What is osteoporosis? What causes low bone density? How can you prevent and treat this condition? Get the answers to these and other key questions about osteoporosis.

Defining Osteoporosis: Explaining Bone Density and Mineral Density

Osteoporosis is a chronic condition characterized by low bone density and weakened bone structure. It occurs when the body fails to produce enough new bone or when too much existing bone is reabsorbed by the body. This leads to a decrease in bone mineral density (BMD), making bones more fragile and susceptible to fractures.

Risk Factors and Causes of Low Bone Density

There are several factors that can contribute to the development of osteoporosis and low bone density:

• Age: Bone density naturally decreases with age, especially in women after menopause.
• Gender: Women are at a higher risk for osteoporosis than men, as they tend to have lower peak bone mass and experience a more rapid decline in bone density after menopause.
• Genetics: Having a family history of osteoporosis increases the risk of developing the condition.
• Lifestyle factors: Lack of weight-bearing exercise, poor nutrition (especially low intake of calcium and vitamin D), excessive alcohol consumption, and smoking can all contribute to low bone density.
• Medical conditions: Certain diseases and medications can also lead to bone loss, such as rheumatoid arthritis, thyroid disorders, and long-term use of corticosteroids.

Diagnosing Osteoporosis: The Bone Mineral Density Test

The best way to diagnose osteoporosis and measure bone density is through a bone mineral density (BMD) test, also called a DXA or DEXA scan. This non-invasive test uses low-dose X-rays to determine the amount of calcium and other minerals present in a specific area of bone, typically the spine, hip, or wrist.

The results of a BMD test are expressed as a T-score, which compares your bone density to that of a healthy young adult. A T-score of -2.5 or lower indicates osteoporosis, while a score between -1.0 and -2.5 is considered osteopenia, or low bone mass.

Preventing and Treating Osteoporosis

There are several steps you can take to help prevent and manage osteoporosis:

• Nutrition: Consume a diet rich in calcium and vitamin D, which are essential for building and maintaining strong bones.
• Exercise: Engage in weight-bearing exercises, such as walking, jogging, or strength training, to stimulate bone growth and prevent bone loss.
• Medications: In some cases, healthcare providers may prescribe osteoporosis medications, such as bisphosphonates or denosumab, to help increase bone density and reduce the risk of fractures.
• Lifestyle changes: Quit smoking, limit alcohol intake, and maintain a healthy body weight to support overall bone health.

Osteoporosis Complications and Consequences

The primary concern with osteoporosis is the increased risk of fractures, especially in the spine, hip, and wrist. These fractures can lead to chronic pain, disability, and a reduced quality of life. Osteoporosis-related fractures can also be life-threatening, particularly in older adults.

Individuals with osteoporosis may also experience height loss, a stooped posture, and an increased risk of falls due to the weakened bone structure.

Seeking Professional Support for Osteoporosis Management

If you are concerned about your bone health or have been diagnosed with osteoporosis, it is essential to work closely with your healthcare provider to develop a comprehensive treatment plan. This may involve regular BMD testing, dietary and lifestyle modifications, and the use of medication if necessary.

By taking proactive steps to maintain and improve your bone health, you can reduce the risk of osteoporosis-related complications and maintain your independence and quality of life as you age.

Ongoing Research and Advancements in Osteoporosis Management

The field of osteoporosis research is constantly evolving, with ongoing studies exploring new diagnostic techniques, innovative treatment approaches, and strategies for preventing bone loss. As our understanding of this condition deepens, healthcare providers are better equipped to develop personalized care plans and help individuals with osteoporosis live fuller, more active lives.

Bone Density | Bone Mineral Density | BMD

Also called: Bone mass

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Strong bones are important for your health. A bone mineral density (BMD) test is the best way to measure your bone health. It compares your bone density, or mass, to that of a healthy person who is the same age and sex as you are. It can show:

• Whether you have osteoporosis, a disease that makes your bones weak
• Your risk for breaking bones
• Whether your osteoporosis treatment is working

Low bone mass that is not low enough to be osteoporosis is sometimes called osteopenia. Causes of low bone mass include family history, not developing good bone mass when you are young, and certain conditions or medicines. Not everyone who has low bone mass gets osteoporosis, but they are at higher risk for getting it.

If you have low bone mass, there are things you can do to help slow down bone loss. These include eating foods rich in calcium and vitamin D and doing weight-bearing exercise such as walking, tennis, or dancing. In some cases, your doctor may prescribe medicines to prevent osteoporosis.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

• Bone Mineral Density Tests: What the Numbers Mean

  (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

  Also in Spanish

• Food and Your Bones — Osteoporosis Nutrition Guidelines

  (Bone Health and Osteoporosis Foundation)

• Low Bone Density

  (Bone Health and Osteoporosis Foundation)

• Osteopenia

  (American Academy of Family Physicians)

  Also in Spanish

• Exercise for Your Bone Health

  (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

  Also in Spanish

• Osteoporosis

  (Endocrine Society)

• HIV and Osteoporosis

  (National Institutes of Health, Office of AIDS Research)

  Also in Spanish

• Osteopetrosis

  (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

  Also in Spanish

• ClinicalTrials. gov: Bone Density

  (National Institutes of Health)

• Article: The Impact of Age and Body Composition on Bone Density among. ..

• Article: Sex and age do not modify the association between glucocorticoids and…

• Article: The association between weight-adjusted-waist index and total bone mineral density in. ..

• Bone Density — see more articles

• National Institute of Arthritis and Musculoskeletal and Skin Diseases

  Also in Spanish

• National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center

  (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

• Kids and Their Bones

  (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

  Also in Spanish

• Breast Cancer and Bone Loss

  (Endocrine Society)

• Menopause and Bone Loss

  (Endocrine Society)

Low Bone Density | Lurie Children’s

What Is Low Bone Density?

Low bone density or decreased bone density means that your bones are not as dense or strong as they should be. Usually this refers to the range where the density or strength of the bones are below normal, but not as low as is seen in osteoporosis. Sometimes this is called osteopenia. In children, the term osteoporosis is used only when the density of the bones is significantly below normal and they have a fracture history. Because of this, the phrase low bone density or decreased bone density can be used in any child whose bone density is below normal in any range, whether or not they have a fracture history.

What Causes Low Bone Density?

There are many factors that lead to low bone density. These are usually the same things that can cause osteoporosis. Some of the factors cannot be changed or prevented, such as a family history of osteoporosis or low bone density. Also, women and persons of white or Asian descent have a higher risk of having low bone density. Age is also a factor. While low bone density can happen at any age, there is a much higher chance of it after age 50 years.

An additional risk factor that can lead to low bone density is having health problems that can affect the bones. These may include:

• Autoimmune disorders such as rheumatoid arthritis and lupus
• Gastrointestinal disorders such as celiac disease and crohn’s disease
• Endocrine disorders such as diabetes, hyperthyroidism and relative energy deficiency syndrome (RED-S)
• Cancer and blood disorders such as leukemia and thalassemia as well as inflammatory lung disease, kidney disease and liver disease

Medications used to treat some disorders can also cause low bone density. Corticosteroid or “steroid” medications are the main medications that can decrease bone density. Some additional medications are some anticonvulsant (seizure) medications, chemotherapy and transplant antirejection medications, and proton pump inhibitors (stomach reflux medications)

Limited weight bearing and low physical activity levels can also lead to low bone density.

What Are Signs & Symptoms of Low Bone Density?

Low bone density and osteoporosis can be silent diseases, where there are not a lot of symptoms. Sometimes a fracture, especially a fragility fracture, might be the first sign. 

Some people might have more bone pain with low bone density

How Is Low Bone Density Diagnosed?

Bone density problems are diagnosed with a radiology test called dual-energy x-ray absorptiometry (DXA) scan. This scan does use radiation similar to a traditional x-ray, but at much lower amounts, making it a very safe test. This test is most commonly done in adults, usually in women above 50 years of age since they are at greatest risk for low bone density. It is done in other age groups as well if there are risk factors. The areas to measure and the comparisons used to understand the test results are different in adults and children. Because of this, it is best that your child have this test performed at a facility that frequently evaluates children. Additionally, the test is sensitive, so it is better to have follow up tests done on the same machine over time.

In adults, T-scores are used. These compare the person being evaluated to a general group of persons in their 20’s. In children, Z-scores are used, which compare children to age and gender matched peers. A normal Z-score in a child is between –1.0 and +1.0. Low bone density is diagnosed with a Z-score >/= -2.0 without a history of fracture. Your child’s provider may make a diagnosis of decreased bone density for age and gender with a score less than –1.0 depending on other clinical factors.

How Is Low Bone Density Treated?

If your child has been diagnosed with low bone density, the first thing to figure out is the cause. If the cause is something treatable, like celiac disease or hyperthyroidism, then treating that health problem helps treat the low bone density. If it is from a cause that cannot be fully treated, then the main things are to focus on improved nutrition and physical activity. You will need to make sure your child is getting enough calcium and vitamin D in their diet. Additionally, physical activity can make a positive difference in bone density, especially during the years around puberty. Physical activity should include weight-bearing activities that can include walking, running, soccer, baseball, and tennis. Activity should also include resistance exercises to help with muscle mass. These activities may include biking, rollerblading, swimming, and strength training.  

What Are the Long-Term Effects of Low Bone Density?

Some children can have low bone density and may never fracture. If their bone density remains below normal as they grow and mature, they may be at higher risk for fractures and developing osteoporosis now. Additionally, there is a concern that if they spend their childhood and middle adult years with low bone density, they are at high risk for osteoporosis later in life. Sometimes lower bone density can improve during childhood with low risk treatments mentioned above.

Additional Resources

For more information, please refer to these websites: 

• International Osteoporosis Foundation
• National Osteoporosis Foundation 

Make an Appointment 

To make an appointment with one of our specialists, call 1.800.543.7362 (1.800.KIDS DOC®). You can also request an appointment online.

Densitometry and osteoporosis – Medical Clinical Center Medica

Osteoporosis is the most common bone disease that develops with age. It consists in a decrease in the density of bone tissue and an increased risk of fractures. The maximum bone density in humans is reached at 20-30 years of age, and begins to decline from 40 years of age. The maximum risk of osteoporosis in a woman occurs during menopause, that is, after 50 years, in a man also at this age against the background of a decrease in testosterone.

Why is this a problem?

Unfortunately, osteoporosis does not hurt, they learn about it when some kind of fracture has already developed. Moreover, the fracture happens unexpectedly. Pain appears, the patient, as a rule, is treated for a long time by a neurologist, receives physiotherapy, massage. And then, having decided to do an X-ray, MRI or CT scan, he finds out that he has a compression fracture of the spine. After that, during the diagnosis, it is revealed that it is osteoporosis.
By the way, fractures are most often low-traumatic: a fall from a height of one’s own height and with a slight impact. Most often, the radius, ankle, spine, less often the ribs and other bones suffer.
Risk factors. As we noted, in women, this is menopause or removal of the ovaries. It is worth considering if frequent spontaneous fractures occur, if it is noticed that there has been a decrease in height by 4 cm compared to a young age, that a curvature of the spine has appeared, and stoop has increased. At risk are patients taking long-term drugs associated with the treatment of arthritis, bronchial asthma, which reduce bone density, patients with diabetes mellitus.

Today, the Grand Medica Medical Center has the most modern densitometer device that meets international standards. It allows you to determine the density of bone tissue at the level of the lumbar spine and femoral neck. The endocrinologist directs the examination, the patient, if he considers himself to be at risk, can undergo it at will, also contacting the endocrinologist.

For the densitometry procedure, it is additionally necessary to do a general and biochemical blood test, establish a control over the calcium level, if necessary, check the blood hormones in order to form an overall picture and give recommendations. If everything is normal, the patient will manage with prevention, which consists primarily in a sufficient intake of calcium with food. If the examination showed any deviations, drugs are prescribed. And be sure to take vitamin D. Separately! Some patients find that if they take calcium supplements with vitamin D, then this is enough. Actually it is not. Basically, we all live with a lack of vitamin D, at worst – with a deficiency. In addition, the area where we live, initially with a deficiency of vitamin D, we have little sun. When a patient constantly consumes dairy products, cheese, cottage cheese, he has enough calcium, and it is not necessary to take it additionally. But vitamin D, we can neither eat nor sunbathe.

When there are already changes in the bones, then only calcium preparations are not enough, it is necessary to prescribe drugs that will act directly on the bone tissue: either stop the destruction of bones, or give an increase in bone tissue. To date, there is a good group of drugs that make it possible to compensate for the deficiency of bone tissue, to make it with a margin for the next 7-10 years. The treatment is carried out once in a lifetime in a treatment of two years. It is impossible to remain without treatment, because the most dangerous disabling fractures are hip fractures, after which patients walk poorly or do not get up at all. The treatment of osteoporosis is costly all over the world, so it is best to take preventive measures in advance.

Our program provides examination of the patient on the three most “fragile” areas – two hips and lower back. However, osteoporosis is a multifactorial disease, and the low mineral density that we determine using densitometry is only part of the problem, which is why the program includes laboratory diagnostics that detects metabolic abnormalities at the earliest stage, which means that it is possible to cure or prevent this pathology. Blood tests for hormones, as well as general and biochemical ones, will tell about the state of the body. A comprehensive assessment of twelve blood parameters allows you to accurately diagnose, identify the causes of the disease.

Make an appointment with an endocrinologist by calling 8 (3843) 99-40-40 or leave a request on the website.

Osteoporosis | Clinical Rheumatology Hospital №25

Osteoporosis | Clinical Rheumatology Hospital №25

What is osteoporosis?

Osteoporosis is a systemic disease affecting all bones of the skeleton. Osteoporosis of the bones is accompanied by a decrease in bone density and strength, which leads to a high risk of fractures even with minimal trauma, such as a fall from one’s height or lifting a load of about 10 kilograms.

Most common fractures of joints and bones in osteoporosis:

• fracture of the radius in the “typical location”
• hip fractures (50% of patients remain disabled)
• compression fractures of the spine

The following main forms of osteoporosis are distinguished:

Primary osteoporosis:

• Type I (postmenopausal) develops during menopause in women;
• Type II (senile) occurs with the same frequency in women and in men of elderly and senile age (70 years and older)

Secondary osteoporosis is a complication of many diseases – endocrine, inflammatory (especially rheumatic), hematological, gastroenterological, etc. or drug therapy and can develop at any age, both in women and men.

What causes osteoporosis?

Factors contributing to the development of osteoporosis:

• Women suffer much more often than men. So, during the first five years after the onset of menopause, women lose ¼ of their bone mass. Early (before age 45) and surgical menopause (after the removal of the ovaries) increase the risk of osteoporosis.
• Diseases that limit movement may contribute to the development of osteoporosis. Therefore, low physical activity can contribute to the development of osteoporosis.
• Chronic diseases of the gastrointestinal tract, accompanied by a decrease in the absorption of nutrients, vitamins, macro- and microelements, disrupt bone metabolism.
• Kidney diseases leading to chronic renal failure
• Endocrine diseases, long-term use of glucocorticoid hormones and thyroid hormones (L-thyroxine) is an additional risk factor
• Bad habits (smoking, alcohol abuse, coffee)
• Hereditary predisposition

How to suspect osteoporosis?

Symptoms of osteoporosis. Signs of osteoporosis.

The disease is often detected in the later stages, when there is already a pronounced decrease in bone density. Osteoporosis does not cause any pain until a fracture develops. No wonder the disease is called the “silent epidemic”. That is why it is important to pay attention to such signs of the development of the disease as a decrease in height by several centimeters, a change in posture (the formation of thoracic kyphosis “hump”)

Diagnosis of osteoporosis.

The only method to confirm the diagnosis and detect the disease in the early stages is bone densitometry (measurement of bone density, determination of bone density). This study can be done either in the direction of the clinic, or on a paid basis.

Indications for densitometry see here…

The main directions of osteoporosis prevention:

1. Physical activity – gymnastics, isometric exercises, swimming.
2. Proper nutrition – a meal high in protein, calcium and vitamin D (dairy products) and relatively low in phosphate, salt and fiber.
3. Elimination of risk factors for osteoporosis – smoking, excessive intake of alcohol, caffeine (less than 4 cups per day), heavy physical exertion.
4. Elimination of risk factors for accidental loss of balance – correction of visual impairment, if possible, the exclusion of the use of sleeping pills and sedative drugs.

How to treat osteoporosis?

Treatment of osteoporosis is aimed at reducing the risk of osteoporotic fractures. Bisphosphonates (in particular, alendronic acid), salmon calcitonin (miacalcic), calcium and vitamin D, hormone replacement therapy, active vitamin D metabolites are indicated as therapy. a specialist either in the direction of the clinic, or on a paid basis.

RHEUMATOLOGIST’S CONSULTATION

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