What is it?

Progressive bone loss with an increased risk of fractures over a period of time is a disease known as Osteoporosis.  Literally it means "porous bone."  It develops over the course of one's life often unnoticed, until on fractures a bone.  The reason it needs to be taken seriously is because it is a major health problem that affects about 25 million Americans each year.

Fifty percent of women and twenty percent of men over the age of 65 will attain a fracture due to Osteoporosis.  Many of those fractures are from falls, and can be debilitating (see also preventing falls in elderly).  Even tasks such as lifting open an old heavy chest can cause a fracture, if the bones have been weakened enough by the disease.  The most serious osteoporotic fracture is the hip fracture, because it is very debilitating and often forces people to live assisted for the rest of their lives.

Causes

The exact cause of osteoporosis isn't really known to doctors, but there are some factors that are well known and they are as follows:

  • First and foremost is aging; bone is lost in all people with age.  After the age of 35 the body builds less new bone to replace the losses of old bone.  Generally speaking the older you are the lower your total bone mass, thus the greater your risk for osteoporosis.  A lack of estrogen in elderly women can be correlated with loss of bone.

  • Heredity is another cause.  A family history of fractures, small slender bodies, fair skin, and Caucasian or Asian backgrounds can increase the risk.

  • Nutrition and lifestyle can be other causes.  For example, a low Calcium diet can be linked with osteoporosis.  Also lifestyle, for example excessive smoking and drinking can be linked with osteoporosis.

  • Medications and other illnesses can also be reasons.  Some medications which have been linked include steroids.  Thyroid problems can be linked as well.

Diagnosis

The diagnosis of osteoporosis is usually made by your doctor from both a complete medical history and physical examination, skeletal x-rays, and sometimes bone densitometry.  These simple tests are performed to find out bone mass.  Sometimes bone mass can be low due to other things such as Osteomalacia (low vitamin D intake), which can be ruled out by your doctor.

Prevention

At some point everyone in life will develop osteoporosis, but there are some ways to prolong its development, from slowing its progression to protecting oneself from fractures.  First it is extremely important to have an adequate amount of Calcium in one's diet.  During the early years in one's life it is important to take in a lot of calcium so the bones can grow strong and create a supply of reserve calcium.  Throughout life it is important to take in calcium because your body loses calcium every day.  Calcium can't prevent gradual bone loss after menopause in women, but what it does do is maintain bone quality.  Even if you already have osteoporosis, calcium intake is still important because it can decrease your risk for a fracture.  Excellent sources of calcium include the following: dairy products, yogurt, and cheese.  Also lots of milk is very good, as well as green leafy vegetables, such as broccoli, and collard greens.  If you diet doesn't include enough calcium rich foods, talk to your doctor about getting a calcium supplement.

The next real important source to help prevent osteoporosis is Vitamin D intake.  Again if one doesn't have enough Vitamin D in their diet, talk to your doctor about getting a supplement.

Lastly, and certainly not lease, is exercise.  Just as muscles, bones need exercise to stay in good shape and be strong.  Age doesn't really matter, exercise will help minimize bone loss.  It is also believed to be a good means of managing osteoporosis.  The exercises that really help are the weight-bearing exercises, such as walking, jogging, dancing, treadmill exercising, and weight training.  Weight training is good for the elderly - it just has to be done differently.  All of the above are good ways in which to help oneself with the dreaded disease we will all one day face: osteoporosis.

Treatment

Since lose bone cannot be replaced, treatment for osteoporosis is to prevent further loss of bone.  Treatment usually involves the team approach including a physician, orthopedist, gynecologist, and an endocrinologist.  Exercise and nutrition are very important as stated earlier, but they are not the only things that can be helpful.  For women at risk Estrogen replacement therapy (ERT) is often used.  This is used to help with bone loss.  There are other ways such as Calcitonin and Thiazide but both are controversial.  Other medications are available, and you should discuss them with your physician.