Osteoporosis

Table of Contents

Osteoporosis is a common disease that decreases bone density and can result in a decrease in bone strength that may lead to an increase in fractures. Osteoporosis can occur at any age and affects both men and women of all ethnicities.

Causes of Osteoporosis

When a person loses bone mass, a change results in the structure of the bone tissue. The exact causes for these changes are unknown, however, several risk factors increase the likelihood of someone developing the disease.

Some of these risk factors can be minimized with lifestyle changes. It is important to note that someone with few or no risk factors can still develop the disease.

Risk factors for osteoporosis include:

  • Sex – Women are more likely to develop osteoporosis compared to men. This is due to differences in peak bone mass and bone size.
  • Age – As a person ages, they naturally lose bone mass and are at a higher risk of developing osteoporosis.
  • Race – Statistically, Caucasian and Asian women are at the highest risk for developing osteoporosis while African American and Hispanic women are at a lower risk. Men overall have a lower risk compared to women but Caucasian men are at higher risk compared to other racial groups.
  • Lifestyle – A person with a well-balanced diet that includes calcium and Vitamin D may be at lower risk for developing the disease. Studies also indicate that smoking and heavy alcohol consumption increase risk.
  • Family History – Individuals with a family member who has been diagnosed with osteoporosis may be more likely to develop the disease.

Osteoporosis Symptoms

Osteoporosis can occur throughout the bones of the body and early on in the disease, an individual may not have any symptoms.

Over time, as bones weaken, symptoms may develop such as:

  • Back, hip, or neck pain
  • Loss of height
  • A hunched-over posture or stooped stance
  • Bones that break easily

Types of Osteoporosis

There are two types of osteoporosis: primary and secondary. Primary osteoporosis can be further divided into two groups: type I and type II.

Primary type I involves the loss of spongy tissue within the bone and is six times more common in women.

Primary type II involves the loss of both spongy tissues and the outer bone and is only twice as common in women.

Secondary osteoporosis is also known as high-turnover osteoporosis. Having a high turnover rate increases the likelihood of osteoporosis.

Secondary osteoporosis usually has an identifiable underlying cause such as diabetes and hyperthyroidism or hyperparathyroidism.

Some other links to secondary osteoporosis include leukemia, multiple myeloma, and thalassemia, a hereditary form of anemia.

Diagnosis

The most common way that osteoporosis is diagnosed is through a bone density test. This type of test uses specialized x-rays to measure the density of areas commonly affected by osteoporosis.

X-rays of the hips, wrists, and spine are used to evaluate a patient for disease. These tests are noninvasive and can usually be completed in under 30 minutes.

Doctors may also order tests on a patient’s blood and urine to check for other markers and conditions that may cause bone loss.

Depending on the results of the testing, a healthcare provider will evaluate the severity of the disease and if treatment is necessary.

Osteoporosis Treatments and Medications

Treating osteoporosis can involve multiple approaches including lifestyle changes, supplements, and medications. Unfortunately, there is no cure for the disease but proper treatment can help protect bones and slow the progression of the disease.

Treatments

A weight-bearing exercise program may be implemented to try to curb the disease from progressing. An exercise plan that pushes and pulls on bones can help promote new bone growth.

Vitamin and mineral supplements may be taken if a blood test reveals the person is deficient in minerals like vitamin D and calcium. A doctor will suggest the proper type and dosing.

Medications

Several classes of medications are also available to treat osteoporosis.

Hormone-related therapies like Evista are sometimes used in women specifically to counteract menopausal hormone changes.

Anabolic agents such as Forteo help to rebuild bone structure. Bisphosphonates like Boniva stop the body from reabsorbing bone tissue.

A healthcare provider can determine which is best for the patient.


Sources:

  1. National Institutes of Health ( NIH). Osteoporosis Overview. October 2019. Available at bones.NIH.gov.
  2. Mayo Clinic. Osteoporosis. August 2021. Available at MayoClinic.org.
  3. Albany Medical Center. Osteoporosis: A Patient’s Guide to Osteoporosis. Available at AMC.edu.
  4. Heathline.com. What Do You Want to Know About Osteoporosis?. August 2019. Available at Healthline.com.
  5. Cleveland Clinic. Osteoporosis. April 2020. Available at ClevelandClinic.org.
  6. Drugs.com. Evista. April 2022. Available at Drugs.com.
  7. Drugs.com. Forteo. May 2021. Available at Drugs.com.
  8. Drugs.com. Boniva. April 2022. Available at Drugs.com.

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