Unveiling Osteoporosis – Navigating Treatment and Prevention Strategies

Osteoporosis is like a hidden foe, silently chipping away at our bones’ strength and density, often without us even realizing it. This sneaky bone disease creeps up when our bones lose their mineral density and mass or their strength and structure change. The result? Our bones become more fragile, making us more prone to fractures and casting a shadow over our lives. It’s widespread among older folks, especially women after menopause and older men. Osteoporosis is a significant reason bones highlight the importance of taking action early to prevent and manage it.

What is osteoporosis?

Osteoporosis is a bone illness where bones weaken due to a loss of density, mass, or changes in their structure. This makes bones more fragile and prone to fractures. Osteoporosis-related fractures often occur in the hip, wrist, or spine bones.

What are the symptoms of osteoporosis?

The early stage of bone loss typically has no symptoms. But later, when your bones are affected by osteoporosis, they may show sure signs and symptoms such as:

1. Bones become very brittle and prone to breaking easily.
2. Collapsed spine bones can cause back pain.
3. Bone loss results in a gradual reduction in height over time.
4. I am developing a stooped posture.

Who is at risk of osteoporosis?

Calcium is vital for building new bone tissue; insufficient calcium intake poses a significant risk. Consume enough high-calcium foods and ensure adequate vitamin D intake, which helps in Ca absorption. Your bones may become fragile and prone to fractures if:

• You don’t consume sufficient foods rich in calcium and vitamin D.
• Your body struggles to absorb calcium, such as after gastric bypass surgery.

Other causes of bone loss include:

• Decreased estrogen in women during menopause and reduced testosterone in aging men.
• Prolonged bed rest due to illness, particularly affecting children’s bones.
• Certain medical conditions that increase inflammation in the body.
• Use of specific medications like certain seizure medications, hormone therapies, cancer, and prolonged use of steroid medications.

Other risk factors encompass:

1. Extended absence of menstrual periods.
2. Family history of osteoporosis.
3. Excessive alcohol consumption.
4. Low body weight.
5. Smoking.
6. Eating disorders like anorexia nervosa.

What are the treatment options available for osteoporosis?

There are two main approaches: non-pharmacological and pharmacological.

1. Non-pharmacological management focuses on lifestyle changes and dietary adjustments:

1. Nutrition: This involves dietary changes to reduce risk factors. It’s essential to ensure adequate calcium and vitamin D intake through food or supplements.
2. Calcium: Many postmenopausal women don’t get enough calcium in their diet; hence, supplements may be necessary. These supplements should contain around 500 mg of elemental calcium for optimal absorption. However, they can cause side effects like constipation, and it’s essential to take them separately from certain medications.
3. Vitamin D: Adults over 50 should aim for 800 IU of vitamin D daily. Maintaining a specific vitamin D level in the blood is crucial for bone health.
4. Protein: A sufficient dietary protein intake is recommended, around 1g/kg/day.
5. Exercise: Regular weight-bearing and muscle-strengthening exercises can improve strength, balance, and overall health, reducing the risk of falls and fractures.
6. Smoking and Alcohol: Smoking & excessive alcohol are harmful to bone health and should be avoided.
7. Falls Prevention: For those at high risk of falling, implementing strategies to prevent falls is crucial. This may involve referral to specialized programs or physical therapy.

2. Pharmacological interventions involve medications:

1. Anti-resorptive agents: These medications prevent bone breakdown. Options include hormone replacement therapy (HRT), bisphosphonates, selective estrogen receptor modulators (SERMs), and Denosumab.
2. Anabolic agents: These medications stimulate new bone formation. Examples include Strontium and Teriparatide (such as Forteo Injection).

These treatments are recommended for postmenopausal women who have already experienced fractures, have low bone density, or have a high risk of fractures based on specific criteria.

How can you prevent osteoporosis? 

As we age, especially for women, bone density reduces, which puts them at risk of osteoporosis. Here are three simple proactive steps that may help you present osteoporosis;

• Make sure you get plenty of Ca and vitamin D through a healthy diet. 
• Avoid drinking too much alcohol and smoking
• Staying active with regular exercise. 

When to call Your Doctor?

If you think you broke your hip or have a sudden feeling of numbness in your arms or legs with severe back pain, get help right away. Call your doctor if you have bone or muscle pain, especially in your back, making it hard to do daily things.

To see a doctor, start by making an appointment with your regular doctor. They might refer you to other specialists, such as a bone doctor (rheumatologist), hormone expert (endocrinologist), physical therapist, food expert (dietitian), or bone surgeon (orthopedic surgeon). They will help determine how severe your osteoporosis is and how to manage it. Remember, early action is the key to managing your osteoporosis effectively.