Osteoporosis Causes Treatment

Osteoporosis is a condition in which bones are porous and weak.  

Osteoporosis is a chronic and serious disease,   recurrent fractures, symptoms, causes, treatment. Designed by Nazihpharmacy.

In this article

1. Signs and symptoms
2. Treatment
3. Causes and risk factors 
4. Obesity and osteoporosis
5. Medicines and diseases that increase osteoporosis
6. Prevention
7. Diagnosis 
8. Complications
9. Frequently asked questions
10. Summary

The body absorbs more bone tissue content and produces less to replace it, leading to lower bone density.  

Bones become weak in people with osteoporosis, increasing the risk of fractures. People do not realize they have osteoporosis until they suffer a fracture.  

The bones in the body most susceptible to fractures include: 

• The hips

• Wrists 

• Vertebrae of the spine

• Peripheral joints

Osteoporosis is still often viewed as a “female” disease.  

But according to the International Osteoporosis Foundation (IOF), estimates around the world indicate that (1) in (5) men over the age of 50 will suffer a fracture due to osteoporosis, and the number of hip fractures in men is expected to rise until 2050.

Let us delve deeper into osteoporosis.

Signs and symptoms

Osteoporosis does not usually(1) cause unless a person has a fracture. There are no early warning signs as with some other conditions.

Osteoporosis grows slowly, and even coughing or sneezing can cause a fracture in bones with severe osteoporosis.  

The bones in the body most susceptible to fractures as a result of weak bones are the hip, wrist, or spine.  

If a fracture occurs in the vertebrae of the spine, it may lead to changes in the position and curvature of the spine. People may also notice a shortness in height. 

Symptoms of osteoporosis include the following:

• Back pain due to broken or worn bones in the spine

• Shortening of stature over time

• Body curvature

• Bone fractures are easier than expected

Delayed menstruation and irregular menstruation in young women may lead to physical symptoms and an indicator of osteoporosis.

As irregular menstruation in young women can be a warning symptom of a deficiency in hormonal reserve, which may in turn lead to osteoporosis.

When should we visit the doctor?  

Severe pain and discomfort at any of the common sites of bone damage resulting from osteoporosis indicates an unexpected fracture and is visible on radiography.  

In this case, you must consult a health care provider or specialist doctor to take the necessary measures and appropriate treatment.

Your doctor can order a bone mineral density (BMD) test to evaluate your bone health.  

A T score of -2.5 or less indicates osteoporosis.  People with T scores between -1.0 and -2.5 have low bone mass or osteopenia and may need treatment depending on other risk factors.

Osteoporosis treatment 

Treatment aims to: 

• Prevent fractures

• Reduce pain

• Maintaining healthy bone mass  

• Prevent the development of osteoporosis

• Supporting people in their daily lives

Managing osteoporosis requires the use of preventive lifestyle measures, nutritional supplements, and certain medications.

Drug therapy

Medications that help prevent(2) and treat osteoporosis include: 

Antiestrogens

Doctors also call these selective estrogen receptor modulators (SERMS), raloxifene being one example. This may reduce the risk of spinal fractures, especially in women, as the incidence of osteoporosis increases after menopause.

Bisphosphonates

These drugs slow down and prevent the resorption of bone tissue, thus reducing the risk of fractures.  

Calcitonin (Miacalcic, Calcimar, Miacalcin)

Commonly used as an intramuscular injection, it helps manage osteoporosis in people by preventing spinal fractures and can help manage pain after a fracture.  

Monoclonal antibodies (denosumab, romosozumab)

These treatments are called immunotherapies and are used by some people with postmenopausal osteoporosis. 

Some of these medications may have potential side effects, such as medication (Romosuzumab). Other types of estrogen and hormone therapy may also help.  

Thyroid hormone 

Such as teriparatide, known by the name (Forteo). The Food and Drug Administration (FDA) has approved this hormone to treat people who have a high risk of fractures because it stimulates the formation of bone tissue.

Calcium and Vitamin D

Calcium and Vitamin D are used as adjuncts in the treatment of osteoporosis. 

For postmenopausal women at risk for fractures and who cannot tolerate bisphosphonates, estrogens, selective estrogen response modifiers, denosumab, tibolone, teriparatide, and abaloparatide, we recommend taking supplements.  

Calcium and vitamin D daily to prevent hip fractures.

Osteoporosis, in the elderly, especially women over the age of 50, leads to frequent fractures, pain and curvature of the spine.designed by Nazihpharmacy

The future of osteoporosis treatment

Recently, an increasing number of studies(3) have indicated that the gut microbiota of , with osteoporosis is somewhat different from that of healthy individuals.  

The severity of bone loss is also associated with changes in the gut microbiota, which also suggests that the gut microbiota could be a potential target for the prevention and treatment of osteoporosis.  

At the same time, studies have shown factors affecting the gut microbiome include: 

• The effect of probiotics and prebiotics

• The role of exercise 

• The role of glucocorticoids  

These agents influence the gut microbiome to prevent and treat osteoporosis. 

Causes and risk factors

The body’s natural mechanism of action and its development into osteoporosis: 

• The body constantly absorbs old bone tissue

• The body generates new bone to maintain bone density, strength, and structural integrity

• Bone density peaks when a person is in their late 20s 

• Potassium deficiency

• It starts to weaken at about age 35

• Bones break down faster than they rebuild from the age of 50

• Osteoporosis may develop if this breakdown occurs excessively  

It affects both males and females, but is more likely to occur in postmenopausal females due to the sudden decrease in estrogen, which protects against osteoporosis. 

Risk factors: 

There are many risk factors. According to the American College of Rheumatology, risk factors include the following: 

• Age: The risk increases after the mid-thirties, especially for women after menopause and low estrogen secretion

• Race: White and Asian people face a higher risk than other ethnic groups

• Low sex hormones: Low estrogen levels seem to make it difficult for bones to regenerate

• Height and Weight: If you are taller than 5 feet 70 inches or overweight you are at risk

• History of fractures: A person over the age of 50 who has had previous fractures after a low-level injury is likely to receive a diagnosis of osteoporosis

• Genetic factors: Having a close family member with a hip fracture or osteoporosis increases the likelihood of developing osteoporosis

What is the relationship between obesity and increased risk of osteoporosis?  

Recent studies have shown a clear relationship between obesity and an increased risk of osteoporosis and recommend losing weight.  

The relationship between obesity and osteoporosis is through the following:

• Adipose tissue, in which body fat accumulates, secretes inflammatory cytokines that impair the bone building process

• Adipose tissue also secretes the hormone leptin, which may have a negative effect on the bone building process

• Fatty acids cause reabsorption of minerals from the bone, which increases the risk of osteoporosis

• Stored fat also causes an increase in insulin resistance, which has a negative impact on the bone building process

• If fat accumulates in the bones over time, this fat increases osteoclasts and decreases osteoblasts

• The extra load on fragile bones caused by excess weight can increase the likelihood of fractures

Avoiding excess weight is an important issue for people with osteoporosis. 

But it must be done carefully without reaching the stage of obsessive-compulsive disorder and eating disorders that may lead to adverse results.

Medicines and diseases that increase osteoporosis

Doing weight-bearing exercises helps prevent osteoporosis. It applies controlled pressure to the bone, which supports bone growth.

Medications and health conditions: 

• Medications cause changes in hormone levels, and some medications reduce bone density

• Some diseases cause changes in hormone levels, including some autoimmune diseases, hyperthyroidism, hyperparathyroidism, and others

Research conducted in 2015(4) suggests that transgender men are not at risk of developing osteoporosis.  

It appears that transgender women who receive hormone therapy (HT) may have an increased risk of osteoporosis.  

However, use of antiandrogens for a year before starting HT may reduce the risk.  

Diseases that increase the risk of osteoporosis include: 

• Inflammatory autoimmune diseases, such as rheumatoid arthritis and ankylosing spondylitis. Pituitary gland disorders.  

• High cholesterol in the blood leads to the death of cartilage cells, arthritis, osteoporosis, and thus easy fracture

• Cancer or bone tumors may stimulate the production of osteoclasts that cause osteoporosis

• Cushing's syndrome, an adrenal gland disorder. Hyperthyroidism and hyperparathyroidism

• People with diabetes are more likely to develop bone disease, as over time diabetes can affect the muscles and skeleton, leading to joint pain and nerve damage 

• Magnesium deficiency

• Some digestive diseases, such as celiac disease 

• Estrogen or testosterone deficiency

Medications that increase the risk include: 

•  Thyroid hormone (Thyroxine and triiodothyronine)

• Glucocorticoids and corticosteroids as prednisone and prednisolone 

• Anticoagulants and blood thinners such as heparin, warfarin, and clopidogrel

• Antidepressant medications as fluoxetine and paroxetine

• Medicines containing vitamin A as retinoids,  To treat skin cancer

• Proton-pump inhibitors (PPIs) as lansoprazol, omeprazol and some other antacids

• Thiazide diuretics as (Chlorothiazide,  Indapamide, Hydrochlorothiazide)

• Some diabetes medications, such as thiazolidinediones, reduce bone density 

• Sex hormone inhibitors, such as anastrozole

• Some immunosuppressive drugs, such as cyclosporine

• Hormone-suppressing medications, including letrozole, which is used to treat breast cancer by blocking estrogen, and leuprorelin (Lupron), which treats prostate cancer by blocking testosterone 

One important note about medication-induced osteoporosis is that glucocorticoid-induced osteoporosis is the most common type that develops due to medication use.

Prevention

Prevention of osteoporosis that helps reduce the risk of infection includes the following: 

• Changing the diet pattern

• Change your daily routine

Some lifestyle modifications can help reduce the risk of osteoporosis.  

Take calcium and vitamin D daily

Eating an appropriate amount of calcium and vitamin D helps build bones and compensate for the deficiency.  

The recommended amount of calcium for ages over 19 years is 1000 mg per day(5).  

Females over 51 years old and all adults over 71 years old need to take 1200 mg daily.  

Food sources rich in calcium and vitamin D include: 

• Leafy vegetables such as spinach, kale, lettuce, and broccoli

• Dairy products such as milk and cheese

• Fish such as salmon and tuna 

• Almonds rich in calcium

• Fortified breakfast cereals

Vitamin D helps absorb calcium. It is an important nutrient, and there are many foods rich in vitamin D.  

Most of our vitamin D comes from the sun, so it is recommended to be exposed to the sun daily in moderation.  

Supplements may be taken if calcium intake from food is insufficient.  

Osteoporosis occurs when vitamin D and calcium are deficient. It is recommended to follow a healthy diet and change the lifestyle towards practicing sports activities.designed by Nazihpharmacy

Diet

A healthy diet helps strengthen bones and muscles and improve the mood of people with osteoporosis, include:  

• Eating foods rich in Omega-3, which have many benefits that help reduce the risk of osteoporosis

• Eating anti-inflammatory foods protects the body from diseases and supports the immunity of those with osteoporosis, such as okra

• Eating grains such as oats, sesame, flax, and other vegetable oils, supports bone health and weight loss

• Eating fruits such as avocado, blueberry, orange, and lemon, which contain vitamin C

Changing the daily lifestyle

Changing the daily routine can help reduce the risk of osteoporosis. This change includes the following: 

• Not consuming excessive energy drinks because they contain high amounts of caffeine and other substances, for the health of the bones and the nervous system

• Limit smoking, as this can reduce bone growth and reduce estrogen levels in females

• Practicing physical activities, such as lifting weights, walking, and carrying weights, to support bone and muscle strength and balance, but in moderation

• Avoid drinking alcohol to maintain bone health

• Having sex with your partner properly after menopause increases estrogen levels, i.e. reduces the risk of osteoporosis

Proper osteoporosis management through nutrition, exercise, and fall prevention plays a major role in reducing the risk of fractures and loss of bone mass.  

Fall prevention tips

• Conduct periodic vision checks to avoid double vision

• Removing tripping hazards from the front area of ​​the injured person 

• Use grab bars at home to facilitate the movement of the joints without stumbling

• Do exercises that help with bone strength and balance

• Use strong home lighting

• Visit your doctor periodically to take the appropriate medication and avoid medications that increase the risk of osteoporosis

It is recommended(6) to conduct periodic bone density tests for all adults, especially women who have been exposed to fractures and who are over 60 years old.

Diagnosis of osteoporosis

Before starting a bone mineral density examination, the doctor asks(7) about:

• Previous fractures

• Your lifestyle habits

• Alcohol abuse

• Smoking history

• Medical conditions and current medications

• Your family history of osteoporosis

• For women, menstrual history

Bone density is checked by X-ray and is known as dual-energy X-ray absorptiometry (DEXA)(8).

Osteoporosis is a chronic and serious disease that causes fractures as a result of weak bone density. Image by pixapay, edited by Nazihoharmacy

The measurement is done with two types of devices: 

• Peripheral device: This is a mobile device that tests the bones in the wrist, heel, or finger

• Central device: The examination takes place in the hospital and measures the bone mineral density of the hip and spine 

DEXA test results

The test results are in the form of a DEXA T score:

• -1.0 or higher indicates bone strength

• -1.0 to -2.5 indicates osteopenia

• -2.5 or less indicates osteoporosis

The doctor repeats the test every two years because this allows him to compare the results and determine the extent of the condition’s development or response to medications. 

Ultrasound imaging

Imaging of the heel bone, ultrasound(9) can be performed in a primary care setting. 

Doctors use it to evaluate osteoporosis. It is less common than DEXA. 

Complications of osteoporosis

Complications of osteoporosis include: 

• Bones become weaker

• Cardiovascular disease 

• Kidney stones

• Repeated fractures

• They take longer to heal as you age

• Constant pain

• Collapse of the spine and hip bones  

• You may need artificial joints 

The solution to these complications is to see a doctor periodically to manage osteoporosis well and prevent the risk of fractures. 

Frequently asked questions

Some common questions about osteoporosis and methods of prevention.  

What is osteoporosis?  

Osteoporosis is a serious, chronic bone disease that occurs when bone mineral density and bone mass decrease, or when bone quality or structure changes.

How can you fix osteoporosis?  

Treating osteoporosis helps slow or prevent the progression of the condition with medications such as bisphosphonates, estrogen agonists, calcitonin, parathyroid hormone, and taking calcium and vitamin D.  

What is the main cause of osteoporosis?  

The main cause of osteoporosis is a decrease in bone mass and changes in the level of the elements that make up a person's bones. 

This occurs with age, especially in women after menopause and also in men after the age of 70.

Summary

Osteoporosis is a chronic and serious disease. Anyone can reverse bone loss resulting from osteoporosis by using some medications and changing lifestyle to suit the condition. 

Such as diet and practicing some physical activities help avoid serious complications and continue life.