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Osteoporosis

Osteoporosis is a disease of thinning bones that causes bone fracture with a slight fall or even with a sudden movement, like coughing. Most of the fractures occur in the spine, wrist or hip. Osteoporosis affects women more than men but men are affected as well. Osteopenia is a condition of thinning bones that is not so severe as to be called "osteoporosis". Osteoporosis is preventable and somewhat treatable with the right medications and exercise.

There are usually no symptoms in early osteoporosis. As the disease progresses, however, you will find some symptoms of the disease, including loss of height, pain in the back as a result of compression fractures of the vertebrae, posture that is stooped over and fracture of one of the most common bones fractured in osteoporosis: hip, back or wrist.

Doctors don't know why osteoporosis occurs. It is likely secondary to some abnormality in bone remodeling. Bone is broken down faster than it can be created, resulting in a net loss of bone. Peak bone mass occurs around the age of 30; beyond that, bone is continued to be laid down but more is lost than is put down. Loss of bone is called resorption. If you attain a lot of bone mass in your 20s to 30s, you will have a decreased chance of getting osteoporosis. Bone mass depends on the quantity of calcium, phosphorus and miscellaneous minerals in the bone. Hormones also play a role in getting osteoporosis. Estrogen is especially important and, when it is lost at menopause, osteoporosis rates increase. In men, it is low levels of estrogen and testosterone that play a role in getting the disease.

There are some risk factors that can be changed in the development of osteoporosis. You can increase the calcium in your diet or take calcium supplements in order to maximize bone production. You can quit smoking, because smoking is linked to loss of bone. Those with eating disorders like anorexia or bulimia are at increased risk of getting the disease later in life. If you drink alcohol excessively (more than two drinks per day), you run the risk of getting osteoporosis. If you are sedentary, your bones will thin faster than if you are active. Long term use of steroid medications like prednisone will cause your bones to become thin. This is also true of aromatase inhibitors used in breast cancer treatment, antidepressant use, methotrexate use, seizure medications (some), proton pump inhibitors for stomach problems and aluminum-containing antacid drugs.

There are some risk factors for osteoporosis that cannot be changed. This is true of your gender (women are at greater risk than men), being of an older age and being of Asian descent. You cannot change a strong family history of osteoporosis and you cannot change the fact that people of small stature with small bones have a greater risk of developing osteoporosis. If you have hyperthyroidism, you are also at greater risk of getting osteoporosis. This is also true of taking too much thyroid hormone supplement. Those who have had a gastrectomy or weight loss surgery don't absorb calcium as much and are at greater risk of developing the disease. Crohn's disease, high parathyroid hormone, Cushing's disease and celiac disease predispose one to getting low bone mass.

Osteoporosis is measured by determining the bone density of the individual. This is done through the use of a Dual Energy X-ray Absorptiometry Scan or DEXA (DXA) scan. It is a rapid way of measuring the density of the bones in the primary target areas: the wrist, hip and spine. Other possible testing measures include an ultrasound of the bone, CT scan of the bone and single photon absorptiometry.

You should see the doctor to be evaluated for osteoporosis if you are a woman over the age of sixty five or a man older than 70. If you have a risk factor for osteoporosis and are postmenopausal, you should see the doctor. Men between t he ages of 50 and 70 should be scanned if they have a risk factor and anyone older than 50 that has a broken bone history should be scanned. Remember the list of medications that put you at risk for osteoporosis and see the doctor to be scanned if you are on one of them for a long time. Women with early menopause should be scanned for osteoporosis.

The treatment of osteoporosis includes medications that stop bone loss. These include bisphosphonate medications like Fosamax, Boniva, Actonel and Reclast. You can preserve and even increase bone mass by taking these medications. They are used on a long-term basis. Side effects include nausea and vomiting, pain in the abdomen, problems swallowing and a risk for an inflamed esophagus. A rare but serious side effect is osteonecrosis or bone death in the jaw.

There are other, less commonly used, medications for osteoporosis including calcitonin, Evista, and Forteo, which is an analog of parathyroid hormone that stimulates new bone growth.