An Introduction to Osteoporosis
WHAT IS OSTEOPOROSIS?
Osteoporosis is a disease of the bones where the struts that make up the bone structure become thin and fragile.
Osteoporosis means ‘porous bones’ and is commonly linked to post menopausal women but can affect men or women at any age.
Causes:
There are 3 mechanisms where osteoporosis can develop:
- Inadequate peak bone mass where the skeleton develops insufficiently during growth.
- Excessive bone resorption where the mineral from the bone is released back into the blood stream.
- Inadequate formation of new bone where replacement of old bone for new bone doesn’t form properly.
Hormonal factors strongly affect the rate of resorption e.g. lack of oestrogen resulting from a menopause increases bone resorption.
Calcium metabolism affects bone turnover. Deficiency of calcium and vitamin D leads to reduced bone deposition.
The parathyroid gland also maintains calcium in the blood stream by secreting a hormone that increases bone resorption.
Symptoms and effects:
There are no specific symptoms for osteoporosis.
The main consequence is the increased risk of bone fractures. Osteoporosis itself will not cause bones to break but will increase the chance of fractures when you fall.
Osteoporosis causes bones to break following a minor bump or fall that would not normally affect healthy people – these are referred to as fragility fractures. Fragility fractures are most common in the wrist, hip and spine.
Compressed bones in the back resulting from a vertebral collapse/fracture causes back pain, loss of height and spinal curvature.
Family history of osteoporosis can increase the heritability chance you will have osteoporosis.
Treatment and prevention:
A healthy lifestyle can reduce the risk of osteoporosis. This includes:
- A balanced diet to incorporate a variety of foods.
- Regular calcium intake included in the diet.
- Vitamin D intake from sunlight.
- Stop smoking.
- Reduce alcohol intake.
- Exercise to increase bone strength.
Treatment for osteoporosis includes calcium and vitamin D supplementation with proven benefits to those above 65 years of age.
The main treatment for osteoporosis is bisphosphonate. Bisphosphonate drug treatments are available as daily/weekly/monthly tables or as a once a year infusion of the bisphosphonate Zoledronate.
Parathyroid hormone treatment might also be considered and involve daily injections given over a period of time. Testosterone may be prescribed to men with low hormone levels to strengthen their bones.