Osteoporosis

Your bones are like living, growing tissue, constantly rebuilding. Osteoporosis happens when this rebuilding process slows down, leaving bones thinner and more fragile. This makes them prone to breaking easily, even from minor bumps or everyday activities like a cough or bending over. Common fracture sites include the hip, wrist, and spine.

Essentially, osteoporosis happens when the body isn't making new bone fast enough to replace the old bone that's naturally breaking down. This imbalance leads to weaker bones.

Osteoporosis can affect anyone, regardless of their background. However, white and Asian women, particularly those past menopause, are more likely to develop it. There are steps you can take to prevent bone loss or strengthen weakened bones, including medication, a healthy diet, and weight-bearing exercise.

Osteoporosis often has no noticeable signs at first. However, as your bones weaken due to osteoporosis, you might experience some symptoms. These can include:

• Back pain: This can happen if a bone in your spine breaks or collapses.

• Loss of height: Over time, your height might decrease as your spine loses its structure.

• Stooped posture: Your back may start to curve, making you appear hunched over.

• Increased bone fragility: Even minor falls or bumps can lead to fractures (broken bones) more easily than they should.

If you've experienced early menopause or have taken steroid medications like corticosteroids for a long period, talk to your doctor. A family history of hip fractures in your parents also raises your risk. Knowing these risk factors can help you and your doctor take steps to prevent or manage osteoporosis.

If you experienced menopause before the typical age or used steroid medication for a long time, talk to your doctor about osteoporosis. Also, if either of your parents broke a hip, it's a good idea to discuss osteoporosis with your doctor. These factors can increase your risk of developing osteoporosis, a condition that weakens bones.

Healthy bones look like a honeycomb under a magnifying glass (top). Bones with osteoporosis are more like a sponge, having lots of holes (bottom).

Your body is always rebuilding your bones. It's a continuous process where old bone is broken down and new bone is made. When you're young, your body makes new bone faster than it breaks down old bone, so your bones get stronger and denser. This usually happens until your early twenties, and most people reach their strongest bone structure by age 30. As we get older, bone loss happens faster than the body can build new bone.

The chance of getting osteoporosis later in life is partly determined by how much bone you built in your youth. How much bone you have at your peak is influenced by your genes and also by your ethnicity. The more bone you have at your peak, the more "bone savings" you have to draw from as you age. This means you're less likely to develop osteoporosis as you get older.

Osteoporosis, a condition where bones become weak and brittle, increasing the risk of fractures, can be influenced by various factors. Understanding these risk factors can help you take steps to protect your bone health.

Some risk factors are beyond your control:

• Gender: Women are significantly more prone to osteoporosis than men. This is largely due to the drop in estrogen levels during menopause.
• Age: The older you get, the higher your risk. As we age, our bodies produce less bone tissue, and bone density naturally decreases.
• Ethnicity: People of white or Asian descent have a higher risk of osteoporosis.
• Family History: If a parent or sibling has osteoporosis, particularly if a hip fracture occurred, you have a greater chance of developing it yourself.
• Body Size: Smaller body frames often mean less bone mass to start with, increasing the risk as you age.

Other factors influence bone health and can increase osteoporosis risk:

• Hormonal Imbalances: Hormones play a key role in bone health. Lowered levels of sex hormones (estrogen in women and testosterone in men) weaken bones. Medical treatments for certain cancers (like prostate or breast cancer) that lower these hormones can accelerate bone loss. Problems with other glands like the thyroid, parathyroid, and adrenal glands can also contribute to osteoporosis. For instance, overactive thyroid glands or taking too much thyroid medication can lead to bone loss.

• Nutritional Deficiencies: A lifetime of inadequate calcium intake weakens bones, leading to reduced bone density, early bone loss, and an increased risk of fractures. This is crucial for building strong bones throughout life. Eating disorders, characterized by severe dietary restrictions and low body weight, also weaken bones in both men and women. Surgery to alter the digestive system, including weight-loss surgeries, can limit nutrient absorption, impacting calcium intake.

• Medications: Long-term use of corticosteroids (like prednisone), drugs used to treat seizures, gastric reflux, cancer, or transplant rejection, can interfere with bone rebuilding.

• Medical Conditions: Certain medical conditions raise the risk of osteoporosis. These include celiac disease, inflammatory bowel disease, kidney or liver disease, multiple myeloma, and rheumatoid arthritis.

Lifestyle choices also impact bone health:

• Inactivity: A sedentary lifestyle, meaning spending a lot of time sitting, increases the risk of osteoporosis. Weight-bearing exercises, activities that promote balance and good posture are crucial for maintaining strong bones. These include activities like walking, running, jumping, dancing, and weightlifting.
• Excessive Alcohol Consumption: Regularly consuming more than two alcoholic drinks a day can increase osteoporosis risk.
• Smoking: While the exact connection between smoking and osteoporosis isn't fully understood, it's known that smoking can weaken bones.

If you have concerns about your bone health, discussing your risk factors with a doctor is essential. They can assess your individual situation and recommend appropriate preventative measures.

Your spine is made of small bones called vertebrae. If these vertebrae become weak, they can break and collapse. This weakening, often a result of osteoporosis, can cause a number of problems. One common problem is back pain. Another is a loss of height as the spine compresses. You might also develop a stooped or hunched posture.

Broken bones, especially in the spine or hip, are major concerns with osteoporosis. Hip fractures are often caused by a fall. These fractures can lead to serious disabilities. Sadly, a hip fracture can even increase the risk of death within the first year after the injury.

Sometimes, spinal fractures can happen without a fall. Just like a hip fracture, a spinal fracture happens when the weakened vertebrae collapse. This can cause pain in the back, a decrease in height, and a person may develop a bent or hunched posture.

Maintaining Healthy Bones as You Age

Your bones are constantly changing, and while some bone loss is normal throughout life, you can take steps to keep them healthy. This article will discuss ways to optimize your bone health and prevent fractures.

General Strategies for Healthy Bones:

• Prevent Falls: Falls are the leading cause of fractures. Make your home safer by removing tripping hazards like loose rugs, ensuring good lighting, and keeping walkways clear of clutter. Avoid activities that increase your risk of falls, such as climbing ladders without proper support or shoveling snow. Use proper lifting techniques to protect your back.
• Exercise Regularly: Regular exercise is crucial for strong bones. Aim for 30-60 minutes of daily activity, including weight-bearing exercises (walking, jogging, dancing, stair climbing), aerobic exercise, muscle-strengthening exercises, and balance exercises like Tai Chi. Talk to your doctor about the best exercises for you.
• Eat a Calcium-Rich Diet: Getting enough calcium is essential. Good sources include dairy products (milk, yogurt, cheese), dark leafy greens (spinach, kale, broccoli), canned salmon or sardines with bones, fortified foods (orange juice, cereals, soy products), and calcium supplements. Aim for at least three servings per day from your diet. If you can't get enough from food, consider a supplement, but discuss this with your doctor. Don't take too much calcium, as excessive intake, especially from supplements, might increase the risk of kidney stones or (though less clear) heart disease. The recommended daily calcium intake is 1,000 milligrams for adults aged 18-50, increasing to 1,200 milligrams for women over 50 and men over 70.
• Get Enough Vitamin D: Vitamin D helps your body absorb calcium. You can get vitamin D from sunlight, but if you live in an area with limited sun, take a supplement. Good food sources include fatty fish (salmon, trout), cod liver oil, and fortified foods. Most adults need at least 600 international units (IU) of vitamin D daily, increasing to 800 IU after age 70. Discuss your vitamin D needs with your doctor, especially if you have limited sun exposure.
• Quit Smoking and Limit Alcohol: Smoking and excessive alcohol consumption can weaken your bones. If you smoke, quitting is a crucial step in bone health. Limit alcohol intake to one drink per day for women and two drinks per day for men.
• Medication as a Last Resort: If lifestyle changes aren't enough to prevent bone loss, your doctor might recommend medication. These medications can significantly reduce fracture risk by slowing bone loss or promoting bone growth. The decision about medication should be made in consultation with your doctor.

Understanding Osteoporosis and Osteopenia:

Osteoporosis and osteopenia are conditions characterized by weak bones. These conditions are often painless until a bone breaks. Common fracture sites include the spine, hip, and wrist, but fractures can occur in other bones as well.

• Bone Loss Over Time: After age 50, bone density naturally decreases. Without intervention, people lose 1-3% of their bone mass each year. Factors such as menopause in women, lower testosterone levels in men, certain medications, and a family history of osteoporosis can accelerate bone loss.
• Risk Factors: Several factors can increase your risk of osteoporosis, including age, gender (women are more prone), early menopause, certain medical conditions, medications, smoking, excessive alcohol use, and a family history of the condition. Also, people who have had weight loss surgery or organ transplants are at higher risk.

Important Considerations:

• Prevention is Key: You can take steps to maintain bone health at any age. Starting now can make a significant difference.
• Professional Guidance: Consult your doctor for personalized advice on bone health, especially if you have risk factors. They can assess your individual needs and recommend the best course of action, including whether medication is necessary. They can help you determine the best exercises for you and help you understand how much calcium and vitamin D you need.
• Home Safety: Take steps to make your home a safe environment to prevent falls.

By understanding the factors that contribute to bone health and taking proactive steps, you can significantly reduce your risk of osteoporosis and fractures and maintain strong, healthy bones throughout your life.

Bone density is a measure of how much calcium and other minerals are packed into your bones. A special machine uses a small amount of X-rays to check this. The test is completely painless. You lie on a comfortable, padded table while the machine scans your body. Typically, the machine only looks at specific areas, like your hips and spine, to measure bone density.