IN 2015, the international osteoporosis foundation estimated the number of individuals 50+ age with osteoporosis with 20 million in Europe, 3.8 million in France and 5.3 million in Germany in which incidence of fragility fracture rate per year in 2017 is 2.7 million in Europe, 382000 in France, 765000 in Germany. In the world, it mostly occurs 1/3 in women then 1/5 in men.
Osteoporosis is the disorder characterized by the excessive loss of calcium from the bone without replacement, causing a loss in bone density and making bone porous and fragile, making the loss of bone slowly, silently and constantly.
As the bone is a living connective tissue that has the ability to break down older cells and replace by a new one, its called remodeling. It strengthens our bone and protects our organs, but osteoporosis makes our bone fragile and porous like a honeycomb in which holes and spaces are bigger than the normal bone, which is easy to break from falling and in progressive cases from sneeze or cough.
Bones are strengthened and developed from birth to adulthood and in the early 20s bones are in the highest density rate called peak bone mass, which means high rate to make your bone strong and decrease the rate of osteoporosis, because strong bones decline the rate of osteoporosis.
Osteoporosis mostly involves the spine, hip, wrist and knees.
CAUSES OF POROUS BONE
Osteoporosis is an imbalance between molding (break down) and remodeling (replacement) process of the bone. Calcium is the functional unity in the muscular system (smooth muscles, striated and unstriated muscles of the body) and calcium is deposited in the bone which is used by the body for movement.
Vitamin D, also called 25-hydroxyvitamin D or calcidiol, enhances calcium absorption in the gut, helps in maintaining the concentration of calcium and phosphate, and prevents hypocalcemic tetany.
Imbalance concentration of calcium and vitamin D can result in osteoporosis and other factors which contribute to imbalance concentration are;
- Age: aging increases the chance of osteoporosis. After 50 there is high chance of getting osteoporosis.
- Sex: women are more likely to get osteoporosis than men.
- Race: white and Asian races are more likely to develop osteoporosis. If you are one of them, then protect yourself!
- Family history: having a three-generation history of osteoporosis in the family, makes you more at risk.
- Diet: low calcium intake in life plays a vital role in the development of osteoporosis, which contributes to decreased bone density.
- Sex hormone: decreased sex hormone level also contributes to osteoporosis. Women after menopause and breast cancer are most likely to develop osteoporosis because of low estrogen levels. Whereas, men after the removal of the prostate gland and older age are also at risk because of low testosterone levels.
- Thyroid problem: overproduction of thyroid hormone also causes the loss of bone density because the thyroid hormone stimulates the production of calcium from bone and overproduction means more calcium in blood than in bone which increases porosity.
- Gastrointestinal surgeries; surgeries related to stomach and intestine contribute to reduce the surface of nutrients absorption including calcium.
- Steroid medication: long term usage of corticosteroid medication, interrupts the bone-building process. Some medications are like cortisone, and steroid-related to hyperactivity.
- Other medical conditions: conditions are; inflammatory bowel disease (which interferes with calcium absorption), kidney disease, cancer, rheumatoid arthritis(an inflammatory disorder of joints) and multiple myeloma (accumulation of cancer cells in bone marrow).
- Resting lifestyle: long term rest with less motion and increased weight are more prone to build osteoporosis.
- Daily alcohol consumption: research says daily intake of alcohol more than 2 drinks have more risk to develop osteoporosis.
YOU’LL FACE COMPLICATION LIKE
Osteoporosis gives no symptoms initially but later makes dangerous in way of fractures of spine and hip which is also leads to morbidity and mortality especially in older peoples. other than fractures, osteoporosis also associates permanent pain (sharp and may get more worst with time), loss of height, stooped posture also called dowagers hump (make inflexible and weak muscles of the body), also lead to depression.
Your doctor will ask you to do a BMD (bone mineral density) test, it is a specialized technique in which X rays are used to detect a small percentage of bone loss. It is usually used to see the spine and hip bone density, but it also measures the density of the whole skeleton; it has different options according to places like;
- DXA: used for forearm, fingers and heel.
- SXA: used for heel and wrist.
- DPA: used for spine, hip and the whole body.
- QCT: used for spine and hip.
BDM range is equal to 2.5 or lower considered as osteoporosis.
TREATMENT WITH PREVENTION:
Your treatment is decided on the basis of BDM results in which medication, therapy plus prevention corporately work.
- Medication for osteoporosis: incense of vitamin D and calcium supplements are usually given to people but others are bis-phosphates (alendronate, etidronate), calcitonin (treat postmenopausal osteoporosis) denosumab.
- Hormone replacement therapy (HRT): in this therapy estrogen and progesterone are given in combination form to overcome the osteoporosis process and maintain estrogen and progesterone level in blood. Analysis shows a decrease in fragility fracture rate up to 20-35%. Its side effects are CVS, ovarian cancer in rare cases.
Preventions are lifetime which are good for health and day too:
- Protein intake: Protein is the building block of bone. Vegetables, legumes, low-dairy products, eggs and meat are some sources of protein.
- Weight: underweight and obesity, both are not good for health, as underweight people are more at risk of bone fracture. Healthy weight according to the height is good for height and health too.
- Calcium intake: a normal intake of calcium is 1000 milligram a day, which is increased up to 1200 milligrams when women turn to 50 and men 70 years of age. You may take calcium supplements but not too much because it can cause kidney stones.
- Vitamin D: vitamin D helps the body to absorb calcium and improve bone health. It might get from the sun, as the sunlight is the cheapest source of vitamin D. People with problems like housebound, who live in high altitude and who will have chances to get skin cancer might need vitamin D supplements.
- Exercise: exercise is the best way to overcome the rate of osteoporosis as it makes you strong and healthy. exercise like weight bearing, running, climbing, cycling, swimming and yoga helps to reduce weight, stress and also the risk of falling.
Q. What food items we should avoid to stop osteoporosis?
Food with high salt, soft and hard drinks, coffee, tea are some food items that we should avoid to prevent osteoporosis. Fruits, vegetables, meat, fatty fishes are good sources of food which help to recover osteoporosis.
Q. What professional doctors treat osteoporosis?
Endocrinologist, family practitioner, rheumatologist, gynecologist, geriatricians, and internist are some professional doctors who treat osteoporosis.
Q. Is prevention of osteoporosis possible?
The process of osteoporosis can be slowed but cannot be stopped, by eating a healthy diet with calcium and vitamin D, exercise, by adopting a healthy lifestyle and taking medication on time.
Before you Leave!
Osteoporosis is commonly called a silent disease because it does not give symptoms in early life. You should see a doctor when you feel pain in joints after menopause and steroids. It is important to talk to your doctor about the risk, benefits of medicine and therapy that you are taking.