Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.
Bone is living tissue, which is constantly being absorbed and replaced. Osteoporosis occurs when the creation of new bone doesn't keep up with the removal of old bone.
Osteoporosis affects men and women of all races. But white and Asian women — especially those who are past menopause — are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.
There typically are no symptoms in the early stages of bone loss. But once bones have been weakened by osteoporosis, you may have signs and symptoms that include:
When to see a doctor
Your bones are in a constant state of renewal — new bone is made and old bone is broken down. When you're young, your body makes new bone faster than it breaks down old bone and your bone mass increases. Most people reach their peak bone mass by their early 20s. As people age, bone mass is lost faster than it's created.
How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age.
Osteoporosis weakens bone
Normal bone has the appearance of a honeycomb matrix (top). Under a microscope, osteoporotic bone (bottom) looks more porous. ...
A number of factors can increase the likelihood that you'll develop osteoporosis — including your age, race, lifestyle choices, and medical conditions and treatments.
Steroids and other medications
Bone fractures, particularly in the spine or hip, are the most serious complication of osteoporosis. Hip fractures often result from a fall and can result in disability and even death from postoperative complications, especially in older adults.
In some cases, spinal fractures can occur even if you haven't fallen. The bones that make up your spine (vertebrae) can weaken to the point that they may crumple, which can result in back pain, lost height and a hunched forward posture.
The bones that make up your spine (vertebrae) can weaken to the point that they crumple, which may result in back pain, lost height and a hunched forward posture. ...
Preparing for your appointment
Your family doctor may be the first doctor to bring up bone density testing. If the bone density test is abnormal, you may be referred to a doctor who specializes in metabolic disorders (endocrinologist) or a doctor who specializes in diseases of the joints, muscles or bones (rheumatologist).
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For osteoporosis, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
Your bone density can be measured by a machine that uses low levels of X-rays to determine the proportion of mineral contained in your bones. During this painless test, you lie on a padded table as a scanner passes over your body. In most cases, only a few bones are checked — usually in the hip, wrist and spine.
Treatments and drugs
For both men and women, the most widely prescribed osteoporosis medications are bisphosphonates. Examples include:
Side effects include nausea, abdominal pain, difficulty swallowing, and the risk of an inflamed esophagus or esophageal ulcers. These are less likely to occur if the medicine is taken properly. Injected forms of bisphosphonates don't cause stomach upset. And it may be easier to schedule a quarterly or yearly injection than to remember to take a weekly or monthly pill, but it can be more costly to do so.
Long-term bisphosphonate therapy has been linked to a rare problem in which the middle of the thighbone cracks and might even break completely. Bisphosphonates also have the potential to affect the jawbone. Osteonecrosis of the jaw is a rare condition mostly occurring after a tooth extraction in which a section of jawbone dies and deteriorates. You should have a recent dental examination before starting bisphosphonates.
Raloxifene (Evista) mimics estrogen's beneficial effects on bone density in postmenopausal women, without some of the risks associated with estrogen. Taking this drug may also reduce the risk of some types of breast cancer. Hot flashes are a common side effect. Raloxifene also may increase your risk of blood clots.
In men, osteoporosis may be linked with a gradual age-related decline in testosterone levels. Testosterone replacement therapy can help increase bone density, but osteoporosis medications are better studied in men with osteoporosis and are recommended instead of or in addition to testosterone.
Less common osteoporosis medications
Lifestyle and home remedies
These suggestions may help reduce your risk of developing osteoporosis or experiencing broken bones:
Coping and support
The idea that your bones aren't as strong as they used to be can be frightening. You may find that talking to other people who also have osteoporosis can be encouraging and helpful. Ask your doctor if he or she knows of any support groups in your area. Or contact the National Osteoporosis Foundation (NOF) at 800-231-4222 for a list of local support groups. If there isn't a group in your area, the NOF support group coordinator can give you information on starting a support group.
Three factors essential for keeping your bones healthy throughout your life are:
If you find it difficult to get enough calcium from your diet, consider taking calcium supplements. But too much calcium has been linked to heart problems and kidney stones. The Institute of Medicine recommends that total calcium intake, from supplements and diet combined, should be no more than 2,000 milligrams daily for people older than 50.
Scientists don't yet know the optimal daily dose of vitamin D. A good starting point for adults is 600 to 800 international units (IU) a day, through food or supplements. If your blood levels of vitamin D are low, your doctor may suggest higher doses. Teens and adults can safely take up to 4,000 international units (IU) a day.
Combine strength training exercises with weight-bearing exercises. Strength training helps strengthen muscles and bones in your arms and upper spine, and weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports — mainly affect the bones in your legs, hips and lower spine.
Swimming, cycling and exercising on machines such as elliptical trainers can provide a good cardiovascular workout, but because such exercises are low impact, they're not as helpful for improving bone health as weight-bearing exercises are.
Last Updated: 2013-06-21
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