Osteoporosis

Overview

Osteoporosis is a condition which causes bones to weaken and become brittle. So weak that mild stresses – such as coughing or bending over – or a fall can cause a fracture. The most common osteoporosis related fractures are in the wrist, spine, or hip. 

Our bones are made of living tissue that is constantly breaking down and being replaced. When the creation of new bone doesn’t keep up with the removal of old bone it is called osteoporosis. It affects men and women of all races but Asian and white women (especially if they are past menopause) are at a higher risk. There are many ways to prevent bone loss or strengthened already weakened bones through diet, exercise, and medication.

Signs and Symptoms

In the early stages of bone loss there are usually no symptoms. Once your bones have already been weakened you may experience symptoms including: loss of height, back pain caused by collapsed or fractured vertebra, bone fracture occurring more easily than expected, a stooped posture.

Your bones are constantly being renewed, new bone is created and old bone breaks down. Throughout childhood, adolescence and young-adulthood your body creates bone faster than old bone breaks down and your bone mass increases. By their early 20s most people have reached peak bone mass. As you age your bone mass will be lost faster than it’s created.

Your likelihood of developing osteoporosis depends partially on how much bone mass you attained in your youth. The larger your peak bone mass the less likely you are to develop osteoporosis as you age because you have more bone mass “in the bank”.

There are a number of risk factors that can contribute to the likelihood of developing osteoporosis. Some of these are unchangeable such as: race, age, body frame size, biological sex, and family history. It is also more common in individuals who have too little or too much of certain hormones including: thyroid hormone, hormones produced by the parathyroid and adrenal glands, and sex hormones.

Some pre-existing conditions can also lead to an increased risk of osteoporosis including: cancer, inflammatory bowel disease, kidney or liver disease, celiac disease, lupus, rheumatoid arthritis, and multiple myeloma.

Diagnosis & Treatment

To diagnose osteoporosis you will need to have your bone density measured which can be done using a machine that employs low levels of x-rays to determine the proportion of minerals in your bones.

Treatment choices usually depend on your risk of breaking a bone in the next 10 years using information such as bone density tests. If the risk is low treatment may not include medication and may focus on mitigating risk factor instead.

If you are at an increased risk of fracture you will likely be prescribed a bisphosphonate. Examples include: risedronate, alendronate, zoledornic acid, and ibandronate. If you are unable to tolerate these medications or if they’re not effective enough your doctor may try prescribing you teriparatide or denosumab.

Some lifestyle changes that can help reduce your risk of osteoporosis include: avoid excessive alcohol, prevent falls (wear nonslip shoes, check your house for tripping hazards, install grab bars in your shower etc.) and don’t smoke.