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Osteoporosis - Symptom, Treatment And Causes

Last Updated: Feb 12, 2020

Whta is Osteopororsis?

Osteoporosis is a medical condition which makes the bones brittle and weak. The bone gets so brittle that even mild stress like falling, coughing and bending can cause a severe fracture. The fractures usually occur on the spine, wrist and hip. The bones in our body are constantly broken and replaced.

But in this case, the bone fails to get replaced after breaking down. It affects both women and men, but Asian and white women, especially those who have passed their menopause are at a higher risk. Weight-bearing exercises, healthy diet and medications can strengthen weak bones and avoid bone loss.

What are the symptoms and signs of osteoporosis?

There are no warning signs at the early stages and no conditions shown until there is a fracture. But if there is a family history regarding this issue then you must talk to your doctor and take the necessary precautions. If there are any symptoms, then the treatment must be taken on time. As without treating the disease properly, it can become severe by making the bones thinner and weaker thus increasing the fracture risks.

At times there can be some of the symptoms like Weak grip strength, brittle and weak nails, receding gums. And severe symptoms can include back pain, neck pain and there can be lost in the height. The bones become so weak and fragile that they can break due to strong sneeze.

What are the causes of osteoporosis?

  • Age: It is one of the biggest factors. In our whole life the bones in our body break down and new bones keep growing. But when you reach the age of 30 the bones start breaking down faster rather than growing back, which leads to bones to be more fragile and they prone to breaking more.
  • Menopause: This is the condition which occurs in female at the age of 40-45 and due to the change in the hormonal level the bones start to lose from the body. Males also continue losing bones at this age but slowly than females.
  • Hypothyroidism: It can also be one of the reasons for it.
  • Medical condition or medication: Medicines such as prednisone or cortisone are also responsible for it.

What are the consequences of osteoporosis?

Osteoporosis can have severe life-threatening factors as during the disease the bones become weak and fragile causing fracture as there is a loss in the mass of the bones. This may also lead to long-time chronic pain and disability throughout life. If it becomes severe then it may even lead to death.

Thus, the main goal of the person must be to get bone strength back and preventing fractures by having proper treatment. But in most of the cases, the disease is having a serious threat to life it remains un-diagnosed and untreated.

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What factors determine bone strength?

  • Genetic factors: These factors are important for determining any person’s bone strength.
  • Calcium: The level of calcium in the body must be proper for as it is required to get optimal bone health.
  • Vitamin D: It is important and good for bones as it helps in the absorption of calcium.
  • Physical activities: It helps in increasing and preserving the mass of the bone and also reduces the risk of breaking bones.
  • Maintaining body weight: The weight of the body must be accurate because if the person is underweight then bones become more fragile and weak.
  • Reproductive issues: If there are problems at the time of pregnancy or menopause then there can be issues regarding it.
  • Smoking: It tends to reduce the mass of the bones and also increases the risk of fractures and there can be a variety of diseases. If a person has a habit of alcohol then it must be stopped as this also reduces bone mass.

Who should have bone density testing?

Osteoporosis diagnosis:

Women who are above the age of 65 and men who are above the age of 40 must go for bone density testing. If there are risk factors in younger men and women aged 59-60 should take it seriously and go for the treatment.

What is the treatment for osteoporosis?

The treatment is based on how much risk is there of bone-breaking in next 10 years and this information is gathered by doing the bone density test. The tests and treatment must be done in correct time else the risk is high and bones start to fall and loss. Which increases the chances of curing osteoporosis.

Osteoporosis treatment:

  • Bisphosphonates: At a certain age, both men and women become prone to osteoporosis and the risk of fractures increase and then for Bisphosphonate they prescribe medicine like Alendronate(Binosto, Fosamax), Risedronate(Actonel, Atelvia) Ibandronate(Boniva), Zoledronic acid (Reclast, Zometa)
  • Monoclonal antibody medication: Denosumab (Prolia, Xgeva) show better or similar bone density as compared to bisphosphonate resulting in reducing the chance of all types of fracture.
  • Hormone-related therapy: When estrogen starts releasing soon after the menopause it helps in maintaining the density of bones. But estrogen therapy increases the risk of breast cancer, endometrial cancer, blood clots, and there can also be the possibility of heart diseases. Therefore the use of estrogen must be done on the younger women for increasing the bone health or in women who require treatment for menopausal symptoms.
  • Replacement therapy: In males when the level of testosterone decreases with age then the risk of osteoporosis increases. Replacement therapy can be done to improve the level of testosterone in the body.
  • Bone building medications: Medicine which increases the weight of the bones can also be given to the patient if the treatment does not work properly then the doctor recommend these medicines: Teriparatide (Forteo), Abaloparatide(Tymlos), Romosozumab(Evenity).

What are the risk factors of Osteoporosis?

  • Age: According to studies, the older you are, the more prone you become in developing it.
  • Race: Being of Asian or white ancestry can put you at a greater risk of developing it.
  • Family history: Having a sibling or a parent with Osteoporosis can make you more susceptible to developing it.
  • Body frame: Women and men who have small body frames usually tend to develop at a young age because their bone mass is very less as compared to people with a big body frame.
  • Sex hormones: Low sex hormones weaken the bones. Also, fewer estrogen levels in women during menopause is the most common risk factor for developing it. The treatments used for prostate cancer can reduce estrogen and testosterone levels in men which can lead to bone loss density.
  • Thyroid problems: A lot of thyroid hormone can lead to bone loss. If you have an overactive thyroid, taking thyroid hormone medications to treat the thyroid can develop it.
  • Other glands: Osteoporosis can also be caused due to adrenal glands or overactive parathyroid.
  • Low calcium intake: Lack of calcium plays a major role in it. Low calcium consumption contributes to increased risk of fractures, the early loss of bones and low bone density.
  • Eating disorders: Restricting the consumption of food can severely weaken the bones in both women and men. People who have anorexia are more prone to developing this issue.
  • Gastrointestinal surgery: Surgery which reduces the size of your stomach or surgery to remove parts of the intestine can limit the level of the area available to absorb nutrients like calcium.
  • Steroids: Sometimes certain medications and steroids used to treat seizures, gastric reflux, cancer and transplant rejection can also contribute to developing it.

Can osteoporosis be prevented?

There are many factors which help in preventing osteoporosis for different age groups:

Childhood to adolescence:

  • There must be an adequate amount of calcium intake
  • Avoiding malnutrition and under nutrition
  • The body must get an adequate amount of Vitamin D
  • Doing physical activities
    Adulthood:
  • An adequate amount of calcium and diet must be taken
  • Heavy drinking must be avoided
  • There should not be smoking and heavy smoking
  • Regular weight-bearing activities must be done
  • Avoid weight-loss diets and eating disorders

What is the best diet for osteoporosis?

Foods to avoid in osteoporosis:

  • Beans(Legumes)
  • Meat and other high protein food
  • Salty food
  • Wheat Bran
  • Alcohol, caffeine
  • Soft drinks or carbonated drinks
  • coffee or tea

Foods to eat in osteoporosis:

  • Dairy products like cheese, yoghurt, low fat, and nonfat milk
  • Fish such as sardines and salmon with bones
  • Fresh fruits and vegetables which include turnip greens, kale, okra, Chinese cabbage, mustard greens, broccoli, spinach, potatoes, sweet potatoes, oranges, strawberries, papaya, pineapple, bananas, prunes, red and green peppers.
  • Calcium and Vitamin D intake must be part of every diet.

What are the home remedies for osteoporosis?

  • Vinegar: It helps in increasing the calcium levels in the bones and helps the bone to become stronger.
  • Tofu: In research, it is found that soy resembles the compound which is needed for women to maintain the balance of hormones that is estrogen which is helpful for increasing the density of bones.
  • Red clover: This is a kind of herb which has got certain effects like estrogen and it is shown that women who have an intake of red clover supplement they have good bone density.
  • Stop Smoking: Alterations in the behaviour is also important such as smoking which is harmful to the body and due to this the menopause arrives early in women. Thus, increasing the risk of osteoporosis
  • Not losing too much weight: There must not be very much loss in the weight of the person as for losing weight the person cuts down the diet thus not taking a sufficient amount of vitamins and minerals.

References

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Written ByDr. Kailash Kothari MD - Anaesthesiology,MBBSOrthopaedics
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