Causes and Treatment of Osteoporosis

Life just wouldn’t be the same without our bones. For one thing, we’d all be lying around like jellyfish on a beach. We’re just no good without that internal support system that keeps our muscles and internal organs anchored in place. With that in mind, it’s almost an afterthought to mention that without our bones we’d also have a messed up endocrine system, and cells throughout our bodies would start to malfunction due to scarcity of calcium.

But at least we wouldn’t have to worry about osteoporosis.

Bones are interesting structures. Because they’re the most solid feature in our bodies, we tend to think of them as fixed and unchanging. But that’s not true. As in our other organs, older bone cells die and dissolve away, and are replaced by new cells, slowly “remodelling” entire bones. This constant turnover of cells basically means that your skeleton today is entirely different from the skeleton you had ten years ago.

It’s a good system, but there’s a hitch. As we age, for various reasons, the rate at which we lose bone cells can exceed the rate at which new bone cells are created. This can lead to bones that are lighter, more porous, weaker, and more prone to fracture. That’s osteoporosis. Common symptoms include:

  • Back pain (from fractured or collapsed vertebra)
  • Loss of height
  • Stooped posture
  • Increased susceptibility to bone fractures (the hips are a common break point)

The ultimate cause, as we’ve mentioned, is bone that breaks down more rapidly than it is built up. Osteoporosis generally presents itself as we age, as bone density decreases after peaking in our 20s. If our peak bone density was high, our risk of developing osteoporosis later is lower. 

There are a number of risk factors we should be aware of:

  • Women are much more likely than men to develop osteoporosis
  • People of white or Asian descent are at greater risk
  • A family history of osteoporosis makes osteoporosis more likely
  • Heavier people for once have an advantage — it’s those with lower body mass who have to worry more about osteoporosis, since they have less bone mass to begin with

In addition, certain medical problems are associated with increased risk. Celiac disease, inflammatory bowel disease, kidney or liver disease, cancer, lupus, multiple myeloma, and rheumatoid arthritis are all enough to worry about on their own, but if you’ve been diagnosed with any of these, osteoarthritis is also a potential concern.

Those are the risk factors we have no control over. But there are still ways to lessen the risk. 

Check Your Hormones

Low estrogen levels in women and low testosterone levels in men are associated with osteoporosis. Too much thyroid is also a problem, as are an overactive parathyroid and adrenal gland. Check with your doctor for any of these conditions, and ask what options you might have if osteoporosis is a concern.

Corticosteroids

Oral or injected corticosteroid medications such as prednisone and cortisone can interfere with bone-building. Your doctor should be made aware of your osteoporosis concerns if you’re taking these medications or similar medications (for example, medications for seizures, gastric reflux, cancer, or transplant rejections).

Diet

Here’s an area where you can have more direct control over osteoporosis risk. You should be choosing foods throughout your life that supply adequate amounts of calcium and protein. Vitamin D is also important (although you would generally get this from sun exposure rather than through diet). Eating disorders or severely restricted food intake are also associated with weakened bones. Gastrointestinal surgery can be a problem both because of related calorie restrictions and also because of lessened calcium absorption due to decreased stomach and intestinal surface area.

Lifestyle choices

There’s probably no surprise here, but excessive alcohol consumption and tobacco use are both associated with osteoporosis. And finally:

  • Exercise. Yup, you guessed it. If you sit around a lot, your chances of osteoporosis go up. If you regularly perform weight-bearing exercise activities, your bones get stronger and your osteoporosis risk goes down. Especially helpful are exercises like walking, running, dancing, jumping, and weightlifting. Swimming, cycling, and elliptical machines, while good exercises overall, don’t seem to have the same effect on increasing bone density.

Treatment and prevention

Because osteoporosis is such a slow-moving disease, much damage can be done before you’re even aware you have it. Therefore, awareness of risk factors as discussed above is very important — as is taking appropriate steps for prevention, such as regular exercise, proper diet, and lifestyle choices.

If you are diagnosed with osteoporosis, there are available medications, but these come with additional risks that you’ll discuss with your doctor. Medications may not be required, however — depending on on an analysis of your condition, the most appropriate treatment may simply be continued lifestyle modifications, such as diet, exercise, and balance training to reduce the risk of breaking a bone in a fall.