What is Osteoporosis
How do I know if I have it?
Osteoporosis is a disease of the bone, that occurs when the body is not making enough bone or the body loses too much bone. This results in the bone becoming porous and losing density or mass. Osteopenia is pre-osteoporosis, where the bone is becoming more porous but not weakened enough to be considered osteoporosis. The World Health Organization’s (WHO) criteria for diagnosis of osteoporosis is by Dual energy x-ray absorptiometry (DXA) testing which assesses bone mineral density. The DXA scan gives very precise measurements, of bone density, at high risk fracture sites (leg bones and the spine). DXA scans are able to quantify bone loss and determine if there is osteopenia or osteoporosis.
How does bone loss happen?
- Bone is a living, growing tissue that is mostly made of collagen, a protein that provides the delicate structure for bone, and calcium, a mineral that adds strength to the bone.
- Throughout our lifetime, old bone is removed by the body and new bone is added to the human skeleton. In youth, the new bone is added quicker than removing the old bone, this in turn gives the bones density.
- Once bone mass has peaked in life, around age 30, the removal of bone exceeds the formation of new bone. This can result in porous fragile bones, if bone health is not maintained.
What are possible symptoms?
- Osteoporosis is considered a silent disease because people don’t feel their bones weaken.
- Often the first sign of osteoporosis is breaking a bone or loss of height due to bone loss in the spine.
What are risk factors for developing osteoporosis?
- Women have a greater chance of developing osteoporosis especially during the menopause and postmenopausal years
- Small thin-framed women are at greater risk
- Asian and Caucasian women are at higher risk
- Genetics, including family history of osteoporosis or hip fractures
- Advanced age
- Under weight
- Previous fracture
- Tobacco use
- Excess alcohol intake
- Certain medications increase risk (long term glucocorticoid therapy)
- Breaking a bone
- If osteoporosis affects the bones of the spine it can lead to height loss
- Possible mobility limitations, especially with a past history of a broken bone
What are possible treatments?
- Weight bearing exercise is excellent for your bones, this helps you work against gravity and helps build bone density.
- Examples of weight bearing exercises: walking, jogging, hiking, tennis, dancing and weight training.
- Increasing calcium intake. National Institutes of Health Office of Dietary Supplements (2017) recommend dietary allowances for calcium as follows:
- Females ages 19-50 should consumed 1,000mg/day of calcium and ages 51-70 should consume 1,200mg/day.
- Men ages 19-70 should consume 1,000mg/day of calcium.
- Vitamin D intake is also a necessary part of treating osteoporosis. If the body does not have enough Vitamin D it is unable to absorb calcium and the body takes calcium from the bones to maintain normal levels. Click here for more information on Calcium, Magnesium and Vitamin D.
- If you are at risk for a fracture you may need pharmacologic interventions which should be discussed with your primary care provider.
Where can I get more information?
For additional information, please seek further guidance from your primary care provider and/or specialist.
Drezner, M.K. & Rosen, H.N. (2018). Overview of the management of osteoporosis in postmenopausal women. In C. J. Rosen, K. E. Schmader & J. E. Mulder (Eds.), UptoDate
National Institute of Health Osteoporosis and Related Bone Diseases National Resource Center (2017). Osteoporosis Overview.
National Osteoporosis Foundation (2017). What is Osteoporosis and What Causes It?