osteoporosis

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Overview

Osteoporosis -related to various factors including menopause and aging- is the most common chronic metabolic bone disease, which is characterized by increased bone fragility. Although it is seen in all age groups, gender, and races, it is more common in Caucasians (white race), older people, and women. With an aging population and longer life span, osteoporosis is increasingly becoming a global epidemic. Currently, it has been estimated that more than 200 million people are suffering from osteoporosis. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime. Every fracture is a sign of another impending one. Osteoporosis has no clinical manifestations until there is a fracture. Fractures cause important morbidity; in men, in particular, they can cause mortality. Moreover, osteoporosis results in a decreased quality of life, increased disability-adjusted life span, and big financial burden to health insurance systems of countries that are responsible for the care of such patients. With an early diagnosis of this disease before fractures occur and by assessing the bone mineral density and with early treatment, osteoporosis can be prevented. Therefore, increasing awareness among doctors, which, in turn, facilitates increase awareness of the normal populace, will be effective in preventing this epidemic.

Symptoms

Back pain, caused by a fractured or collapsed vertebra.

Loss of height over time.

A stooped posture.

A bone that breaks much more easily than expected.

Causes

Researchers understand how osteoporosis develops even without knowing the exact cause of why it develops. Your bones are made of living, growing tissue. The inside of healthy bone looks like a sponge. This area is called trabecular bone. An outer shell of dense bone wraps around the spongy bone. This hard shell is called cortical bone.

When osteoporosis occurs, the "holes" in the "sponge" grow larger and more numerous, which weakens the inside of the bone. Bones support the body and protect vital organs. Bones also store calcium and other minerals. When the body needs calcium, it breaks down and rebuilds bone. This process, called bone remodeling, supplies the body with needed calcium while keeping the bones strong.

Up until about age 30, you normally build more bone than you lose. After age 35, bone breakdown occurs faster than bone buildup, which causes a gradual loss of bone mass. If you have osteoporosis, you lose bone mass at a greater rate. After menopause, the rate of bone breakdown occurs even more quickly.

Risk factors

Both men and women can develop osteoporosis, but this condition is more common in women because it’s often caused by hormonal shifts that occur with aging.

Common risk factors for osteoporosis include:

older age

going through menopause before age 45

having ovaries removed before age 45

having low testosterone in men

having low estrogen in women

taking certain medications that decrease hormone levels

smoking cigarettes

having a family history of osteoporosis

drinking alcohol frequently

not getting enough regular physical activity, particularly weight-bearing exercise like walking

According to researchTrusted Source, osteoporosis is more prevalent in white people and people of Asian descent, more specifically women.

Certain medical conditions may also increase your risk for osteoporosis. These include:

kidney failure

vitamin D deficiency

diabetes

hyperthyroidism

hyperparathyroidism

rheumatoid arthritis

dementia

history of breast cancer

cystic fibrosis

sickle cell disease

malabsorption due to inflammatory bowel disease or celiac disease

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Complications

Osteoporosis can increase the risk for bone fractures, particularly fractures of the wrist, spine, or hip.

According to the International Osteoporosis Foundation, globally 1 in 3 women and 1 in 5 men, over age 50, will experience osteoporosis fractures.

The effects of spinal fractures can cause a person to become shorter because these fractures can shorten the spinal column. In some instances, bone fractures may require surgery.

According to researchTrusted Source, bone fractures can increase your risk of disability or death. Hip fractures, in particular, are associated with a 15 to 20 percent increase in mortality within a year, especially among men.

Prevention

Your diet and lifestyle are two important risk factors you can control to prevent osteoporosis. Replacing lost estrogen with hormone therapy also provides a strong defense against osteoporosis in postmenopausal women.

Diet

To maintain strong, healthy bones, you need a diet rich in calcium throughout your life. One cup of skim or 1 percent fat milk contains 300 milligrams of calcium.

Besides dairy products, other good sources of calcium are salmon with bones, sardines, kale, broccoli, calcium-fortified juices and breads, dried figs, and calcium supplements. It is best to try to get the calcium from food and drink.

For those who need supplements, remember that the body can only absorb 500 mg of calcium at a time. You should take your calcium supplements in divided doses, since anything more than 500 mg will not be absorbed.

Recommended daily allowance of calcium

Age and sex Amount

Adults, 19-50 years 1,000 mg

Adult men, 51-70 years 1,000 mg

Adult women, 51-70 years 1,200 mg

Adults, 71 years old and older 1,200 mg

Pregnant and breastfeeding teens 1,300 mg

Pregnant and breastfeeding adults 1,000 mg

Vitamin D is also important because it enables the body to absorb calcium. The recommended daily allowances of vitamin D are listed below. Vitamin D can also be obtained from sunlight exposure a few times a week or by drinking fortified milk.

Recommended daily allowance of Vitamin D

People by age Amount

Infants 0-6 Months 400 IU

Infants 6-12 months 400 IU

1-3 years old 600 IU

4-8 years old 600 IU

9-70 years old 800 IU

Over 70 years old 800 IU

14-50 years old, pregnant/lactating 600 IU

Talk with your healthcare provider about these numbers. In some cases, you might be told to take more vitamin D. Your provider might also have suggestions about the calcium type; for instance, you might be told to take calcium citrate instead of calcium carbonate. Calcium citrate does not need acid to work, so it may be a better choice for people who take antacids.