Osteoporosis
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| Osteoporosis: Symptoms, Causes and Treatment |
What is Osteoporosis?
Osteoporosis, also known as bone thinning, is a medical
condition that affects the human bones, leading to a loss of
bone density and strength. It can occur at any age but is more
prevalent in the elderly, particularly among women.
In individuals with osteoporosis, there are empty spaces within the bones that
increase in size. Consequently, the bone structure becomes weaker and more
fragile, increasing the risk of fractures. In fact, fractures can occur during
routine activities such as standing or walking in individuals affected by
osteoporosis.
The most commonly affected bones include the ribs, hips, wrists, and the spine, which are also the most susceptible to fractures.
There are two types of osteoporosis:
Primary osteoporosis: This type encompasses bone thinning during
menopause due to estrogen deficiency and age-related bone thinning.
Secondary osteoporosis: This type occurs as a result of specific
identifiable causes, such as bone thinning resulting from certain medical
conditions or the use of certain medications.
Osteoporosis Causes
The body continuously absorbs old bone tissue and generates new bone to
maintain bone density, strength, and integrity.
The optimal bone density is achieved when individuals are in their late
twenties.
Bone weakening begins at the age of 35, and as individuals age, the rate of
bone loss or breakdown exceeds the rate of bone rebuilding. Excessive
bone loss is a significant factor contributing to bone thinning.
Osteoporosis is more likely to occur in women after menopause due to
the sudden decrease in estrogen, which typically protects women from bone
thinning.
Factors that increase the risk of osteoporosis
There are several factors that increase the risk of developing osteoporosis, including the following:
- Age: The risk of developing bone thinning increases after the mid-thirties, especially after menopause.
- Low sex hormones: Decreased levels of estrogen make bone renewal difficult.
- Ethnicity: Caucasians and Asians are more at risk of developing osteoporosis than others.
- Genetic factors: The chances of developing the disease increase if there is a family history of it.
Medications and medical conditions that increase the risk of
osteoporosis
There are certain medical conditions that cause hormonal changes in the body, leading to the development of osteoporosis. Additionally, there are medications that can cause a loss of bone mass in the body.
Medical conditions that increase the risks include:
- Some autoimmune diseases: such as rheumatoid arthritis and ankylosing spondylitis.
- Cushing's syndrome: a disorder of the adrenal gland.
- Pituitary disorders.
- Overactive thyroid and parathyroid glands.
- Deficiency of estrogen or testosterone hormones.
- Some digestive disorders such as celiac disease, which causes problems in mineral absorption.
Medications that increase the risks include:
- Glucocorticoids (corticosteroids): such as prednisone and prednisolone.
- Thyroid hormone.
- Anticoagulants and blood thinners: such as heparin and warfarin.
- Acid reducers: such as Proton Pump Inhibitors (PPIs) that negatively affect mineral absorption.
- Some antidepressant medications.
- Some vitamin A drugs (retinoids).
- Chemotherapy: such as letrozole used for breast cancer treatment, and leuprorelin used for prostate treatment.
Glucocorticoid-induced osteoporosis is the most common
type of osteoporosis resulting from medication use.
Osteoporosis
There are no symptoms in the early stages of the disease, and the patient may not realize they are affected until a fracture occurs. However, some symptoms may appear, such as:
- Receding gums.
- Weak grip strength.
- Brittle nails.
- Bone fractures.
- Lower back pain.
Individuals with a family history of osteoporosis should consult a doctor to help them detect the disease and assess the risks to avoid fractures.
Low Bone Density in Women
No symptoms may appear until bone fractures occur, with hip, wrist, and spinal fractures being the most common. Spinal vertebrae support the body and assist in standing and sitting.
Bone thinning in the vertebrae can cause serious problems for women, as
fractures in this area can occur during regular daily activities such as
climbing stairs, lifting objects, or bending forward. This type of fracture
can lead to symptoms such as sloping shoulders, bending backward, back pain,
and kyphosis.
How is Osteoporosis Diagnosed?
The doctor will inquire about the family history and any risk factors, and if osteoporosis is suspected, they will request a Bone Mineral Density test (BMD).
The Bone Mineral Density test uses a type of X-ray known as Dual-Energy X-ray Absorptiometry (DEXA). bone density test results help determine the likelihood of fractures for the individual and monitor their response to treatment.
There are two types of devices used for DEXA testing:
Central device: this hospital-based test measures mineral density in the hip
and spine bones.
Peripheral device: A portable device that tests bones in the wrist, heel, or
finger.
Doctors may also use ultrasound for heel bone diagnosis, but it may not
be as accurate as bone density scan.
How to Prevent Osteoporosis?
Osteoporosis can often be avoided, as the development of healthy bones from a young age provides a good reserve of calcium salts capable of withstanding changes that may occur later in life. The critical period during which bone builds itself is between the ages of ten and thirty.
As with any disease, prevention is preferable to treatment. Preventing osteoporosis, or at least reducing the likelihood of its occurrence, can be achieved by:
1. Consuming calcium-rich foods and vitamin D, as vitamin D is essential for
calcium absorption in the body. Here are some top Vitamin D supplements on Amazon
2. Regular physical exercise to stimulate the slowing of
bone mass loss. Check out these exercise equipment options
3. Avoiding smoking and alcohol consumption.
4. Undergoing regular screenings with a specialist physician in cases of
genetic predisposition to detect early signs of osteoporosis.
5. Focusing on consuming calcium-rich foods such as yogurt, cheese, salmon,
sardines, almonds, and cauliflower. Here are some calcium supplements to consider.
6. Meeting the recommended daily calcium intake.
7. Engaging in weight-bearing exercises.
8. Quitting smoking.
9. Weighing the pros and cons of hormone therapy for women.
10. Consulting with a physician about the best preventive measures if at risk
of bone thinning.
11. Treating vitamin D deficiency.
Complications of Osteoporosis
Osteoporosis can lead to several complications, including:
1. Mobility issues: Difficulty in movement can lead to weight gain, which puts
pressure on the bones, especially the knees, and may also lead to heart and
diabetes conditions.
2. Depression: Mobility difficulties can lead to loss of independence and
hinder the individual's ability to perform activities, in addition to the fear
of fractures, all of which can contribute to depression.
Osteoporosis Treatment
There is no definitive cure for osteoporosis, but appropriate treatment can help strengthen bones and protect them from fractures. Some treatments may also stimulate the growth of new bone.
Osteoporosis treatment includes medication and lifestyle changes, such as following specific diets or engaging in physical activities.
Medication Treatment
The most commonly used medications for treating osteoporosis are bisphosphonates, which prevent bone mass loss. They can be administered orally or via injection and include:
- Alendronate
- Ibandronate
- Risedronate
- Zoledronic acid
Other medications that can be used in treatment include:
- Testosterone: Testosterone helps increase bone density in men.
- Hormone therapy: Using estrogen during and after menopause helps prevent
bone density loss in women, but it is also associated with increased
risk of blood clots, heart disease, and certain types of cancer.
- Raloxifene: This medication can be used instead of estrogen to avoid the
risks associated with estrogen use.
- Denosumab: Administered by injection, this medication has shown promising
results in reducing bone loss more than bisphosphonates.
- Teriparatide: This medication is also administered by injection and
stimulates bone growth.
- Salmon calcitonin: This medication is taken as a nasal spray and reduces
bone loss.
Romosozumab: The Food and Drug Administration (FDA) has approved the use of this medication for treating postmenopausal women at risk of fracture. It is administered as two subcutaneous injections (in the same session) once a month for 12 months or less. However, the use of this medication may increase the risk of heart attacks or strokes, and therefore it is not recommended for individuals with a history of either.
Dietary Treatment for Osteoporosis
The diet for patients with osteoporosis should include essential nutrients for
bone health such as calcium and vitamin D. Calcium helps maintain strong
bones, while vitamin D enhances calcium absorption. A deficiency in calcium
increases the risk of osteoporosis. Patients also require protein,
magnesium, vitamin K, and zinc. Here are some dietary supplements that can help.
Prolia injection and Prolia side effects
Alternative medicine Treatment:
Horsetail (Equisetum)
Horsetail is one of the richest herbs in silicon in the form of mono-silicic acid (Manosilic Acid). Silicon helps prevent osteoporosis, treats it when it occurs, and prevents its complications. This is because mono-silicic acid, which the body can easily use, can be extracted by adding a spoon of sugar to the herb powder and boiling it for 3 hours. The sugar will attract more silicon into the drink. The beverage is then strained, cooled, and consumed cold.
Cabbage (Brassica oleracea)
Cabbage contains boron, which helps in preserving bone mass and preventing its weakening.
Dandelion (Taraxacum)
Dandelion contains two important compounds for osteoporosis, silicon, which plays a crucial role in preventing osteoporosis, and boron, which preserves bone health.
Pigweed (Amaranth)
The leaves of this herb are rich in calcium, which is important for bone structure, formation, and reconstruction. Fresh leaves of this herb can be consumed, or the dried leaves can be boiled and consumed as an herbal drink.
Avocado (Persea americana)
Avocado fruits can be mashed with yogurt or blended with milk. They are rich in calcium and vitamin D, which aids in the deposition of calcium in the bones and its utilization.
Soybean (Glycine max)
Soybean contains genistein, a type of plant estrogen. Estrogen helps maintain
bone health, prevents heart diseases, and, by preserving bone strength,
contributes to bone solidity and reinforcement.
Black Pepper:
Black pepper contains four anti-osteoporotic compounds. It can be added to soups or salads.
Parsley:
Parsley contains bone-strengthening compounds such as boron and fluorine. Its leaves and stems can be consumed directly or crushed with the addition of olive oil.
Ginger:
Ginger prevents bone resorption, improves bone inflammation, and is a factor in osteoporosis. Therefore, ginger can help prevent bone fragility.
Oregano:
Oregano contains antioxidant compounds, preventing the body's cells from being attacked by free radicals and boosting immunity, thereby reducing the general weakness associated with osteoporosis.
Osteoporosis Fruits:
Pineapple, grapefruit, nuts, figs, almonds, kiwi, and citrus fruits such as
lemon and orange are rich in vitamin C.