Osteoporosis Definition, Reason, Symptoms, Treatment & Prevention

Osteoporosis Definition, Reason, Symptoms, Treatment & Prevention

Understanding

Osteoporosis is a bone disease characterized by a decrease in overall bone density. This occurs due to the body’s inability to regulate the mineral content in the bones and is accompanied by damage to the inside of the bones. Bones become porous and prone to fractures.

It takes quite a long time for the bones to become porous. Generally, new osteoporosis is known after the patient has fallen or been in a situation that fractures the bone.

Common injuries in people with osteoporosis are:

• Fractured wrist
• Hip fracture
• Cracked spine

However, fractures can occur in other bones such as the arms and hips. Sometimes even a light cough or sneeze can cause cracked ribs or cracks in the spine. Osteoporosis itself does not cause pain unless the condition has resulted in fractured bones.

Symptoms

Osteoporosis disease occurs slowly over many years. This condition is generally only known after a person has fractured bones. If you have osteoporosis, your bone density will decrease and you will be more prone to fractures.

Common injuries experienced by people with osteoporosis are bone fractures in the wrists, hips, and spine. In severe cases of osteoporosis, a light cough or sneeze can cause rib or spine fractures.

Osteoporosis is generally not painful unless there is a bone fracture. If you have persistent back pain, this could be a symptom of osteoporosis.

Another symptom of osteoporosis can be seen from a stooped posture in the elderly. This condition is the result of osteoporosis in the spine which makes the spine unable to support the weight of the body.

Reason

Osteoporosis occurs due to decreased bone density. This condition can happen to anyone. However, some are more at risk and experience this condition more quickly than others.

Bone prime period is when humans enter adulthood. In this period the bone mass is very dense and strong. Bone density continues into the late 20s and begins to decline gradually by the age of 35.

Gradually, the bones become more brittle than before. As you get older, bone density decreases too. This causes bones to become weak, porous, and prone to fractures.

Risk Factors for Developing Osteoporosis

Most people with osteoporosis are women. The results of a study in 2006 showed that 23 percent of female respondents aged 50-80 years and 54 percent of female respondents aged 70-80 years had osteoporosis. This research was conducted in Indonesia.

The process of bone formation begins when the embryo is 6-7 weeks old and lasts until adulthood. In the early 20s, bones slowly stop growing. However, bone mass will continue to increase until the peak period in the early 30s. Furthermore, bone mass will decrease starting around the age of 35 years.

Women are more at risk of developing osteoporosis than men, especially if they experience early menopause (before the age of 45 years). Women are prone to decrease bone mass in the first years after menopause (when menstruation stops and the ovaries stop producing eggs).

Causes of Osteoporosis Based on Gender

• In Women

Women are more at risk of developing osteoporosis than men. The cause of osteoporosis is the hormonal changes that occur during menopause which directly affect bone density.

The female hormone estrogen has an important role in bone health. After menopause, estrogen levels decrease. This can cause a drastic decrease in bone density.

Groups of women who have a higher risk of developing osteoporosis include:

1. Early menopause (before age 45)
2. Having a hysterectomy (surgical removal of the uterus) before the age of 45, especially if both ovaries are removed
3. Not having menstrual cycles for more than six months as a result of too much strenuous activity or excessive dieting

• In Men

In many cases, the cause of osteoporosis in men is not known for certain. But this has something to do with the hormone testosterone, which contributes to maintaining bone health. A man’s body continues to produce testosterone into old age, but the risk of osteoporosis remains if testosterone levels are low.

Generally, low testosterone levels are caused by several things, including:

• Use of certain drugs, such as corticosteroids
• Excessive drinking of liquor
• Conditions that cause testosterone levels to be lower than normal (hypogonadism)

Factors Causing Increased Risk of Osteoporosis

The process of bone regeneration is strongly influenced by many hormones. If you have disorders of the hormone-producing glands, then you are more at risk of developing osteoporosis.

Some gland diseases that can trigger osteoporosis:

• Hyperthyroidism (overactive thyroid gland)
• Low levels of the hormones estrogen and testosterone
• Adrenal gland disorders
• Disorders of the pituitary gland

Apart from gland disease, other factors that can increase the risk of developing osteoporosis are:

• Parental history of osteoporosis and hip fractures
• Body Mass Index below or equal to 19
• Using corticosteroid drugs (commonly given for people with arthritis and asthma)
• People with eating disorders such as anorexia or bulimia
• Heavy smoker and often consume liquor
• Rheumatoid arthritis
• Malabsorption, in which the intestine is unable to absorb nutrients to the fullest
• Not active for long periods of time
• Taking drugs to treat breast cancer or prostate cancer which can affect hormone levels

Diagnosis

Osteoporosis is often detected only after a fracture occurs. If you are at risk for osteoporosis, your doctor may recommend a bone mass density (BMD) check with a DEXA (multiple energy X-absorption X-ray) scan.

DEXA Scan: Measures Bone Density

This examination aims to measure bone mineral density. The procedure is short in duration and painless. DEXA results will be compared to the bone density of individuals who are generally healthy, according to your age and gender.

The results of the comparison are seen as the standard deviation (a measure of variability based on the average or expected value), known as the T score.

The comparison results can be seen as follows:

• Above Standard Deviation (SD) (-1) means the norm
• Between SD (-1) and (-2.5) is classified as osteopenia, which is a condition when bone density is lower than average, but not yet as low as osteoporosis bones
• Below SD (-2.5) is categorized as osteoporosis. A DEXA scan can diagnose osteoporosis, but a BMD result isn’t the only factor that determines your risk of fractures. Your doctor will also take into account your age, gender, and previous injuries to determine if you need treatment for osteoporosis.

FRAX: Prediction of Bone Fractures

There are now online programs that can predict the risk of fractures. This program takes into account the risk of someone aged 40-90 years experiencing bone fractures.

The algorithm used can calculate the risk of bone fractures up to 10 years after the examination is carried out. FRAX is the result of the development of studies conducted on populations of Europe, North America, Asia (including Indonesia), and Australia.

You can use FRAX for Indonesia by visiting the page http://www.shef.ac.uk/FRAX/tool.aspx?country=46

Low bone mineral density does not mean you are at high risk for fractures. Consult a doctor about what steps you can take to maintain bone health.

Treatment

Osteoporosis treatment is focused on increasing bone density. In addition, you also have to try not to fall to reduce the risk of bone fractures.
Some important steps are recommended for people with osteoporosis, the elderly, those at risk of osteoporosis:

• Falling is an unavoidable risk as we age. However, there are preventive measures so that bone fractures can be avoided.
• Adopt a healthy lifestyle by exercising regularly and eating a balanced nutritional diet.
• If you have difficulty walking or maintaining balance, see a doctor immediately. This needs to be done so that the factors that cause falls such as quality of vision and decreased muscle strength can be identified immediately.

Various Osteoporosis Treatments

Treatment is usually adjusted for several factors such as age, sex, fracture risk, and previous history of falls. If you are diagnosed with osteoporosis because of a fracture, you will need treatment to minimize the risk of a more severe fracture in the future.

You need to keep your intake of calcium and vitamin D sufficient. The doctor may suggest changes in diet and provide supplements to be consumed so that the needs are met.

There are various choices of drugs that can be consumed to treat osteoporosis, such as:

Calcium and Vitamin D Supplements

Calcium and Vitamin D play an important role in maintaining bone health. Make sure you get your daily calcium intake with the following calculations:

• 1000 mg per day for ages 19-50 years
• 1200 mg per day for over 50 years of age

As for Vitamin D intake, which the body needs to help absorb calcium, the guidelines are:

• 200 IU per day for ages 19-50 years
• 400 IU per day for ages 50-65 years
• 600 IU per day for over 65 years of age

If you are not getting enough calcium and Vitamin D in your diet, talk to your doctor about taking supplements.

Bisphosphonate

This is a drug that can maintain bone density thereby reducing the risk of bone fractures. Given in the form of tablets or injections. Several types of bisphosphonates that are commonly given by doctors to osteoporosis sufferers include alendronate, ibandronate, dan zoledronic acid.

Make sure you take bisphosphonates as directed by your doctor. Esophageal irritation, difficulty swallowing, and stomach pain are side effects that may arise as a result of taking this drug.

Strontium ranelate

This drug triggers new bone-forming cells (osteoblasts) and suppresses the performance of bone-decaying cells. Usually given as an alternative to bisphosphonates if it is not suitable for sufferers. This drug is consumed in powder form which must be dissolved in water. Side effects of this drug are nausea and diarrhea.