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Osteoporosis

Osteoporosis is the thinning of the bones so that they become weak, brittle, and susceptible to breaking at even the slightest stress. Bone is constantly undergoing turnover, with old bone tissue breaking down while new bone tissue replaces it. Osteoporosis occurs when the rate at which new bone is made is unable to keep up with the rate at which old bone is discarded. This leads to loss of bone tissue.

Symptoms

Common symptoms of osteoporosis include

  • Back pain
  • Height loss
  • Hunched over posture
  • Bones breaking easily or frequently

In the early stages of osteoporosis, there are typically no noticeable symptoms.

Causes & Risk Factors

Osteoporosis is caused by a loss of new bone. New bone is always being made and old bone is always being broken down by the body. As humans reach 30, new bone is made faster than old bone is broken down. This is the age when we have the most bone mass we’ll ever have in our lifetime. Once we go past the age of 30, old bone starts to break down faster than new bone is made. Whether or not this turns into osteoporosis is determined by a few factors, including how much bone mass a person had when they were younger, ethnic group, and if your parents had osteoporosis.

Risk factors for osteoporosis that cannot be changed include:

  • Sex – women are more likely to develop it than men
  • Age – the older you are, the more likely you are to develop osteoporosis
  • Race – people in White or Asian ethnic groups are more likely to develop osteoporosis
  • Genetics – having a family member with osteoporosis puts you at a greater risk
  • Body size – people of both sexes who have smaller bodies are more at risk for developing osteoporosis because they have less overall bone mass
  • Low hormone levels
  • Overactive thyroid, parathyroid, or adrenal glands
  • Eating disorders
  • Gastrointestinal surgery – surgery that reduces stomach size decreases the amount of available tissue to absorb nutrients like calcium
  • Celiac disease
  • Inflammatory bowel disease (IBS)
  • Kidney or liver disease
  • Multiple myeloma
  • Rheumatoid arthritis

Risk factors for osteoporosis that someone can try to prevent include:

  • Lack of regular physical activity
  • Excessive alcohol consumption
  • Tobacco use
  • Low calcium intake – lack of calcium can contribute to less bone density over one’s lifetime
  • Long term use of certain medications

Anyone who took steroids for a long period of time, experienced early onset menopause, or has a family history of osteoporosis, may want to consult a doctor about their risk for osteoporosis and what they can do to prevent it.

Diagnosis & Complications

A doctor will diagnose osteoporosis with a combination of current symptoms, medical history, and a bone density test. A bone density test will allow your doctor to make a definitive diagnosis. Bone density tests involve low-level X-rays that detect the amount of minerals in your bones. An abnormally low amount of minerals indicates osteoporosis.

Bone fractures are the most common complication of osteoporosis. They frequently occur in the spine and hips. Hip fractures can be particularly dangerous, often resulting in death within a short period of time.

Treatment & Management

There are a wide range of treatment options for osteoporosis. An individual’s treatment will be based on their current risk of breaking a bone based on a bone density test. Lower-risk individuals typically focus on lessening any existing risk factors for falls and increasing current bone density, while higher-risk individuals may take medications.

Treatment options include:

  • Bisphosphonates – these are a widely prescribed class of medication for individuals at risk of breaking a bone
  • Denosumab – this is a medication that helps reduce the chance of bone fractures and increases bone density
  • Hormone therapy – Oestrogen and testosterone can be given as therapies for osteoporosis in women and men, respectively. However, due to potential complications and the efficacy of osteoporosis medications, hormone therapy is not used for everyone, and it is often used with medication.
  • Medications that build new bone

An individual with osteoporosis and their doctor will create a treatment plan that best suits their needs.

 
 
 

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