What You Should Know About Osteoporosis

ABOUT OSTEOPOROSIS

Osteoporosis is a serious health problem. In the United States, more than 24 million people are affected--mostly women. One of every four women over the age of 50 will develop the disease. It's the major cause of bone fractures in postmenopausal women and the elderly. But it can be prevented and treated, so it's important to learn about it, and work with your physician on prevention and treatment. Here, we'll tell you a bit about what it is, what causes it, who is at risk, how it can be prevented, and how it's diagnosed.

What is it?

Osteoporosis is a disease that causes bones to become fragile and break easily. The bones become less thick, less dense, more porous, hence the name osteoporosis: "osteo" means bone, and "porosis" means that which is porous. This weakening occurs gradually. At the outset there are no symptoms. As the disease progresses, the bones become increasingly brittle and vulnerable. Down the line, a fractured bone may be the first obvious sign that the disease has taken hold.

Normal Bone
Osteoporotic Bone

Healthy bone is dense and strong. It's a honeycomb-like living tissue full of calcium and mineral deposits. It's built to withstand minor bumps and falls. Across a liftime, the body continually cycles, breaking down old bone, and producing new. Until our mid-thirties we produce more bone than we lose. After our mid-thirites, the bone-replacement cycle goes into balance so we produce the same amount of bone we lose. Then with advancing age, we do lose some bone--that's normal.

But some people experience the severe bone loss of osteoporosis. The body's bone-building cycle goes way out of balance. Their bones--especially those of the wrist, hip, and spine--become so brittle that they can no longer withstand pressures imposed by everyday living. A minor fall or bump results in bone fracture, which causes pain, height loss, decreased mobility and a deformed backbone that curves forward ("dowager's hump"). When bones become extremely fragile, even coughing, lifting a bag of groceries, or stepping from a curb can cause a bone to break, with devasting effect.

Causes

There are many, but menopause is the major one. Around the age of 50, a woman's body begins producing less estrogen. The drop in this hormone causes increased bone loss. In many the loss is severe enough to cause osteoporosis.
Severe bone loss can also be triggered by extended use of certain medications, inadequate nutrition, numerous lifestyle factors and health conditions.

Read on--next, we'll give an idea of who should be most concerned.

Who is at risk?

There are numerous risk factors for osteoporosis. Discuss them with your physician.

Female

Menopause (including menopause due to surgical removal of the ovaries)

Early menopause (prior to 45)

Family history of osteoporosis

Broken bone resulting from minor injury to the wrist, spine, pelvis or hip

Caucasian or Asian descent

Thin or small build

Stooped posture in older family members

Extended use of certain medications: corticosteroids (e.g., prednisone and cortisone) or thyroid hormones

Smoking

Significant alcohol consumption

High caffeine intake

Too little exercise

Inadequate calcium intake (now, or during childhood)

Allergy to milk products or lactose intolerance

Low intake of calcium-rich foods

Cessation of menstruation due to excessive exercise

Cessation of menstruation for reasons other than pregnancy or nursing

Eating disorder (bulimia or anorexia nervosa)

Surgery to remove part of your stomach or intestines

Advanced age

Low levels of testosterone (men only)

How can it be prevented?

Though some of the risk factors can't be controlled, there are steps you can take to help prevent osteoporosis. Prior to your 30s, you can take steps to produce as much bone as possible. After that, the same steps may help slow bone loss. So stop smoking and cut down on alcoholic beverages. Practice good nutrition, and get enough exercise.
Take enough calcium. The amount you need depends on your sex, age and risk of osteoporosis. Foods are the best natural sources. Dairy products, green leafy vegetables, broccoli, shellfish, sardines, oysters, brazil nuts, tofu and almonds are all calcium-rich. Some foods can be fortified with calcium: orange juice, bread, and cereals. Read the labels to check. And if you don't get enough calcium in your diet, you might consider calcium supplements. Your doctor can help you determine what's best for you.

Take enough vitamin D. It increases the amount of calcium your body absorbs and helps build bone. Liver, fish oil and vitamin-D fortified milk are good sources. It's also produced by your body in response to sunlight.

Exercise to strengthen your bones. Experts disagree on just how much weight-bearing exercise you need, but one rule of thumb recommends 20 to 30 minutes, three to four times each week. Aerobics, dancing, jogging, cross-country skiing, stair climbing, tennis and walking are all beneficial.

How is it diagnosed?

Because of the "silent" onset of osteoporosis, it can be difficult to detect. Your doctor may get some clues from certain signs and symptoms: back pain, height loss, broken bones, or a curving spine. The disease may be visible in a x-ray taken for some other purpose, though if this happens the disease is fairly advanced; early osteoporosis does not show up in an x-ray.
The only sure method of early detection is a bone density test. It will give your doctor the information needed to determine your whether you have osteoporosis, and whether you are at risk in the future. Follow-up tests will let your doctor see how fast you are losing bone over time, and how well you are responding to treatment.