Osteoporosis
What is Osteoporosis?
Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis can be present without any symptoms for decades because osteoporosis doesn't cause symptoms until bone fractures. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain but fractures can also be silent, i.e. without symptoms. Normally, bone density accumulates during childhood and reaches a peak by around age 25. Bone density then is maintained for about 10 years.
After age 35, both men and women will normally lose 0.3%-0.5% of their bone density per year as part of the aging process. During the first five to 10 years after menopause, women can suffer up to 2%-4% loss of bone density per year. This can result in the loss of up to 25%-30% of their bone density during that time period. The accelerated bone loss after menopause is a major cause of osteoporosis in women, referred to as postmenopausal osteoporosis. The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women.
What causes Osteoporosis:
Family history of osteoporosis, low body weight (BMI<19 kg/m2), previous fracture, lack of exercise, excessive alcohol consumption, malabsorption (nutrients are not properly absorbed from the gastrointestinal system, i.e. celiac sprue), low estrogen levels in women (menopause before 45 yrs of age or early surgical removal of both ovaries), low testosterone levels in men, amenorrhea in young women (as in anorexia nervosa), rheumatoid arthritis, primary hyperparathyroidism, Vitamin D deficiency, oral treatment with corticosteroids such as prednisone
DXA (dual-energy X-ray absorptiometry scan) measures bone density in the hip and the spine. The test takes only five to 15 minutes to perform, exposes patients to very little radiation (less than one-tenth to one-hundredth of the amount used on a standard chest X-ray), and is quite precise.
The bone density of the patient is compared to the average peak bone density of young adults of the same sex and race. This score is called the "T score," and it expresses the bone density compared to peak young adult bone mass.
It is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as important as treatment. The following are osteoporosis prevention and treatment measures: Lifestyle changes, including quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D, medications that stop bone loss and increase bone strength, such as alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista), ibandronate (Boniva), calcitonin (Calcimar), zoledronate (Reclast), and denosumab (Prolia) or Medications that increase bone formation such as teriparatide (Forteo).
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