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Reasons for bone loss. The Comprehensive Guide to Osteoporosis: Symptoms, Causes, and Prevention

What are the symptoms of osteoporosis? What causes osteoporosis? How can I prevent osteoporosis?

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Understanding Osteoporosis: An Overview

Osteoporosis is a bone disease that develops when bone mineral density and bone mass decrease, leading to a weakening of the bone structure. This can significantly increase the risk of fractures, even from minor falls or stresses. Osteoporosis is often called a “silent” disease because it typically does not have any noticeable symptoms until a bone is broken.

Who is at Risk for Osteoporosis?

Osteoporosis can affect individuals of all races and ethnic groups, but certain factors can increase the risk:

  • Sex: Women have a higher risk than men, as they tend to have lower peak bone mass and smaller bones.
  • Age: Bone loss accelerates as we get older, making the risk of osteoporosis greater with advancing age.
  • Body size: Slender, thin-boned individuals have less bone mass to lose and are at higher risk.
  • Race: Non-Hispanic white and Asian women have the highest risk, while African American and Hispanic women have a lower but still significant risk.
  • Family history: If a parent has a history of osteoporosis or hip fracture, your risk may be increased.
  • Hormonal changes: Low levels of certain hormones, such as estrogen in women, can contribute to bone loss and osteoporosis development.

Symptoms of Osteoporosis

Osteoporosis is often called a “silent” disease because it typically does not have any noticeable symptoms until a bone is broken. Some potential symptoms of osteoporosis include:

  • Severe back pain, often due to vertebral (spine) fractures
  • Loss of height over time
  • A stooped or hunched posture (kyphosis)

These symptoms may only become apparent after a bone has already been weakened to the point of fracturing, which is why osteoporosis is often not detected until a break occurs.

Causes of Osteoporosis

Osteoporosis occurs when the body loses too much bone mass and the structure of the bone tissue changes. Several factors can contribute to the development of osteoporosis, including:

  • Sex: Women are at higher risk due to lower peak bone mass and smaller bones.
  • Age: Bone loss accelerates with age, making older individuals more susceptible.
  • Body size: Slender, thin-boned individuals have less bone mass to lose.
  • Race: Non-Hispanic white and Asian women have the highest risk, while African American and Hispanic women have a lower but still significant risk.
  • Family history: If a parent has a history of osteoporosis or hip fracture, your risk may be increased.
  • Hormonal changes: Low levels of certain hormones, such as estrogen in women, can contribute to bone loss.

Preventing Osteoporosis

While some risk factors for osteoporosis cannot be changed, there are steps you can take to help prevent the development of this bone disease and reduce the risk of fractures:

  • Engage in regular weight-bearing exercises, such as walking, to help maintain bone health.
  • Consume a diet rich in calcium and vitamin D, which are essential for strong bones.
  • Limit alcohol consumption and quit smoking, as these habits can contribute to bone loss.
  • Take prescribed medications, if recommended by a healthcare provider, to help prevent fractures in individuals with osteoporosis.

Diagnosing and Treating Osteoporosis

Osteoporosis is typically diagnosed through a bone density test, which measures the mineral content and density of the bones. This test can help identify individuals with low bone mass who are at risk of developing osteoporosis. Treatment for osteoporosis may include:

  • Medications to slow or stop bone loss and increase bone density
  • Calcium and vitamin D supplements to support bone health
  • Physical therapy and exercise to improve balance and prevent falls

Early detection and appropriate treatment can help prevent fractures and maintain bone strength in individuals with osteoporosis.

Osteoporosis in Children and Teens

While osteoporosis is more common in older adults, a rare form of the disease called idiopathic juvenile osteoporosis can occur in children and teenagers. The cause of this condition is often unknown, but most children with idiopathic juvenile osteoporosis recover without the need for treatment. Healthcare providers may monitor these cases and provide guidance on maintaining bone health during the growing years.

Ongoing Research and Advancements

Researchers continue to study the causes, risk factors, and potential treatments for osteoporosis. Advances in diagnostic techniques, medications, and lifestyle interventions have helped improve the management and prevention of this bone disease. As our understanding of osteoporosis continues to evolve, healthcare providers can work with patients to develop personalized strategies for maintaining strong, healthy bones throughout the lifespan.

Osteoporosis Causes & Symptoms | NIAMS

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  • Overview, Symptoms, & Causes

  • Diagnosis, Treatment, & Steps to Take

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Overview of Osteoporosis

Osteoporosis is a bone disease that develops when bone mineral density and bone mass decreases, or when the structure and strength of bone changes. This can lead to a decrease in bone strength that can increase the risk of fractures (broken bones).

Osteoporosis is a “silent” disease because you typically do not have symptoms, and you may not even know you have the disease until you break a bone. Osteoporosis is the major cause of fractures in postmenopausal women and in older men. Fractures can occur in any bone but happen most often in bones of the hip, vertebrae in the spine, and wrist.

However, you can take steps to help prevent the disease and fractures by:

  • Staying physically active by participating in weight-bearing exercises such as walking.
  • Drinking alcohol in moderation.
  • Quitting smoking, or not starting if you don’t smoke.
  • Taking your medications, if prescribed, which can help prevent fractures in people who have osteoporosis.
  • Eating a nutritious diet rich in calcium and vitamin D to help maintain good bone health.

Who Gets Osteoporosis?

Osteoporosis affects women and men of all races and ethnic groups. Osteoporosis can occur at any age, although the risk for developing the disease increases as you get older. For many women, the disease begins to develop a year or two before menopause. Other factors to consider include:

  • Osteoporosis is most common in non-Hispanic white women and Asian women.
  • African American and Hispanic women have a lower risk of developing osteoporosis, but they are still at significant risk.
  • Among men, osteoporosis is more common in non-Hispanic whites.

Certain medications, such as some cancer medications and glucocorticoid steroids, may increase the risk of developing osteoporosis.

Because more women get osteoporosis than men, many men think they are not at risk for the disease. However, both older men and women from all backgrounds are at risk for osteoporosis.

Some children and teens develop a rare form of idiopathic juvenile osteoporosis. Doctors do not know the cause; however, most children recover without treatment.

Symptoms of Osteoporosis

Osteoporosis is called a “silent” disease” because there are typically no symptoms until a bone is broken. Symptoms of vertebral (spine) fracture include severe back pain, loss of height, or spine malformations such as a stooped or hunched posture (kyphosis).

Bones affected by osteoporosis may become so fragile that fractures occur spontaneously or as the result of:

  • Minor falls, such as a fall from standing height that would not normally cause a break in a healthy bone.
  • Normal stresses such as bending, lifting, or even coughing.

Causes of Osteoporosis

Osteoporosis occurs when too much bone mass is lost and changes occur in the structure of bone tissue. Certain risk factors may lead to the development of osteoporosis or can increase the likelihood that you will develop the disease.

Many people with osteoporosis have several risk factors, but others who develop osteoporosis may not have any specific risk factors. There are some risk factors that you cannot change, and others that you may be able to change. However, by understanding these factors, you may be able to prevent the disease and fractures.

Factors that may increase your risk for osteoporosis include:

  • Sex. Your chances of developing osteoporosis are greater if you are a woman. Women have lower peak bone mass and smaller bones than men. However, men are still at risk, especially after the age of 70.
  • Age. As you age, bone loss happens more quickly, and new bone growth is slower. Over time, your bones can weaken and your risk for osteoporosis increases.
  • Body size. Slender, thin-boned women and men are at greater risk to develop osteoporosis because they have less bone to lose compared to larger boned women and men.
  • Race. White and Asian women are at highest risk. African American and Mexican American women have a lower risk. White men are at higher risk than African American and Mexican American men.
  • Family history. Researchers are finding that your risk for osteoporosis and fractures may increase if one of your parents has a history of osteoporosis or hip fracture.
  • Changes to hormones. Low levels of certain hormones can increase your chances of developing osteoporosis. For example:
    • Low estrogen levels in women after menopause.
    • Low levels of estrogen from the abnormal absence of menstrual periods in premenopausal women due to hormone disorders or extreme levels of physical activity.
    • Low levels of testosterone in men. Men with conditions that cause low testosterone are at risk for osteoporosis. However, the gradual decrease of testosterone with aging is probably not a major reason for loss of bone.
  • Diet. Beginning in childhood and into old age, a diet low in calcium and vitamin D can increase your risk for osteoporosis and fractures. Excessive dieting or poor protein intake may increase your risk for bone loss and osteoporosis.
  • Other medical conditions. Some medical conditions that you may be able to treat or manage can increase the risk of osteoporosis, such as other endocrine and hormonal diseases, gastrointestinal diseases, rheumatoid arthritis, certain types of cancer, HIV/AIDS, and anorexia nervosa.
  • Medications. Long-term use of certain medications may make you more likely to develop bone loss and osteoporosis, such as:
    • Glucocorticoids and adrenocorticotropic hormone, which treat various conditions, such as asthma and rheumatoid arthritis.
    • Antiepileptic medicines, which treat seizures and other neurological disorders.
    • Cancer medications, which use hormones to treat breast and prostate cancer.
    • Proton pump inhibitors, which lower stomach acid.
    • Selective serotonin reuptake inhibitors, which treat depression and anxiety.
    • Thiazolidinediones, which treat type II diabetes.
  • Lifestyle. A healthy lifestyle can be important for keeping bones strong. Factors that contribute to bone loss include:
    • Low levels of physical activity and prolonged periods of inactivity can contribute to an increased rate of bone loss. They also leave you in poor physical condition, which can increase your risk of falling and breaking a bone.
    • Chronic heavy drinking of alcohol  is a significant risk factor for osteoporosis.
    • Studies indicate that smoking is a risk factor for osteoporosis and fracture. Researchers are still studying if the impact of smoking on bone health is from tobacco use alone or if people who smoke have more risk factors for osteoporosis.

Osteoporosis Related Information

Juvenile Osteoporosis

Osteoporosis is a bone disease that develops when the bones get weaker and less dense. When a child or teen develops osteoporosis, the condition is known as juvenile osteoporosis.


Osteoporosis in Men

Osteoporosis is a bone disease that develops when bone mineral density and bone mass decreases, or when the quality or structure of bone changes. This can lead to a decrease in bone strength that can increase the risk of broken bones (fractures).


Pregnancy, Breastfeeding, and Bone Health

How do pregnancy and breastfeeding affect a woman’s bones? Calcium is in high demand during both pregnancy and breastfeeding – since it is needed to support the baby’s growth and development in the mother’s womb and after birth.


Preventing Another Broken Bone

After you break a bone, recovery is your first priority. But you might want to find out whether this broken bone is a sign of osteoporosis.


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Osteopenia Causes | Jean Hailes

Causes of osteoporosis & osteopenia

There are many causes of osteoporosis. Not only do bones lose density with age, medications used to treat breast cancer, arthritis, asthma, Crohn’s disease and Addison’s disease can also lower bone density. Some illnesses such as hyperthyroidism, hypopituaritism and eating disorders also cause bones to lose strength. You will find information on all of these causes of lowered bone density, along with the role of oestrogen in bone density.

Osteoporosis is a condition in which bones become thinner, or lose ‘bone mineral density’. This leads to an increased risk for fractures. Osteoporosis is more common in women, especially after menopause. However, a number of conditions may be associated with a decrease in bone density.

The things that affect bone density include:

Ageing

Ageing reduces bone strength because more bone is broken down than can be made – everyone develops osteoporosis if they live long enough.

Alcohol

Excessive alcohol intake increases the risk of developing osteoporosis.

Breast cancer

Women with breast cancer have an increased risk of developing osteoporosis because of the treatments used and their effect on oestrogen levels.

Calcium

A lack of calcium affects bone strength and the muscles that support bones, so adequate intake is essential.

Corticosteroid therapy

A steroid replacement hormone including:

  • Prednisolone
  • Cortisone
  • Hydrocortisone
  • Dexamethasone

Long-term use (more than 2 months) of oral corticosteroid type medications, with doses of more than 5-7. 5mg of prednisolone per day, increases the risk of developing osteoporosis[1] by reducing bone formation and bone density

If other risk factors for osteoporosis (such as being postmenopausal) are present, the effect on bones will be more severe

Corticosteroid therapy may be prescribed for a variety of conditions such as:

  • chronic airways disease
  • asthma
  • rheumatoid arthritis
  • inflammatory bowel diseases (i.e. Crohn’s disease)
  • certain skin conditions
  • inflammatory conditions such as polymyalgia rheumatic (affects muscles and joints causing pain and stiffness)
  • Addison’s disease: This causes a deficiency in the hormone cortisol and is treated with corticosteroid drugs to replace the cortisol
Eating disorders
(including anorexia nervosa and bulimia)
  • Eating disorders cause a loss of bone density because they create deficiencies in nutrition, which in turn affects hormone levels
  • If you stop having your periods (due to poor nutrition and/or excessive exercise routines) this reduces your oestrogen level, which reduces your bone density

Eating disorders in early adolescence, when the skeleton is in the process of growing, severely reduce the potential to achieve peak bone mass and this can lead to osteoporosis in women as young as the early 20s. If you develop an eating disorder after the process of skeletal growth has been completed you still risk reducing your bone mineral density.

Excessive exercise
  • Although exercise is vital for the development of peak bone mass in childhood and adolescence, excessive or elite level exercise in the adolescent years may have negative effects on your ability to achieve peak bone mass
  • Athletes who have periods tend to have normal or increased bone density, whereas athletes who do not menstruate have reduced bone density[2]
  • Some activities can help maintain or increase bone mass
Family history

You are at increased risk of osteoporosis if you have a family member with osteoporosis, especially a parent or sibling who has had a hip fracture.

Hormones

A drop in oestrogen can cause a loss in bone strength and this means bone density may be decreased:

  • if you have late onset of menstrual periods
  • absent or infrequent menstrual periods
  • by premature or early menopause
  • with menopause
Hyperthyroidism
(overactive thyroid)

  • High concentrations of thyroid hormone can lead to more bone breakdown than bone formation, which affects bone density and causes osteoporosis
  • Graves’ disease can result in an overactive thyroid
  • If the thyroid condition is treated with a thyroxine hormone (sold as Oroxine and Eutroxsig), there has been concern that an over replacement may also impact on bone health
Hypopituitarism
(pituitary gland failure)

  • Hypopituitarism can cause a deficiency in cortisol and the usual treatment is long-term replacement of the cortisol with corticosteroid drugs
  • There is increasing evidence the doses of corticosteroid drugs to replace the cortisol can lead to osteoporosis – usually this is when the dosage is too high or when there are other co-existing risk factors for osteoporosis
Illness/diseases

Illness or diseases, and sometimes their treatments, can affect bone strength including:

  • chronic liver disease
  • chronic kidney disease
  • Coeliac disease
Physical inactivity

Lack of physical activity reduces bone and muscle strength, which increases the risk of fractures and falls.

Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disorder that may affect tissues and organs, but principally attacks flexible joints (i.e. elbows and knees). It is a condition affecting approximately 1% of the population, with women affected around 3 times more than men.

If prednisolone is prescribed as part of the medical treatment, this can also lead to the development of osteoporosis, especially in bones adjacent to the affected joints.

Smoking

Smoking, especially how much you smoke, can cause:

  • a significant reduction in bone density leading to an increased risk of fracture
  • you to experience menopause 1.5-2 years earlier, so you risk developing osteoporosis earlier than average
Vitamin D

Low vitamin D can reduce the body’s ability to absorb the calcium required for bone strength.

Lack of oestrogen & bone health

The sex hormone oestrogen plays a vital role in the development of bones.

Adolescence – 20’s

  • During puberty (10-17 years) sex hormones increase rapidly and these increased levels of oestrogen and testosterone lead to increased bone mass
  • The ongoing production of oestrogen is vital in adolescent females and young women to develop and maintain bone mass

30’s – 40’s

  • The balance between bone loss and bone formation changes around 30 years of age and you start to lose more bone than you make
  • In the years immediately before menopause there can be a drop in oestrogen levels and this can lead to a reduction in bone mineral density[3]

Menopause

  • Menopause means a dramatic fall in oestrogen levels and the loss of bone is accelerated
  • This period of significant bone loss can last from 4-8 years after the onset of menopause
    • Bone loss is most severe during the first 3 years after menopause when you may lose approximately 2% of bone mass per year in your spine, hip or wrist
    • The rate of bone loss then slows and you may lose less than 1% of bone density at the hip per year and less in the spine[4]

** Currently under review **

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at December 2013.

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Osteopenia – causes, symptoms, diagnosis and treatment

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Contents of the article:

• Danger of osteopenia
• Causes of osteopenia
• Signs of bone osteopenia
• Diagnosis of osteopenia
• Treatment of bone osteopenia
• Stages of development
• Species of osteopenia
• Complications of osteopenia
• Prevention of osteopenia

Danger of osteopenia

As a result of age-related changes, bone cells are destroyed faster than new ones are formed, so the bones become thinner. An imbalance in the mechanism can lead to a decrease in bone mass. Bones become brittle and prone to fracture due to changes in the chemical composition of the bone structure. This is due to the process of human physiology. By the age of 30, bones in a person reach maximum strength, therefore, the stronger the bones at this age, the later will be the decrease in mineral density and decrease in bone mass. Bone mass loss in men and women occurs at different rates. It depends on the hormonal background of women, so it increases significantly during menopause and after 55 years. In men, bone mass does not depend on age and changes at a constant rate throughout life.

Osteopathic treatment
Reception of osteopath – 1 session/1 hour 7000
Reception of osteopath Kishinevsky E.V. (Honored Doctor of the Russian Federation) — 1 session/1 hour 10000

Causes of the disease

The development of osteopenia begins when processes that affect the formation of bones occur in the body. The disease depends on individual characteristics: gender, age, physical activity and heredity. Risk factors include:

  • Underweight.
  • Sedentary lifestyle, sedentary work, lack of physical activity.
  • Abuse of drinks containing caffeine.
  • Bad habits: drinking and smoking.
  • Calcium deficiency in the body.
  • Chronic inflammation due to diseases such as rheumatoid arthritis.
  • diseases of internal organs: liver, lungs, kidneys.
  • Celiac disease is an autoimmune, hereditary disease of the digestive tract.
  • Radiotherapy and chemotherapy.

Signs of osteopenia

As long as there are no painful fractures, for example, of the hip or vertebrae, osteopenia does not cause discomfort or pain. The pathological condition can be asymptomatic for a long time until a diagnosis is made. Sometimes there are symptoms that indirectly indicate pathology, for example, disorders of the gastrointestinal tract, metabolic failure, joint pain, stiffness of motor functions, diseases of the lumbar spine, injuries, and the development of vascular diseases.

Consultative appointment with a specialist doctor 4000
Consultative appointment with a neurologist Ye. 6000

Diagnosis of osteopenia

For examination, blood and urine tests are prescribed, as well as hormonal parameters, calcium and phosphorus levels are checked, because osteopenia develops due to their lack. The presence of osteopenia can be diagnosed using spectral imaging of bone mineral density (BMD) with two x-rays with different energy levels. This method is called absorptiometry. Densitometry, both quantitative ultrasound and peripheral bone densitometry, is a method of X-ray scanning of the internal structure of bones, is prescribed to determine the level of nutrients and minerals in bone tissue, mainly in the region of the femoral head, wrist, shoulder and knee joints, as well as to determine risk of injury.
Sometimes additional hardware diagnostic methods are used, such as computed tomography and magnetic resonance imaging.

According to statistics, osteopenia most often affects women over 55 years of age. In men, the development of this disease begins later due to a higher BMD. For the prevention of women’s health during menopause, complex laboratory diagnostics are recommended. Especially if there are such risk factors as: European type, osteoporosis in the family, low body weight, long-term treatment with corticosteroids, bad habits.

Treatment of osteopenia

Patients with osteopenia should change the quality of nutrition, it is important to move more, take vitamin D, calcium and some other trace elements, not only with food, but also in the form of special supplements.

Daily intake of vitamin D: women over 70 years old – 800 IU, men and women of young age – 600 IU, and children under 1 year old – 400 IU.
Calcium intake per day: women over 45 years old and men over 55 years old – 1000 mg, women over 55 years old and men over 70 years old – 1200 mg. Calcium is taken fractionally, not more than 600 mg at a time.

First of all, doctors begin to treat a disease that provokes bone fragility, such as celiac disease, diabetes, enlarged endocrine glands.
The disease therapy program is compiled depending on the clinical results of the diagnosis, taking into account such risk factors as: hereditary predisposition, physique, chronic diseases. Calcitonin and hormones such as estrogen and progesterone are often prescribed. The use of special preparations is not required. However, bisphosphonates should be used in exceptional cases, because their use as a prophylaxis for skeletal fractures usually leads to side effects. Therefore, the doctor monitors the dynamics of changes in bone density.

In addition to drug treatment, the treatment of osteopenia includes osteopathy: therapeutic massage, exercise therapy (therapeutic physical culture).

exercise therapy
Primary appointment with a doctor of exercise therapy 5000
1 exercise exercise session individually 5000
Massage
Classic massage (general massage) 60 min 2800
Classic massage (general massage) 90 min 4000

Stages of development

There are three stages of osteopenia: to be.
second stage – decrease in bone density is more severe, accompanied by a risk of fractures and a feeling of pain between the shoulder blades and in the lower back. There is discomfort and stiffness during movement.
third stage – a chronic form of pathology, the appearance of arthritis, arthrosis, osteoporosis and other diseases.

Types of osteopenia

According to statistics, osteopenia in women is observed more often than in men due to the peculiarities of the hormonal background. Women in the menopausal period and over 50 years of age are at risk. Abortions, breastfeeding, professional sports negatively affect the structure of bones, since in these situations more estrogens and microelements are required.
Osteopenia in children appears very rarely, may occur due to serious genetic abnormalities, hypertrophy, and also during puberty.

Classification by cause of occurrence
There are four groups:

    • The senile form appears due to the development of friability in the bone structure.
    • Post-traumatic form due to trauma and mechanical damage to the bones.
    • Postmenopausal form due to hormonal disruptions in the body of women during menopause.
    • Dosage due to long-term use of corticosteroids.

Complications of osteopenia

If you do not change your lifestyle and start treatment with medication in a timely manner, the risk of fractures in different parts of the body increases. Due to the progression of the disease, there may be a limitation of motor function, as well as the development of osteoarthritis, sciatica, rheumatism. In severe cases, even disability is possible.

Prevention of osteopenia

To minimize the risk of developing osteopenia, it is necessary to lead an active lifestyle, do not consume alcohol and tobacco, eat well, including a diet, taking vitamin D and calcium in sufficient quantities.
It is necessary to strengthen bone tissue until the age of 30, until its density has reached its maximum. The process of loss of bone density can be prevented, and the development of osteoporosis significantly slowed down with a balanced diet, regular active exercise.
Make an appointment for an initial appointment at the medical center so that such specialists as: endocrinologist, gastroenterologist, rheumatologist and even a neurologist can conduct an examination at the clinic. At the consultation, doctors prescribe tests to make a diagnosis, and also choose a drug therapy regimen.

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Exercises Time The number of repetitions
Squats 30 seconds 5-10 times
Rope 5 minutes 3-5 times
Walk ba 30 minutes daily