Osteoporosis
Osteoporosis is a condition in which the bones become thin, brittle and weak. These changes can increase the risk of fractures. Fractures can lead to disability. Fractures caused by osteoporosis have been linked to an increased risk of death.
Osteoporosis occurs five times more often in women than in men. Estrogen, a female hormone, protects against bone loss. After menopause, the ovaries produce very little estrogen. This triggers a period of rapid bone loss in women that starts one year before the final menstrual period and lasts for about three years. The natural effects of aging on bones may contribute to this bone loss as well.
Risk Factors
The following factors cause or contribute to osteoporosis and fractures:
- Certain medications
- Diseases such as inflammatory bowel disease, rheumatoid arthritis and lupus
- Low calcium intake
- Vitamin D insufficiency
- Excess vitamin A
- High caffeine intake
- High salt intake
- Aluminum (in antacids)
- Alcohol (three or more drinks per day)
- Inadequate physical activity or being immobile
- Smoking (active or passive)
- Falling
- Being thin
Symptoms
Osteoporosis may not cause any symptoms for decades. However, some signs and symptoms do occur as the disease progresses. As the spinal bones weaken, they can fracture. Fracture in the front part of the spinal bones can result in loss of height or a slight curving of the spine. This type of spinal fracture often causes no pain. Sometimes, fractures of the spine can cause pain that travels from the back to the sides of the body.
Diagnostics
In a bone mineral density (BMD) test, bone density is measured at the heel, spine, hip, hand or wrist. Several types of BMD tests are available. Dual-energy X-ray absorptiometry (DXA) of the hip and spine is considered to be the most accurate BMD test available.
All women aged 65 years or older should have a BMD test. Younger women and those past menopause should have a BMD test if they have had a bone fracture because of fragile bones or have other risk factors for osteoporosis, such as rheumatoid arthritis, smoking, alcoholism, a history of hip fracture in a parent or a body weight less than 127 pounds. During a DXA scan, you lie down for 3–10 minutes while a machine scans your body. With this test you are exposed to a small amount of radiation, less than the amount in a normal chest X-ray.
After the test, a T-score is given for each site measured. A negative score means that you have thinner bones than an average 30-year-old woman. A positive score means that you have stronger bones than an average 30-year-old woman. If the T-score at any site is -1 to -2.5, you have a low BMD and are at increased risk of osteoporosis. A score of -2.5 or lower means that you have osteoporosis. Treatment usually is recommended to prevent fractures.
Treatments
Various medications are used to treat osteoporosis and help reduce the risk of fractures. Some can be used for prevention.
Lifestyle plays a key role in preventing osteoporosis. Exercise, a healthy diet and not smoking can help keep your bones strong and healthy throughout your life.
Exercise increases bone mass before menopause and slows bone loss after menopause. Bone is living tissue and exercise makes it grow stronger. The Centers for Disease Control and Prevention recommend that healthy adults get 150 minutes of exercise a week, which works out to be about 30 minutes on most days of the week.
Weight-bearing exercises can help keep bones strong. Weight-bearing exercises are activities performed while standing and that require your muscles and bones to work against gravity. An example is brisk walking. Non-weight-bearing exercises, such as Tai Chi, Yoga and Pilates, can build endurance and improve balance and posture, thereby reducing your risk of falls. Strength training also is good for bones. In this type of exercise, muscles and bones are strengthened by resisting against weight, such as your own body, an exercise band or handheld weights.
Calcium is important to building and maintaining healthy bones. Vitamin D helps the body absorb calcium. To increase your daily levels of calcium, eat a variety of calcium-rich foods like dark, leafy greens; yogurt, milk and cheese; and canned fish with soft bones, like salmon and sardines. You can increase your intake of vitamin D by eating foods fortified with vitamin D (orange juice, cereal and milk). You also can get vitamin D by being in the sun for 15 minutes a few days a week.