A Honeycomb of Bones: Understanding Osteoporosis

Osteoporosis is a disease that prevents bone tissue from regenerating and as a result, the bones become very brittle and break easily. For people with osteoporosis, something as simple as a cough or sneeze could cause a bone to break.

Approximately 54 million Americans have osteoporosis and low bone mass, which is called osteopenia. It’s estimated that osteoporosis causes two million broken bones every year, and results in $19 billion in healthcare costs. It’s important to know how to prevent the disease before it results in falls, broken bones and potentially lengthy recovery periods.

When a person with osteoporosis falls and breaks a bone, it most commonly breaks the hip, spine, or wrist. This can result in extended hospital stays, a lengthy recovery time, and possibly inpatient rehabilitation; all of which can have long term implications for seniors. It can make it difficult for them to fully return to activities of daily living, contribute to repeated falls, and lead to depression, isolation and loneliness. Prevention of osteoporosis is very important, as is early detection and effective treatment.

Osteoporosis can develop without any symptoms, aches, or pains and consequently is called a “silent disease”. It makes detection challenging. Usually the first indication of osteoporosis is a broken bone that occured much too easily. Other signs of the disease can include:

• Losing height and getting shorter over time
• A noticeably humped back and/or a stooped posture
• Back pain that is caused by a spine fracture or collapse of one of the vertebra in the spine

If you or a loved one notice any of these symptoms it’s important to check with a doctor as soon as possible.

There are many risk factors for osteoporosis

Some, like lifestyle habits, can be controlled to reduce risk for the disease, while other risks cannot be changed or reduced. These risk factors include:

• Gender
• Age
• Race
• Family history
• Small body frame

Health conditions that increase the risk of osteoporosis include:

• Celiac disease
• Smoking
• Inflammatory bowel disease
• Kidney or liver disease
• Cancer
• Lupus
• Multiple myeloma
• Rheumatoid arthritis
• Hormone levels including:
  • Low estrogen levels in women and low testosterone levels in men
  • High levels of thyroid hormones
  • Overactive parathyroid and adrenal glands

Other risk factors include smoking, drinking alcohol excessively, eating too little calcium and not getting enough Vitamin D.

Diagnosing osteoporosis

Those who are at increased risk of osteoporosis should have bone mineral density(BMD) testing regularly. The National Osteoporosis Foundation and the American Medical Association recommend a very specific test called dual-energy X-ray absorptiometry scan (DXA, formerly known as DEXA). The test measures BMD and can predict the future risk of bone fracture just like increased blood pressure may predict the future risk of stroke.

Treatments for osteoporosis

The most common treatments for osteoporosis are medications designed to increase bone strength. Many of them have side effects, so discuss these drugs carefully with you doctor before taking them. They include:

• Alendronate (Fosamax)
• Risedronate (Actonel, Atelvia)
• Ibandronate (Boniva)
• Zoledronic acid (Reclast)

You can take action to treat your osteoporosis by controlling risk factors through diet and exercise. Here are some of the things you can do to keep your bones as strong as possible:

1. Eat healthy amounts of calcium: consistently eating too little calcium can contribute to osteoporosis. It can also lead to low bone density and early bone loss. The U.S. Department of Agriculture (USDA) recommends 1,300 mg of calcium each day, which equals about three cups of food from the dairy group daily. That could include yogurt, milk, cheddar or mozzarella cheese, calcium fortified orange juice and other calcium-rich foods. If you are lactose intolerant and have difficulty eating dairy, talk to your doctor about calcium supplements and/or eat more of these calcium-rich foods:
   1. Dark green leafy vegetables
   2. Canned salmon or sardines with bones
   3. Soy products, such as tofu
   4. Calcium-fortified cereals
2. Get enough vitamin D:This important vitamin improves the body’s ability to digest calcium and absorb it into the bones. It is possible to get vitamin D from sunlight, but those living in northern climes may have to take supplements. Although there is no scientifically-based minimum dose of daily vitamin D, it recommended that adults get at least 600 to 800 international units (IU) each day.
3. Exercise: Weight-bearing exercise and activities that require balance and good posture help to build bones. The less exercise you get and the more time you spend sitting, the higher your risk of osteoporosis.
4. Limit alcohol consumption: Drink less than two alcoholic drinks per day. Anything more increases your risk of osteoporosis.
5. Don’t smoke. Don’t start smoking. If you do smoke, stop. Smoking is  a contributing factor to weak bones.
6. Eat enough protein: Scientists aren’t exactly sure what “enough protein” means for each adult, but they do know protein is very important to the building of bone tissue. Talk to your doctor about the appropriate types and amounts of protein for you.

Osteoporosis can have serious implications for those who suffer from it. Regular check-ups with your doctor will provide the opportunity to discuss your risk and if a bone scan in warranted to detect the disease before it results in broken bones.

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Sources:

• https://commons.wikimedia.org/wiki/File:Osteoporosis_in_Bones.jpg