Osteoporosis Overview
What Are the Symptoms of Osteoporosis?
A person is often not aware that he or she has osteoporosis until a fracture occurs. But there are occasionally symptoms of the disorder. They could include:
Backache
A gradual loss of height and an accompanying stooped posture
Fractures of the spine, wrist, or hip
Call Your Doctor About Osteoporosis If:
You develop a backache or sudden severe back pain, which can indicate a spinal compression fracture caused by osteoporosis.
Dental X-rays reveal a loss of bone in the jaw, which can be a sign of osteoporosis.
What Is Osteopenia?
Think of it as a midpoint between having healthy bones and having osteoporosis.
Osteopenia is when your bones are weaker than normal but not so far gone that they break easily, which is the hallmark of osteoporosis.
Your bones are usually at their densest when you’re about 30. Osteopenia, if it happens at all, usually occurs after age 50. The exact age depends how strong your bones are when you’re young. If they’re hardy, you may never get osteopenia. If your bones aren’t naturally dense, you may get it earlier.
Osteopenia — or seeing it turn into osteoporosis for that matter — is not inevitable. Diet, exercise, and sometimes medication can help keep your bones dense and strong for decades.
Who Is Most Likely to Get It?
This condition happens when your body gets rid of more bone than it is creating.
Some people are genetically prone to it, with a family history of the condition. You’re also more likely to get it if you’re a woman.
Women have lower bone mass than men. Also, women live longer, which means their bones age more, and they usually don’t get as much calcium as men.
Calcium is the key to keeping bones healthy. Hormone changes that happen at menopause increase the chance for osteopenia for women, and men with lower testosterone levels have higher odds of getting it.
Medical Causes
Sometimes, you may have a medical condition or treatment that can trigger the condition.
Eating disorders, such as anorexia and bulimia, can starve your body of nutrients needed to keep bones strong. Other causes include:
Untreated celiac disease: People with this condition can damage their small intestine by eating foods with gluten in them.
An overactive thyroid. Too much thyroid medication can also play a role.
Chemotherapy: Exposure to radiation can have an effect.
Certain medications. These include steroids such as hydrocortisoneor prednisone and anti-seizure drugs such as carbamazepine(Carbatrol, Tegretol), gabapentin (Gralise, Horizant, Neurontin), or phenytoin (Dilantin, Phenytek).
Lifestyle Causes
Problems in your diet, lack of exercise, and unhealthy habits can contribute to this condition. Watch out for:
- A lack of calcium or vitamin D
- Not enough exercise, especially strength training
- Smoking
- Too much alcohol
- Carbonated beverages
Diagnosis
Osteopenia usually doesn’t have any symptoms. This makes it hard to diagnose unless you have a bone mineral density test.
The National Osteoporosis Foundation recommends the test if you meet any of the following:
● You’re a woman 65 or older
● You’re a postmenopausal woman 50 or older
● You’re a woman at the age of menopause and have a high chance for breaking bones
● You’re a woman who has already been through menopause, younger than 65, and have other things that give you a higher chance of osteopenia
● You’re a man older than 50 with risk factors
● You break a bone after age 50
The test is painless and fast. It estimates how dense or thick your bones are by using X-rays.
Prevention and Treatment
It’s never too early to take steps to prevent osteopenia. Talk with your doctor about an exercise plan that’s right for you. Eat the right kinds of food.
But even if you already have osteopenia, it’s not too late for you to stop it from turning into osteoporosis with these strategies:
Get enough calcium and vitamin D: This may be the most important thing you can do for your bones at any stage of life. You can get calcium in:
- Dairy products such as yogurt, cheese, and milk (go for low-fat or nonfat varieties)
- Spinach and broccoli
- Dried beans
- Salmon
Vitamin D, which helps your body absorb calcium, can be found in eggs and in oily fish such as salmon and sardines.
Some foods, including orange juice, cereal, and bread, have added calcium and vitamin D.
It’s also a good idea to spend 10 to 15 minutes in the sun twice a week because this helps your body convert sunlight to vitamin D.
If your doctor doesn’t think you’re getting enough calcium and vitamin D, he or she may suggest that you take a supplement.
Weight lifting: You can do regular, weight-bearing exercises to prevent or slow osteopenia. Talk with your doctor before you start a strength-training program.
Lifestyle changes: If you smoke, try to quit. Cut down on carbonated drinks and alcohol.
Medications
Prescription medications are sometimes used to treat osteopenia if your bones are starting to get weak.
Medicines also used to treat osteoporosis might be prescribed. These include:
- alendronate (Fosamax)
- ibandronate (Boniva)
- raloxifene (Evista)
- risedronate (Actonel, Atelvia)
- zoledronic acid (Reclast, Zometa)
You might have side effects such as digestive problems and bone and joint pain. They might also make you feel tired.
Types of Osteoporosis
Did you know there are different types of osteoporosis? While white women are at the greatest risk, the disease does not discriminate. Men and women of all ethnic groups can develop osteoporosis. So can children and teenagers.
Osteoporosis Risk in Men and Women
Women experience more rapid bone loss in their 50s than men do. By the time they’re both in their late 60s, though, men and women lose bone mass at the same rate. Statistics show that 2 million men have osteoporosis today. Another 12 million are at risk. And one out of every four men over age 50 will break a bone due to osteoporosis.
When Does a Woman’s Risk of Osteoporosis Rise?
A woman’s risk of osteoporosis rises sharply after menopause. This is especially true for white women and Asian women. It’s also especially true for women who have small, thin frames.
Why Are Younger Women at Risk of Osteoporosis?
Teens and college-age women who are thin and who exercise excessively are at a high risk of not having menstrual periods. This is a condition called amenorrhea. Loss of menstrual periods is linked to decreased estrogen levels. Decreased levels of estrogen may cause osteoporosis. A diet low in calcium and other bone-boosting nutrients can also contribute to low bone density.
Teenage girls who restrict their eating and who lack menstrual periods are at risk of osteoporosis and fractures. Young female athletes who try to reach a low body weight for running or dancing are more likely to not have periods. So are those who compete in scoring sports such as gymnastics and figure skating.
A young female athlete who appears to be in top physical condition often has the highest risk of low bone density — osteoporosis — and fracture, especially if she has an eating disorder and lacks periods. In fact, a fracture may be the sign that first alerts the doctor there is a problem. Up to 30% of ballet dancers suffer from repeated stress fractures, which can be a sign of eating disorders and low body weight.
Types of Osteoporosis in Children
There are two kinds of osteoporosis in children: secondary and idiopathic.
Secondary juvenile osteoporosisrefers to osteoporosis that develops as a result of another condition. This is by far the most common kind of osteoporosis in children. Some of the diseases that can lead to osteoporosis in children include:
- anorexia nervosa
- Cushing’s syndrome
- cystic fibrosis
- diabetes
homocystinuria, a genetic metabolic disorder - hyperparathyroidism
- hyperthyroidism
- juvenile arthritis
- kidney disease
- leukemia
- malabsorption syndrome
- osteogenesis imperfecta, sometimes called brittle bone disease
Some osteoporosis in children is a direct result of disease itself. With rheumatoid arthritis, for example, children may have lower than expected bone mass, especially near arthritic joints. Certain drugs can also lead to juvenile osteoporosis. These can include chemotherapy for cancer, anticonvulsants for seizures, or steroids for arthritis. If your child has one of these conditions, ask your child’s health care provider about testing and monitoring bone density.
Idiopathic juvenile osteoporosis means that there is no known cause of the disease. This type of juvenile osteoporosis is rare. It develops most often just before the onset of puberty. Although most of the bone density may return during puberty, children with juvenile osteoporosis usually have lower peak bone mass as adults.
No matter what the cause, juvenile osteoporosis is a very serious condition. You build about 90% of your bone mass by the time you’re ages 18 to 20. Losing bone mass during prime bone-building years can put a child at serious risk for long-term complications such as fractures.
What Can I Do to Prevent Osteoporosis?
Here are some things you can do to build bone now and help prevent osteoporosis later:
Do weight-bearing exercise: Just like your muscles, your bones need to be worked regularly to stay strong. Studies show that young women who participate in athletics have the highest bone density. They also show that postmenopausal women who take part in regular exercise can prevent or reverse bone loss by almost 1% a year.
Eat a diet rich in calcium and vitamin D: Adults (men and women) under age 50 need 1,000 mg (milligrams) of calcium each day. All women over age 50 should get 1,200 mg of calcium daily. Men ages 51 to 70 should get 1,000 mg of calcium a day and 1,200 mg after they reach age 70. Men and women under age 70 need 600 international units (IU) of vitamin D daily. That increases to 800 IU of vitamin D after age 70. Experts feel that it is best to get your calcium and vitamin D from your diet. Good natural sources of these nutrients include milk, yogurt, cheese, dark green leafy vegetables, and fortified cereals and juices. Three and a half ounces of cooked salmon contains 90% of your daily dose of Vitamin D. If you can’t get enough calcium and Vitamin D in your diet, talk to your health care provider.
Don’t smoke: The more you smoke and the longer you smoke, the greater risk you have of fracture in old age. Quitting smoking appears to lower this risk over time.
If you are concerned about your bone health, talk to your health care provider. Screening tests are available to check your bone health.
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