Osteoporosis
Osteoporosis is a generalized, progressive loss of bone density causing skeletal weakness.
How Common Is It?
What Causes It?
What Are the Risk Factors?
What Are the Symptoms?
Health Consquences
Terms You Should Know
How Is It Diagnosed?
Best Treatment Options
Can It Be Prevented?
What Should You Do Next?
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How Common Is Osteoporosis?
- An estimated 41% of white women over age 50 have lost bone mass.
- When bone density is measured at the hip, spine, and wrist, 15% of white women aged 50-59 and 70% of white women older than 80 have osteoporosis in at least one of those places.
- The prevalence of osteoporosis in Mexican-American women is similar to the prevalence in white women.
- While rates of osteoporosis in African American women are approximately one-half those of the other groups, they are still substantial (8% among women older than 50).
- Including all races, an estimated 14 million women over age 50 have osteopenia (reduced bone mass), and over 5 million have osteoporosis (brittle bones).
- 16% of postmenopausal women have osteoporosis of the low back.
What Causes Osteoporosis?
- Osteoporosis occurs when there is poor bone mass development in adolescence and accelerated bone loss later in life.
- Reduced bone mass results from the factors listed below under Risk Factors for Osteoporosis.
- Primary osteoporosis. Loss of bone mass that is not due to any other chronic illness. It is typically due to advancing age, decreased estrogen levels, poor calcium intake, sedentary lifestyle, and tobacco or alcohol use.
- Secondary osteoporosis. Loss of bone resulting from a chronic health condition such as hyperthyroidism, hyperparathyroidism, cancer, gastrointestinal diseases, medications, and kidney problems.
What Are the Risk Factors for Osteoporosis?
- Aging
- Female gender
- Small body frame
- Low body weight
- White, Asian, or Mexican American ancestry
- Family history of osteoporosis
- Sedentary lifestyle (low activity level/non-exerciser)
- Prolonged bed rest, immobilization and/or physical disability
- Caffeine intake vSoda/cola/pop intake
- High red meat consumption
- Low intake of calcium, phosphorus, magnesium, and vitamin D due to poor diet
- Excessive alcohol intake
- Cigarette smoking
- Low sunlight exposure which leads to low levels of Vitamin D, a hormone necessary for the body to manage calcium
- Post-menopausal status (due to lower estrogen levels)
- Nulliparity (never having had children)
- Drugs (corticosteroids, thyroid hormone, dilantin, barbiturates, heparin, tetracycline, anticonvulsants, or aluminum containing antacids) may contribute to osteoporosis.
- History of menstrual problems: late onset menses, infrequent menses, history of amenorrhea (periods of time without a menstrual cycle), and anovulation (menstrual cycles where release of an egg does not occur)
- Acid/base imbalance in body
- History of anorexia nervosa
- History of stress fractures
- History of digestive problems which impair absorption of calcium and other nutrients (i.e. gall bladder disease, primary biliary cirrhosis, malabsorption, low stomach acid, and lactose intolerance)
- Endocrine disease. Imbalances of various hormones (glucocorticoids, parathyroid hormone, androgens, prolactin, and insulin) all may lead to secondary osteoporosis.
- Kidney disease
- Surgery: thyroidectomy, removal of all or part of intestines
- Excess Vitamin A
What Are the Symptoms of Osteoporosis?
- There may be no osteoporosis symptoms until a bone fracture occurs.
- Loss of height
- Bone weakness or increased fractures
- Severe back pain
- Kyphosis (very slumped posture)
Health Consequences of Osteoporosis
- Osteoporosis can have severe health consequences, including death and disability.
- Osteoporosis may not display symptoms until it is too late, so it's essential for people who have osteoporosis risk factors to have screening tests performed.
- Health consequences of osteoporosis include:
- Hip fractures. More than 90% of hip fractures are associated with osteoporosis.
- Nine out of ten hip fractures in older Americans are the result of a fall.
- Individuals who have a hip fracture are 5-20% more likely to die in the first year following that injury than others in this age group.
- For those living independently before a hip fracture, 15-25% will still be in long-term care institutions a year after their fracture.
- 50% who experience hip fractures have long-term loss of mobility.
Osteoporosis Terms
- Osteoporosis. The World Health Organization (WHO) defines osteoporosis as a Bone Mineral Density (BMD) T score of more than 2.5.
- Osteopenia refers to decreased bone density. WHO defines it as a BMD T score between 1 and 2.5.
- DEXA. DEXA stands for dual-energy x-ray absorptiometry. This is the most common screening test for osteoporosis. It is often called a bone density test.
- T-Score. The T score (taken by DEXA) refers to how a person’s bone density compares to the bone density of a young healthy adult of the same gender.
- Osteoclast. Osteoclasts are cells within human bone that work to break down bone.
- Osteoblast. Osteoblasts are cells within human bone that work to build up bone.
- Calcium balance. Your body works very hard to keep the levels of calcium in the blood within a certain range. It does this by increasing calcium absorption from the food you eat, decreasing calcium excretion (loss) from the kidneys, and by constantly moving calcium into and out of your bones. The osteoclast and osteoblast cells are constantly at work breaking down and building up bone in order to keep blood calcium levels steady.
How Is Osteoporosis Diagnosed?
- Personal and family health history
- Detailed evaluation of risk factors for osteoporosis.
- Physical examination
- DEXA scan or quantitative CT scan
- Laboratory tests
- Your doctor may perform some of the following tests depending on the suspected cause of osteoporosis
- Complete blood count to screen for anemia
- Iron levels in blood or iron stores (ferritin)
- Serum calcium
- Serum phosphorus
- Kidney function tests
- Liver function tests
- Thyroid hormone levels
- Parathyroid hormone levels
- Serum vitamin D levels
- Cortisol levels
- DHEA-S
- Serum protein electrophoresis
- N-telopeptide
- Erythrocyte sedimentation rate (ESR)
- Estrogen or progesterone levels in women
- FSH (follicle stimulating hormone) and LH (luteinizing hormone) levels in women
- Testosterone levels in men
- Laboratory tests to rule out secondary causes of osteoporosis.
What Is the Best Treatment for Osteoporosis?
Conventional Treatment for Osteoporosis
Natural Treatment for Osteoporosis
Can Osteoporosis Be Prevented?
Reducing the modifiable risk factors listed above will go a long way in the prevention of osteoporosis, particularly osteoporosis which is caused by lifestyle practices. In particular, keeping up lifetime physical activity and incorporating the dietary recommendations listed above will promote building healthy bone.
What Should You Do Next?
The doctors at The Connecticut Center for Health are quite experienced in how to halt osteoporosis.
If you would like to learn more about natural medicine approaches to osteoporosis, contact one of our clinics for a free consultation about osteoporosis or an appointment.
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