.
Lack of Vitamin D
Taking too little amount of vitamin D can lead to weak bones and increased bone loss. Among its many other benefits, vitamin D helps your body to absorb and use calcium.
Lack of hormone
Another cause of osteoporosis is lack of hormones i.e. estrogen in women and androgen in men. Women of older age are especially diagnosed with osteoporosis. Menopause is accompanied with low levels of estrogen and increases a woman’s risk of osteoporosis
A Sedentary Lifestyle
Bones weaken if they aren’t properly worked. Early astronauts suffered rapid bone loss from being weightless in the space. For people who have the sedentary lifestyle or have a condition like a paralysis or muscular dystrophy, bone loss happens very quickly. As a cause of osteoporosis, this one is in your hands. You can help “remodel” your bones with weight-bearing exercise, where you’re putting gentle stress on bones which will strengthen them.
Cancer treatment for prostate cancer in males reduces the levels of testosterone and treatment for breast cancer that reduce the estrogen level in females can lead to the acceleration of bone loss.
Thyroid problems may be a reason because too much thyroid problem can cause bone loss. This can occur if the thyroid is overactive or if you take too many medications to treat an underactive thyroid.
Researches show that anyone on high doses on thyroid hormone can benefit from getting regular exercise and taking enough calcium and vitamin D. These lifestyle factors are effective ways to manage your overall fracture risks, along with monitoring the bone density with testing.
Risk Factors for Osteoporosis:
(That are controllable)
A diet without enough calcium and can lead to the weakening of bones. Dairy products contain high calcium levels and some non-dairy products have added calcium. People can also get calcium by supplements but try to get as much calcium as possible from food first.
Vitamin D is mostly present in fatty fish such as salmon and tuna and is added to milk and some cereals. Skin also makes vitamin D from the sun but due to the possibility of skin cancer, many people need to get vitamin D from other sources.
An inactive lifestyle can increase the risk for Osteoporosis in humans. Your bones don’t become as strong if a person is inactive. Inactivity may lead to less protection against osteoporosis which may lead to serious results.
Research indicates that excessive alcohol consumption and cigarette smoking may lead to increased risk of osteoporosis and bone loss. Excessive alcoholism is associated with low bone density, issues with metabolism, impaired bone cell activity that also reduces the bone health.
- Lack of weight-bearing exercises
- Taking the oral cortisone treatments for over three months
Other risk factors
- Being a female
- Age ( older age)
- Smaller body frame (thin people)
- Ethnicity (White, Asian)
- Family history
- Early menopause in female(before the age of 45)
- The absence of menstruation for more than six months in a female (not linked to pregnancy)
Once the bones have been weakened by osteoporosis, signs, and symptoms may include:
- Receding Gums may be one early sign of osteoporosis. Our teeth are connected to the jaw bone and if the jaw is losing the bone, gums can recede. So ask your dentist to share any information or insight he may glean from your x-ray or exam regarding the bone health.
- Decreased grip strength is one of the main factors. Recent studies on postmenopausal women show that the handgrip test is the most important physical test factor related to overall bone mineral density. So it is a good sign when nail strength improves.
- Weak and brittle fingernails is another sign. Fingernails grow stronger and healthier right along with the bones.
- Height Loss is very common as we age. It may be due to many reasons including poor posture and vertebral fractures. Poor posture may not mean you have the bone loss but it may indicate the weakening of muscles around your spine since bone and muscles work in one unit, gain and loss strength synchrony, it is most possible that muscle loss will lead to bone loss. Compression suppression in the spine causes loss of height. It is one of the most noticeable signs of osteoporosis.
- Back pain caused by a collapsed and fractured vertebra
- Bone fracture that may occur much more easily than expected
When to see a doctor :
Osteoporosis symptoms cause pain and discomfort. See a doctor immediately if
- You are having severe pain particularly of the back, hip, neck, and wrist.
- You are over 50
- You are postmenopausal
- You have small thin, frame
- You are taking steroids for a long period of time
- Dental X-rays reveal a loss of bone in the jaw, which may be a sign of osteoporosis.
Osteoporosis Diagnosis :
Bone density test can help determine if you are having osteoporosis or at a risk. It is possible to detect osteoporosis, even before a bone is broken, by getting this bone density test. The test can also detect if the bone density in your body is lower than normal for a person of your age and sex. Bone loss that has not reached the stage of an osteoporosis diagnosis i.e., before osteoporosis is called osteopenia. A bone density test is the best to predict fracture risks.
Bone density test
This test is used to measure bone mineral density (BMD). It is most commonly performed using dual-energy x-ray absorptiometry (DXA or DEXA) or by bone densitometry.
The DXA machine converts raw density information to the T score and Z score.
T score measures the amount of bone you have in comparison to the normal population of younger people and is used to estimate your risk of developing a fracture in the future.
Z score measures the amount of bone you have in the body in comparison to those in your age group. This number can help indicate whether there is a need for further medical tests or not.
These following procedures can be performed to determine bone injury or fractures caused due to osteoporosis:
Bone x-ray produces images of bones within our body, including the hand, wrist, shoulder, foot, arm, elbow, ankle, leg (shin), knee, thigh, hip, pelvis or spine. It helps in the diagnosis of fractured bones, which are sometimes a result of osteoporosis.
CT scan of the spine:
CT scanning of the spine is performed to assess for alignment and fractures of the bone. It can be used to subjectively measure the bone density and determine whether the vertebral fractures in your body are likely to occur. This technique is called quantitative CT (QCT).
MRI of the spine:
It gives the better understanding of the bone pathology.
Osteoporosis Prevention :
Many of the things that raise your chances for osteoporosis are the things you can’t change like your genes, your age, and your sex. But that doesn’t mean you can’t prevent the disease. The healthy things you do every day can be a part of your plan to build strong bones.
Exercise Your Bones :
Just like your muscles, your bones get stronger gradually if you give them a workout. Weight-bearing exercises are best for the strengthening of your bones.
Weight-bearing exercises include:
- Climbing stairs
- Tennis and other racket sports
- Water aerobics
Workout is a key to preventing osteoporosis. Your muscles pull on your bones when you working out or stretching them. That cases strengthening of bones. These workouts also make you more flexible and they lower the chances of your fall — the No. 1 reason for broken hips.
Any of these daily routine workouts can also help you build muscle and bone:
- Lifting the canned goods or bags of groceries
- Lifting the free weights
- Lifting the young children
- Using the ankle and wrist weights
- Using the elastic resistance bands
- Doing pushups or other moves that use your own body weight
Preventing falls :
Indoor falling can be prevented by:
- Wearing nonslip shoes
- Making sure the carpets are properly tacked to the floor
- Keeping the rooms brightly lit
- keeping a flashlight next to your bed at night
- Putting the grab bars in bathroom
Outdoor falling can be prevented by :
- Using a support i.e., a cane or walker
- Rubber-soled non-slip shoes with friction
- Wearing the glasses of right prescription to prevent falls due to poor vision.
Calcium and Vitamin D Build Bones :
- When your body does not have enough calcium, it starts to break down your bones to get what it needs. It means you lose bone mass gradually so it’s important to make sure you have these nutrients every day in your diet in the adequate amount or from supplements for proper functioning. Get it from:
- Low-fat or the fat-free dairy products
- Beans and legumes
- Calcium-fortified foods and juices, like cereal, soy milk, and tofu
- Salmon and sardines with bones
- Dark green leafy vegetables like broccoli and kale
There are some components in your diet that can interfere with the absorption of calcium in your body:
Phytic acid: This is found in unleavened bread, grains, soy, peanuts, seeds and raw beans.
Oxalic acid: Oxalic acid is found in spinach, beet greens, kale, cocoa powder, bran flakes. Calcium that spinach contains will not be absorbed because of this oxalic acid.
Sodium: If Sodium is present in higher amount in your body, it will interfere with calcium retention; the higher your sodium intake the more calcium your body needs to meet its daily requirement for proper functioning, so it’s best to keep your sodium intake low.
Vitamin D helps your body to absorb the calcium you eat.
You can get it from:
- Fatty fish like salmon, tuna, and mackerel
- Beef liver, egg yolk, and cheese
- Fortified foods like cereal, milk, and orange juice
Your skin also naturally makes vitamin D when sunlight hits the skin. You can get at least some of what you need if you spend a little favorable time outdoors every day. But don’t overdo it – it is harmful because too much time in the sun raises your chances for skin cancer.
Phosphorus is mostly present in :
- Dairy products
- Whole Grain
Drink less soda :
It dmages your bones and is unhealthy in the long run.
Don’t drink too much alcohol :
Consuming too much alcohol is linked to higher chances of bone loss.
Quit smoking :
Smoking doubles the chance of bone loss and fractures which can lead to osteoporosis by keeping the hormone estrogen low in your body.
Treatment for osteoporosis includes such medications that help build bone mass in the body.
Estrogen hormone therapy performed after menopause (previously called hormone replacement therapy or HRT) has been proved to prevent the loss of bone in the body. It increases the bone density and prevents bone fractures. This estrogen hormone therapy is useful in preventing osteoporosis in postmenopausal women. Estrogen is available orally (Premarin, Estratest, Estrace and others) for taken through the mouth or as a skin patch (Vivelle, stardom, and others).
If menopausal symptoms appear in postmenopausal women such as vaginal dryness and hot flashes, HRT will be the best choice for these menopausal symptoms as well as prevent the osteoporosis. After the menopausal symptoms have passed, some other non-estrogen prescription medications will be considered for the use of a long term.
Complications of Osteoporosis:
Osteoporosis can cause Kyphosis hump. It is an abnormal curving of the spine. It gives you an abnormal hunched over appearance(due to osteoporosis). This abnormal curve can be caused by weekend vertebrae and vertebrae that have collapsed upon one another. This curvature can sometimes lead to breathing problems due to an inability of the ribs to expand fully during the inhaling.
Spine deformities are particularly significant because they can affect your posture and even cause a loss in height. They can also be extremely painful if any nerve is compressed by them.
What things to avoid for good bone health :
Wheat bran with milk
When you eat wheat bran with milk, your body absorbs less calcium. But if u take a calcium supplement after taking this meal then allow at least 2 hours between your pill and bran.
Binge watching means watching many episodes of the program for a long time in one sitting. When it becomes a habit to spend a long time without moving, your bones missed out and suffer. Exercise make the bones stronger.
Too much salt
If you are taking too much salt, your body will get rid of calcium which means this calcium will not help the bones. So try to consume as low amount of salt as possible.
Spending too much time indoors
You need to get out more because your body makes vitamin D in sunlight. Just 10 minutes in a week can help achieve the goal. But don’t overdo this activity because spending too much in sun can increase the risk of skin cancer.
Overdoing some drinks
Consuming too many cola flavored or sods drinks will harm your bones. Consuming too many cups of coffee and tea in a day can rob calcium in your bones.
Your own prescription
There are some medications that can have a negative impact on your bones if you are taking them for a long time. Don’t use your own prescription instead consult your doctor in any health issue.
A low body weight i.e., BMI 18.5 or less than this means there are greater chances of bone loss and fractures.
Osteoporosis is a dangerous disease. It is strongly associated with increased morbidity, mortality and healthcare cost. It affects mostly the females after menopause. Many people even don’t have any idea that they have osteoporosis until the first fracture. There are many things people can do from a very young age to help prevent osteoporosis in older age. Bones need calcium for proper maintenance and growth and body needs vitamin D to help absorb calcium in bones.
Exercise also plays an effective role in building strong bones and to avoid the risk of fractures. After menopause women must consult their health care provider about a bone mineral density test to check if they are on right track to avoid osteoporosis. Osteoporosis can easily overcome with proper exercise and a healthy diet. Keep your bones strong and healthy.
“Osteoporosis is not an inevitable part of aging, it is preventable. So it is important that all of us, of all ages, start taking care of our bones now before it is too late.”
About the Author :
My name is Maryam Gul. I am a student of BS human nutrition and dietetics. I always believe that good health is life’s greatest blessing. Your diet is a bank account, good food choices are best investments for older age. I have written this article to make people aware of osteoporosis.
Osteoporosis is a silent killer and most people are unaware that they have osteoporosis and they don’t feel any sign before the fracture happens. This article is a minor contribution towards building an osteoporosis free society. Let’s encourage others to break free from osteoporosis and help to stop this disease before it robs anymore of our dear ones. Because there is no better time than now to start living healthy.
Eat healthy, Be healthy and live life to its fullest.