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What cause bone loss: What Causes Bone Loss? Symptoms & Treatments for Density Loss

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Tests to Determine Secondary Causes of Bone Loss

Primary osteoporosis is associated with the normal loss of estrogen following the menopause as well as age.  The average older woman with normal bone density loses about 13% of her bone density in 10 years or about 1.3% per year.  However, there are a number of medical conditions and medications that can cause more rapid bone loss — the most common conditions are hyperparathyroidism, hyperthyroidism, vitamin D deficiency and celiac disease, and the most common medications are steroids and aromatase inhibitors.  If you have low bone density, there may be other tests that your doctor will consider to determine if active bone loss is occurring. It is important to correct underlying causes before taking a treatment for osteoporosis.

What tests to expect

Your doctor will ask questions about your medical history and may prescribe blood or urine tests. This is especially important if you have had any broken bones.  There are also tests that your doctor might request before determining what osteoporosis medicine to prescribe.  

Standard blood panel

  • Complete blood count (CBC)
  • Chemistry levels (Calcium, renal function, phosphorus, and magnesium)
  • Liver function tests
  • Thyroid-stimulating hormone (TSH) level
  • Serum 25(OH)D level
  • Parathyroid hormone (PTH)
  • Total testosterone and gonadotropin levels in younger men
Blood tests for certain situations
  • Serum protein electrophoresis (SPEP), serum immunofixation, serum free light chains
  • Tissue transglutaminase antibodies
  • Iron and ferritin levels
  • Homocysteine
  • Tryptase
  • Bone-specific Alkaline Phosphatase

Urine tests

  • 24-hour urinary calcium
  • Urine NTx (N-linked peptide of type 1 collagen)
Urine tests for certain situations
  • Protein electrophoresis (UPEP)
  • Urinary free cortisol level
  • Urinary histamine

Factors and medical conditions that cause bone loss and increase fracture risk

Lifestyle factors

Alcohol > 3 drinks/day

High salt intake

Smoking (active or passive)

Low calcium intake

Not enough physical activity

Falling

Vitamin D insufficiency

Immobilization

Weight < 127 lbs

Excess vitamin A

   

 

Genetic

Low sex hormone

Gastrointestinal

Cystic fibrosis

Androgen insensitivity

Celiac disease

Ehlers-Danlos

Anorexia nervosa and bulimia

Gastric bypass

Gaucher’s disease

Hyperprolactinemia

GI surgery

Glycogen storage diseases

Premature menopause

Inflammatory bowel disease

Hemochromatosis

Premature ovarian failure

Malabsorption

Homocystinuria

Athletic amenorrhea

Pancreatic disease

Hypophosphatasia

 

Primary biliary cirrhosis

Idiopathic hypercalciuria

Endocrine

 

Marfan syndrome

Adrenal insufficiency

Central nervous system

Menkes steely hair syndrome

Diabetes mellitus (Type 2)

Epilepsy

Osteogenesis imperfecta

Cushing’s syndrome

Multiple sclerosis

Parent history of hip fracture

Hyperparathyroidism

Parkinson’s disease

Porphyria

Central Adiposity

Spinal cord injury

Riley-Day syndrome

Thyrotoxicosis

Stroke

 

Other
conditions

Hematologic
disorders

Rheumatologic and autoimmune diseases

AIDS/HIV

Multiple myeloma

Ankylosing spondylitis

Alcoholism

Thalassemia

Lupus

Amyloidosis

Leukemia and lymphomas

Rheumatoid arthritis

Chronic metabolic acidosis

Systemic mastocytosis

 

Chronic obstructive lung disease

Hemophilia

 

Congestive heart failure

Monoclonal gammopathies

 

Depression

Sickle cell disease

 

End-stage renal disease

 

 

Hypercalciuria

 

 

Idiopathic Scoliosis

   

Muscular dystrophy

   

Chronic metabolic acidosis

   

Post-transplant bone disease

   

Sarcoidosis

   

Weight loss

   

Reviewed: 10/31/19.
As a service to our readers, American Bone Health provides access to our library of archived content. Please note the date of the last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Low Bone Density | Michigan Medicine

Overview

What is low bone density?

Low bone density (sometimes called osteopenia) refers to bone density that is lower than the normal peak density but not low enough to be classified as osteoporosis. Bone density is a measurement of how dense and strong the bones are. If your bone density is low compared to normal peak density, you are said to have low bone density. Having low bone density means there is a greater risk that, as time passes, you may develop bone density that is very low compared to normal, known as osteoporosis.

What causes low bone density?

Bones naturally become thinner as people grow older because, beginning in middle age, existing bone cells are reabsorbed by the body faster than new bone is made. As this occurs, the bones lose minerals, heaviness (mass), and structure, making them weaker and increasing their risk of breaking. All people begin losing bone mass after they reach peak bone density at about 30 years of age. The thicker your bones are at about age 30, the longer it takes to develop low bone density or osteoporosis.

Some people who have low bone density may not have bone loss. They may just naturally have a lower bone density. Low bone density may also be the result of one or more other conditions, disease processes, or treatments. Women are far more likely to develop low bone density and osteoporosis than men. This is because women have a lower peak bone density and because the loss of bone mass speeds up as hormonal changes take place at the time of menopause. In both men and women, the following things can contribute to low bone density:

  • Eating disorders or metabolism problems that do not allow the body to take in and use enough vitamins and minerals
  • Chemotherapy, or medicines such as steroids used to treat a number of conditions, including asthma
  • Exposure to radiation

Having a family history of osteoporosis, being thin, being white or Asian, getting limited physical activity, smoking, and drinking excessive amounts of alcohol also increase the risk for low bone density and, eventually, osteoporosis.

What are the symptoms?

Low bone density has no symptoms. You notice no pain or change as the bone becomes thinner, although the risk of breaking a bone increases as the bone becomes less dense.

How is low bone density diagnosed?

Low bone density is diagnosed with a bone density test, usually done to see whether you have osteoporosis. The most accurate test of bone density is dual-energy X-ray absorptiometry (DXA), although there are other methods. DXA is a form of X-ray that can detect as little as 2% of bone loss per year. A standard X-ray is not useful in diagnosing low bone density, because it is not sensitive enough to detect small amounts of bone loss or minor changes in bone density. See the topic Osteoporosis for more information on bone density testing.

The United States Preventive Services Task Force (USPSTF) recommends that all women age 65 and older routinely have a bone density test to screen for osteoporosis. If you are at increased risk for fractures caused by osteoporosis, routine screening should begin sooner. footnote 1 USPSTF recommends that you and your doctor check your fracture risk using a tool such as FRAX to help decide whether you should be screened for osteoporosis. Talk to your doctor about your risk factors and when to start bone density screening.

The FRAX tool can help predict your risk of having a fracture related to osteoporosis in the next 10 years. You can use this tool. Go to the website at www.sheffield.ac.uk/FRAX, and click on Calculation Tool. If you have had a bone density test on your hip, you can type in your score. If you have not had that test, you can leave the score blank.

Things that increase risk include:

  • Being white (Caucasian) or, to a lesser degree, being Asian.
  • A family history of osteoporosis.
  • Being thin.
  • Long-term use of corticosteroids, such as hydrocortisone or prednisone for inflammatory conditions, or anticonvulsants, such as carbamazepine (Tegretol), gabapentin (Neurontin), or phenytoin (Dilantin) for pain or seizures.
  • Eating disorders or diseases that affect the absorption of nutrients from food.
  • Being inactive or bedridden for a long period of time.
  • Smoking.
  • Drinking excessive amounts of alcohol.
  • Having a diet low in calcium or vitamin D.

Information for men. Talk to your doctor about your risk factors and whether bone density screening is right for you. Experts disagree about whether to screen men for osteoporosis and which types of men are more likely to benefit.footnote 1, footnote 2 Aside from the hormonal change in women as they go through menopause, the things that put people at risk for low bone density are true for men as well as for women. Men are also at risk if they have low levels of the hormone testosterone. Talk with your doctor if any risk factors apply to you.

How is it treated?

Low bone density is treated by taking steps to keep it from progressing to osteoporosis and, for a few people, by taking medicine. Lifestyle changes can help reduce the bone loss that leads to low bone density and osteoporosis.

What you eat is very important to bone development. Calcium is the most critical mineral for bone mass. Your best sources of calcium are milk and other dairy products, green vegetables, and calcium-enriched products.

Your doctor may also want you to take a calcium supplement, often combined with vitamin D. Vitamin D helps your body absorb calcium and other minerals. It is found in eggs, salmon, sardines, swordfish, and some fish oils. It is added to milk and can be taken in calcium and vitamin supplements. In addition to what you take in from food, your body makes vitamin D in response to sunlight.

Exercise is important for having strong bones, because bone forms in response to stress. Weight-bearing exercises such as walking, hiking, and dancing are all good choices. Adding exercise with light weights or elastic bands can help the bones in the upper body. Talk to your doctor or a physical therapist about starting an exercise program.

In addition to diet and exercise, quitting smoking and avoiding excessive use of alcohol will also reduce your risk of bone loss.

There are medicines for treating bone thinning. But these are more commonly used if you have progressed past low bone density to the more serious condition of osteoporosis. Medicines that may be used for low bone density include bisphosphonates, raloxifene, and hormone replacement. For more information on these medicines, see the topic Osteoporosis.

How can low bone density be prevented?

Whether you will tend to develop low bone density is, in part, already determined. Things like whether you have any family members who have had osteoporosis or low bone density, whether you have chronic asthma that requires you to take steroids, and how much calcium and vitamin D you got while you were growing up are beyond your control now. But if you are a young adult or if you are raising children, there are things you can do to help develop strong bones and help slow down loss of bone and prevent osteoporosis.

Your bones don’t reach their greatest density until you are about 30 years old. So for children and people younger than 30, anything that helps increase bone density will have long-term benefits. To maximize bone density, make sure you get plenty of calcium and vitamin D through your diet and by spending a little time in the sun, get weight-bearing exercise on a regular basis, don’t smoke, and avoid excessive alcohol. If you have children, teach them to eat healthy, get regular exercise, and avoid smoking and alcohol. Also, get them to play a little in the sunshine to help their bodies make more vitamin D. Talk with your doctor about how much and what sources of vitamin D are right for your child.

If you’re older than 30, it’s still not too late to make these lifestyle changes. A balanced diet and regular exercise will help slow the loss of bone density and delay or prevent osteoporosis.

What Women Need to Know

Being female puts you at risk of developing osteoporosis and broken bones. Here are some facts:

  • Of the estimated 10 million Americans with osteoporosis, about eight million or 80% are women.
  • Approximately one in two women over age 50 will break a bone because of osteoporosis.
  • A woman’s risk of breaking a hip is equal to her combined risk of breast, uterine and ovarian cancer.

There are multiple reasons why women are more likely to get osteoporosis than men, including:

    • Women tend to have smaller, thinner bones than men.
    • Estrogen, a hormone in women that protects bones, decreases sharply when women reach menopause, which can cause bone loss. This is why the chance of developing osteoporosis increases as women reach menopause.

Now the good news:

People used to think that osteoporosis was an inevitable part of aging. Today we know a lot more about how to prevent, detect, and treat the disease. You are never too young or old to take care of your bones. Good lifestyle habits can help you protect your bones and decrease your chance of getting osteoporosis. And, if your healthcare provider hasn’t talked to you about your bone health, it’s time for you to bring it up!

What’s Your Risk?

Osteoporosis and bone health issues vary for girls and women of different ages and ethnic backgrounds. Caucasian women, and older women, are most at risk for osteoporosis; however, osteoporosis and low bone density are common among other groups as well. And not only are women at risk; men can develop osteoporosis as well.

Are you …
Caucasian Women
African-American Women
Asian-American Women
Latina Women

Caucasian Women

  • Twenty percent of Caucasian women age 50 and older are estimated to have osteoporosis.
  • More than half of all Caucasian women age 50 and older are estimated to have low bone mass, which means their bones are getting weaker but they don’t yet have osteoporosis.
  • Between the ages of 20 and 80, Caucasian women lose one-third of the bone mineral density in their hip.
  • About 15 percent of Caucasians are lactose intolerant, which can make it difficult to get enough calcium.

African-American Women

  • Five percent of African American women older than 50 are estimated to have osteoporosis.
  • Another 35 percent are estimated to have low bone mass, which means their bones are getting weaker but they don’t yet have osteoporosis.
  • Recent research shows that even among African American women who do have risk factors for osteoporosis, few are screened for the disease.
  • About 70 percent of African Americans are lactose intolerant, which can make it difficult to get enough calcium.
  • Many African American women don’t get enough vitamin D, which can make it hard for the body to absorb calcium.
    In the United States, African American women are more likely than many other racial or ethnic groups to have diseases that can lead to osteoporosis, such as lupus.
  • Click here to download the infographic: Osteoporosis in the Black Community: Practical Tips and Action

Asian-American Women

  • About 20 percent of Asian American women age 50 and older are estimated to have osteoporosis.
  • More than half of all Asian American women age 50 and older are estimated to have low bone density, which means their bones are getting weaker but they don’t yet have osteoporosis.
  • About 90 percent of Asian American adults are lactose intolerant, which can make it difficult to get enough calcium.

Latina Women

  • Ten percent of Latinas have osteoporosis.
  • Half of all Latinas older than 50 have low bone mass, which means their bones are getting weaker but they don’t yet have osteoporosis.
  • Many Latinas are lactose intolerant, which can make it difficult to get enough calcium.
  • Hip fractures among Latinas in the United States appear to be on the rise.

Menopause: A Time for Action

When a woman reaches menopause, her estrogen levels drop and can lead to bone loss. For some women, this bone loss is rapid and severe.

Two major factors that affect your chance of getting osteoporosis are:

  • The amount of bone you have when you reach menopause. The greater your bone density is to begin with, the lower your chance of developing osteoporosis. If you had low peak bone mass or other risk factors that caused you to lose bone, your chance of getting osteoporosis is greater.
  • How fast you lose bone after you reach menopause. For some women, bone loss happens faster than for others. In fact, a woman can lose up to 20% of her bone density during the five – seven years following menopause. If you lose bone quickly, you have a greater chance of developing osteoporosis.

What about taking estrogen?

If you have menopausal symptoms, such as hot flashes, your healthcare provider may prescribe estrogen therapy (ET) or estrogen with progesterone hormone therapy (HT).  In addition to controlling your menopausal symptoms, these therapies can also help prevent bone loss. Some women are advised not to take ET or HT because of the possible risks that may include breast cancer, strokes, heart attacks, blood clots and cognitive (mental) decline. It’s important to discuss the risks and benefits of your treatment options with your healthcare provider.

For more comprehensive information, download NOF’s resource Hormones and Healthy Bones

Teens: What YOU Can Do Now

Osteoporosis is the disease that is most likely to cause weak bones. It is more common in older people, especially women. But it is doesn’t have to happen to YOU when you get older. That’s because, for many people, osteoporosis can be prevented.

Most people don’t have the opportunity that you have right now: YOU can actually build denser, stronger bones now in a way that isn’t possible later. This will make you healthier, and it will set you up to have stronger bones when you are older – when weak bones can be serious.

The recipe for bone health is simple:

Eating Disorders and Other Warning Signs

The eating disorders anorexia and bulimia can weaken your bones and increase your risk of osteoporosis when you are older. If you have anorexia you become very thin, but you don’t eat enough because you think you are fat. Bulimia involves periods of overeating followed by purging, sometimes through vomiting or using laxatives.

You should talk to a parent, doctor, or health professional immediately if you have one of these disorders or if you stop getting your period for more than three months in a row (and you are not pregnant). This is a condition called amenorrhea and it is also bad for your bones.

Young Adult Women

While osteoporosis is most common in older people, it sometimes affects young people, including premenopausal women in their 20s, 30s and 40s. The term “premenopausal” refers to women who are still having regular menstrual periods and have not yet reached menopause. While it is uncommon for premenopausal women to have osteoporosis, some young women have low bone density which increases their chance of getting osteoporosis later in life.

Low Bone Density and Osteoporosis in Young Adult Women

Young women who have low bone density, often caused by low peak bone mass, are at an increased risk of getting osteoporosis later in life.

Often, when premenopausal women have osteoporosis, it may be due to an underlying medical condition or a medicine that causes bone loss. Osteoporosis that is caused by a medical condition or a medicine is called secondary osteoporosis. Sometimes premenopausal women have osteoporosis for no known reason. This is called idiopathic osteoporosis. The term “idiopathic” just means that the osteoporosis is unexplained and we cannot find a cause for it.

Diagnosing Osteoporosis in Young Women

Diagnosing osteoporosis in premenopausal women is not straightforward and can be quite complicated. First of all, bone density tests (jump link to below) are not routinely recommended for young women. Here are some reasons why:

  • Most premenopausal women with low bone density do not have an increased risk of breaking a bone in the near future. Therefore, having information about their bone density may only cause unnecessary worry and expense.
  • Some premenopausal women have low bone density because their genes (family history) caused them to have low peak bone mass. Nothing can or should be done to change this.
  • DXA tests can underestimate bone density in women who are small and thin. Therefore, a DXA test may indicate that a small person has low bone density, but the bone density is actually normal for the person’s body size
  • Osteoporosis medicines are not approved or advised for most premenopausal women. Bone density tests are used to help guide decisions about treatment.

Diagnosing osteoporosis in young women usually involves several steps. While these steps may differ for each person, they may include:

  • Your medical history
  • Physical exam
  • Bone mineral density (bone density) testing
  • Lab  tests
  • X-rays

Bone density testing. A bone density test shows the amount of bone a person has in the hip, spine or other bones. It is routinely recommended for postmenopausal women and men age 50 and older and is how osteoporosis is diagnosed in older people. Bone density tests are usually only done for premenopausal women if they break several bones easily or break bones that are unusual for their age, such as bones in the hip or spine. Also, if you have a condition or take a medicine that causes secondary osteoporosis, your healthcare provider may order a bone density test. This test should be done on a DXA machine. DXA stands for dual energy x-ray absorptiometry.

One or two years after an initial bone density test,  a second bone density may be done and  will determine if you have low peak bone mass that is staying the same or if you are losing bone. If your bone density drops significantly between the first and second test, you may be losing bone and further evaluation by a healthcare provider is needed.

Understanding your bone density test results

A bone density test result shows a Z-score and a T-score. T-scores are used to diagnose osteoporosis in postmenopausal women and men age 50 and older, but not in premenopausal women. A Z-score compares your bone density to what is normal for someone your age. While a Z-score alone is not used to diagnose osteoporosis in premenopausal women, it can provide important information. Read some tips to help you understand your Z-score.

  • If your Z-score is above -2.0, your bone density is considered within the ranges expected for your age or normal according to the International Society for Clinical Densitometry (ISCD). For example, a Z-score of +0.5, -0.5 and -1.5 is considered normal for most premenopausal women.
  • If your Z-score is -2.0 or lower, your bone density is considered below the expected range. Examples are -2.1, -2.3 and -2.5. If your Z-score is in this range, your healthcare provider will consider your health history and possible causes of bone loss, including secondary osteoporosis, before making a diagnosis of osteoporosis.
  • If your Z-score is normal, but you’ve broken one or more bones from a minor injury, your healthcare provider may diagnose you with osteoporosis because some people with normal bone density break bones easily. As mentioned above, a bone density test will also show a T-score. A T-score compares bone density to what is normal in a healthy 30-year-old adult.

Treating Osteoporosis in Young Women

Most of the osteoporosis medicines available at this time are not approved by the FDA for use in premenopausal women. But, for women who have taken steroid medicines for a long time, three osteoporosis medicines are approved for the prevention and treatment of osteoporosis. In very rare cases, a healthcare provider may recommend that a premenopausal woman consider taking an osteoporosis medicine for other reasons. Examples include when a woman breaks a bone because of low bone density or has severe bone loss due to a medical condition.

Expecting Women

If you are pregnant or breastfeeding, be sure to get enough calcium and vitamin D. Calcium and vitamin D are good for you and for your baby’s growing bones. If you don’t get enough of these nutrients, your baby’s calcium needs will be met by taking calcium from your bones.

Most studies show that while some bone loss may occur during pregnancy, a woman usually regains it after giving birth. In fact, studies show that having children, even as many as 10, does not increase a woman’s chance of getting osteoporosis later in life. Research even suggests that each additional pregnancy provides some protection from osteoporosis and broken bones.

Pregnancy-associated osteoporosis.

Some women develop a temporary type of osteoporosis during pregnancy. While we do not fully understand what causes this type of osteoporosis, it is extremely rare and usually goes away shortly after a woman gives birth.

Breast feeding.

Like pregnancy, breastfeeding may cause some temporary bone loss. However, bone density appears to recover over time and should not cause long-term harm to a woman’s bone health. All women who are pregnant or nursing need to get enough calcium, vitamin D and appropriate exercise to keep their bones healthy. If you’re breastfeeding exclusively, ask your child’s pediatrician if you need to give your baby supplemental vitamin D.

Osteoporosis | Causes, symptoms, treatment

There’s a great deal you can do at different stages in your life to help protect yourself against osteoporosis.

Exercise

Any exercise where the bones are made to carry the weight of the body, such as walking, can speed up the process of new bone growing.

The more weight-bearing exercise you do from a young age, the more this will reduce the risk of getting osteoporosis.

If you do have osteoporosis, doing weight-bearing exercise will minimise bone loss and strengthen muscles.

However, all forms of exercise will help to improve co-ordination and keep up muscle strength. This is important because muscles can also become weaker as we get older, and this is a risk factor for falling and therefore for fractures.

T’ai Chi can be very effective in reducing the risk of falls. Doing T’ai Chi regularly will strengthen muscles in the upper body, lower body and the core. It also improves balance.

Walking is a good exercise to improve bone strength and it is also good for keeping thigh and hip muscles strong, which is important to help people have good balance and prevent falls.

High-impact exercise such as skipping, aerobics, weight-training, running, jogging and tennis are thought to be useful for the prevention of osteoporosis. These exercises might not all be suitable if you have osteoporosis.

For more support, motivation and advice talk to your doctor, a physiotherapist or a personal trainer at a gym about your condition and the best exercise for you.

Diet and nutrition

Calcium

The best sources of calcium are:

  • dairy products such as milk, cheese and yogurt (low-fat ones are best)
  • calcium-enriched types of milk made from soya, rice or oats
  • fish that are eaten with the bones, such as tinned sardines.

Other sources of calcium include:

  • leafy green vegetables such as cabbage, kale, broccoli, watercress
  • beans and chick peas
  • some nuts, seeds and dried fruits.

If you don’t eat many dairy products or calcium-enriched substitutes, then you may need a calcium supplement. We recommend you discuss this with your doctor or a dietitian.

The table below lists the approximate calcium content of some common foods.

Food Calcium content (mg)
115 g (4 oz) whitebait (fried in flour) 980
60 g (2 oz) sardines (including bones) 260
0.2 litre (⅓ pint) semi-skimmed milk 230
0.2 litre (⅓ pint) whole milk 220
3 large slices brown or white bread 215
125 g (4½ oz) low-fat yogurt 205
30 g (1 oz) hard cheese 190
0. 2 litre (⅓ pint) calcium-enriched soya milk 180
125 g (4½ oz) calcium-enriched soya yogurt 150
115 g (4 oz) cottage cheese 145
3 large slices wholemeal bread 125
115 g (4 oz) baked beans 60
115 g (4 oz) boiled cabbage 40

Note: measures shown in ounces or pints are approximate conversions only.

Vitamin D

Vitamin D is needed for the body to absorb and process calcium and there’s some evidence that arthritis progresses more quickly in people who don’t have enough vitamin D.

Vitamin D is sometimes called the ‘sunshine vitamin’ because it’s produced by the body when the skin is exposed to sunlight. A slight lack (deficiency) of vitamin D is quite common in the UK in winter.

The National Institute for Health and Clinical Excellence (NICE) has issued guidance on safe sunlight exposure which aims to balance the benefits of vitamin D against the risks of skin cancer from too much exposure to sunlight.

Vitamin D can also be obtained from some foods, especially from oily fish, or from supplements such as fish liver oil. However, it’s important not to take too much fish liver oil.

Because we don’t get enough sunshine all year round in the UK, and because it’s difficult to guarantee getting enough vitamin D from what we eat, Public Health England recommends that everyone should take a 10 microgram supplement of vitamin D every day during the autumn and winter.

People in certain groups at risk of not having enough exposure to sunlight, or whose skin is not able to absorb enough vitamin D from the level of sunshine in the UK, are encouraged to take a daily supplement of 10 micrograms all year round.

For many people, calcium and vitamin D supplements are prescribed together with other osteoporosis treatments.

What else might help?

It’s important to try to prevent falls. Simple things you can do at home include:

  • mopping up spills straight away
  • making sure walkways are free from clutter or trailing wires.

Some hospitals also offer falls prevention clinics or support groups – ask your doctor if there’s one in your area.

Smoking can affect your hormones and so may increase your risk of osteoporosis. We strongly recommend you stop smoking. Support is available if you wish to stop.

Drinking a lot of alcohol can affect the production of new bone, so we recommend keeping within the maximum amounts (14 units per week) suggested by the government.

Osteoporosis: What You Need to Know as You Age

Osteoporosis

Overview

Osteoporosis, literally “porous bone,” is a disease that thins the framework inside bones so much that even a minor fall or bump against a car door or piece of furniture may cause a fracture. A break can happen at any spot on your skeleton, but fractures of the wrist, hip and spine are among the most common.


Keeping your bones strong is a smart goal at any age. But a fracture-proof frame becomes a bigger priority in the decades after age 50, when weakened bones lead to breaks for one in two women and one in five men. Fortunately, there are plenty of steps you can take at home and with your doctor’s help to protect against painful fractures that can reduce your independence and, surprisingly, even increase your risk of dying due to medical complications.

Causes and Risk Factors

Normally, we can’t feel what’s happening inside our bones, explains Deborah Sellmeyer, M.D., medical director of Johns Hopkins Metabolic Bone Center. Yet throughout our life, a team of specialized cells is constantly updating the microscopic framework of collagen (a type of protein) and minerals, including calcium, that keeps bones strong. Like a never-ending highway reconstruction project, old bone is broken down and replaced daily with new bone.

Until about age 25, this project adds more new bone than it takes away, so bone density increases. From about age 25 to age 50, bone density tends to stay stable with equal amounts of bone formation and bone breakdown. After age 50, bone breakdown (resorption) outpaces bone formation and bone loss often accelerates, particularly at the time of menopause.

The risk for osteoporosis and osteopenia—low bone density that’s not yet in the osteoporosis range—is higher in women because female bones typically are smaller and less dense than male bones. The risk increases at menopause, when levels of bone-bolstering estrogen fall. But men are also at risk. A family history of osteoporosis-related fractures boosts odds for both sexes.

Certain medical conditions can threaten bone strength directly or via the effects of medicines and other treatments. These include overactive thyroid or parathyroid glands, chronic lung disease, cancer, endometriosis, a vitamin D deficiency and medications such as prednisone.

Other risk factors include these conditions and practices:

  • low intakes of calcium, vitamin D, potassium or protein
  • inactivity
  • cigarette smoking
  • overuse of alcohol
  • long-term use of such medications as glucocorticoids (such as prednisone for asthma or arthritis), some antiseizure drugs and overuse of aluminum-containing antacids
  • eating disorders that reduce your body weight
  • low levels of estrogen (for women) or testosterone (for men)



 


Prevention

It’s never too early to start thinking about maintaining bone mineral
density. These steps can help prevent osteoporosis.

Hit your calcium quota.
“There is no doubt that getting enough calcium reduces fracture risk,”
Sellmeyer notes. “There has been controversy recently about possible links
between calcium supplements and vascular calcification [calcium depositing
in blood vessels], but this was seen in one study and has not been seen in
many other studies of calcium and vitamin D.” Everyone should meet but not
exceed the recommended intakes listed below. Food sources of calcium have
other good nutrients for bone, such as protein and magnesium, and can
provide all your calcium needs. For those who have difficulty meeting their
calcium requirement through food, supplements are a good alternative.

Aim for these calcium levels:

  • 1,000 milligrams daily for women age 50 and younger and for men 70 and
    younger
  • 1,200 milligrams daily for women over age 50 and men over 70

“The one exception: People on dialysis due to kidney failure should talk
with their doctor about the right calcium intake for them,” says Sellmeyer.

Take in calcium from food or supplements.
Calcium-rich foods include:

  • low-fat or fat-free milk or yogurt (300 mg per cup)
  • greens, such as kale (100 mg in 1 cup cooked kale)
  • tofu that uses calcium for firmness (253 mg per half cup)
  • beans (81 mg in a half cup of white beans, about 40 mg in a half cup of
    pinto beans, 23 mg in a half cup of black beans)
  • calcium-fortified foods, like breakfast cereals and orange juice (up to
    1,000 mg per serving)

Calcium on food labels is given as a percentage of 1,000 mg, so if the
label says “45 percent,” a serving of that food provides 450 mg of calcium.

Add vitamin D.
Getting enough vitamin D helps with calcium absorption and incorporation
into your bones. “The current recommendation is 600 IU of vitamin D per day
through age 70 and 800 IU per day after age 70,” Sellmeyer says. “Some
individuals may need more to achieve good blood vitamin D levels. It’s
difficult getting all of that from food every day, so you may need a
vitamin D supplement to reach these goals.”

Fit in potassium and protein.
In 2013, research by Sellmeyer and colleagues at Johns Hopkins found that
potassium improved calcium metabolism. Adults need 4,700 mg per day, but
most fall short. You’ll find this mineral in fruits and vegetables,
especially bananas, potatoes (with the skin), prunes, orange juice, tomato
juice, raisins, acorn squash, lima beans and spinach. Get enough protein
too. “Bone is interlocked protein strands with minerals and calcium
attached, so protein is important for strong bones,” Sellmeyer says. “In
some studies, protein has helped with bone healing too.”

Get weight-bearing exercise regularly.
Walking, dancing, aerobics class, weight training: “Any activity that puts
your bones to work stimulates the remodeling that keeps bone strong,”
Sellmeyer says. “You don’t have to pay for a gym membership; just get
outside and walk. Start with 15 to 20 minutes a day. If you’re frail, start
by working with a physical therapist who can help you move properly to get
results and stay injury-free.”

Cut back on caffeine and alcohol.
Drinking either in excess can reduce your bone density.

Quit smoking.
Tobacco use leads to significant bone loss in women and men, longer healing
times after a fracture and a higher risk for complications. Quitting can
reduce the added risk.


Diagnosis

“Osteoporosis—the loss of bone density and weakening of your skeleton—is a silent disease and causes no symptoms until someone has a fracture,” says Sellmeyer. So one of the most important steps you can take is to schedule a bone scan when recommended. Bone density tests are recommended for all women age 65 and older, and for younger women at higher-than-normal risk for a fracture. Men may want to discuss osteoporosis screening with their doctor if they’re over age 70 or at high risk for thinning bones. Talk with your doctor about an earlier scan if you have any warning signs or risk factors for osteoporosis:

  • a bone fracture after age 50
  • sudden back pain
  • loss of height or increasingly stooped posture
  • use of medications that can thin bones
  • a bone-threatening medical condition, such as those listed above
  • a family history of osteoporosis or fracture

A bone densitometry test (DXA or DEXA scan) measures your bone mineral density (BMD). Your bone density is then compared to the average BMD of an adult of your sex and race at the age of peak bone mass (approximately age 25 to 30). The result is your T score.

  • A T score of -1 to +1 is considered normal bone density.
  • A T score of -1 to -2.5 indicates osteopenia (low bone density).
  • A T score of -2. 5 or lower is bone density low enough to be categorized as osteoporosis.

It’s important to know that every one-point drop below 0 (0 is BMD on par with a 25- to 35-year-old) doubles the risk for a fracture. Your doctor may also use your BMD results to help calculate an estimation of your risk for any fracture and for a hip fracture in the next 10 years. This fracture prediction is based on your bone density and other risk factors for fracture, such as family history and smoking.

Treatment

If you have osteopenia or osteoporosis, your doctor will recommend prevention steps (outlined above) to help slow down additional bone loss and reduce fracture risk. In addition, she may recommend an osteoporosis medication.

The medication choice will depend on the extent of bone loss, your tolerance for various medications, and the goals you and your doctor set together. “Discuss the risks and benefits of taking a medication—and of not taking a medication—with your doctor,” Sellmeyer suggests. “The side effects of some osteoporosis drugs have received a lot of attention in the media, but deciding not to take one could mean you’re missing out on significant protection against a fracture. Not taking a medication also carries risks. There are trade-offs to think about.”

There are five major types of osteoporosis medications:

  1. Calcitonin is a once-a-day nose spray that studies have shown reduces spinal fractures by 25 percent. “There’s no evidence that it lowers risk for other fractures,” Sellmeyer says. “But it is one of the best-tolerated osteoporosis medications.” There has been some recent concern about a possible 1 percent increased cancer risk with this medication, and it was reviewed by the FDA, which has kept it on the market while recommending the risks and benefits be discussed by each patient and her physician.
  2. Raloxifene is a once-a-day pill; studies have shown it reduces spine fractures by 30 percent. “Raloxifene works by blocking estrogen’s action in some tissues and stimulating it in others,” Sellmeyer says. “It can also reduce breast cancer risk but can cause hot flashes and raise risk for blood clots.”
  3. Bisphosphonates can reduce the risk for spinal fractures by 50 percent to 60 percent and hip fractures by 50 percent. These drugs are available as a once-a-day or once-a-month pill or as a once-a-year intravenous infusion. Side effects include upper gastrointestinal symptoms like heartburn with the oral medications and flu-like symptoms after the first infusion of the intravenous medications. There are also rare risks like poor healing after dental work (approximately 1 in 50,000 patients) and stress fractures after long-term use (approximately 1 in 75,000 patients). Most doctors use these medications intermittently: five to eight years of treatment followed by one or more years off medication, then another five to eight years of treatment if fracture risk is felt to warrant additional medication.
  4. Denosumab is given as an under-the-skin injection twice a year and can reduce the risk for spine fractures by 50 percent to 60 percent and hip fractures by 50 percent. This medication was FDA-approved in 2010. Side effects include skin reactions like rashes or eczema and a small increased risk of infection.
  5. Parathyroid hormone is given as a once-a-day, under-the-skin injection and can reduce spine fracture risk by 65 percent and the risk for other fractures by 53 percent. “This medication stimulates bone remodeling rather than just slowing down bone breakdown, but use is limited to two years at this point,” says Sellmeyer. Side effects include skin reactions at the site of the injection, increases in blood and urine calcium, and bone pain. In high doses, this medication causes a bone cancer called osteosarcoma in rats, but this has not been seen in people.

Learn more about the symptoms, diagnosis and treatment of osteoporosis.


Living With

A diagnosis of osteoporosis can change your life, but you can manage your condition with the healthy steps outlined in the “Prevention” section. Here are a few more tips to help you stay safe and enjoy, as much as possible, the activities you’ve always loved.

Stay active and connected. A physical therapist can help you find ways to move safely in activities and even enjoy a physical relationship with your partner. If you need to modify sport or hobby participation, explain your situation to loved ones and brainstorm new ways to spend time together.

Maintain your balance. Prevent falls by keeping your eyeglass prescription up-to-date and by getting help for hearing loss. (Diminished hearing increases the risk for falls and balance problems.) Keep floors and stairs clear of obstacles that could trip you. Ask about a referral to a physical therapist for safe muscle-building exercises or advice from your doctor about exercises that are right for you. Strong muscles lower your risk for a fall. Ask about exercises that can help you maintain healthy posture, which may reduce the risk for a spine fracture. If your doctor has recommended that you use a walker or cane after an osteoporotic fracture, do so—it will help your balance and allow you to stay more active. If you feel drowsy or dizzy, ask your doctor if this could be a side effect of other medications you may be taking, and ask what you can do about it.

Talk through feelings. Bone loss may lead to feelings of depression if you feel you can no longer do the things you enjoy or have lost independence. Talk with your doctor about your mood and any anxieties you have. Look into support groups too. You’ll find listings on the website of the National Osteoporosis Foundation, nof.org .


Research

Johns Hopkins experts are looking at osteoporosis in many ways but with one
aim: preventing this condition and improving life for people who have it.
Here are some notable findings:

Strong muscles reduce the risk for fragile bones.
In a Johns Hopkins study of 84 people, researchers found that those with
more muscle strength were less likely to have low bone mineral density.
That may be because activities that build strong muscles also stress bones,
thus stimulating growth.

Bone checks reduce hip fracture risk.
In a study of 3,107 people, Johns Hopkins scientists found that those who
were screened for osteoporosis were 36 percent less likely to have a hip
fracture in the next six years. The reason: Screenings can uncover thinning
bones in time for treatment, the researchers suspect.


For Caregivers

You can help a loved one stay strong and fracture-free with these strategies.

Serve a strong diet. When you cook, prepare meals, snacks and desserts that contain bone-friendly foods and ingredients.

Make the most of meds. Help your loved one remember to take osteoporosis medications as directed.

Try simple but powerful fall prevention. Encourage your loved one to wear glasses and hearing aid if needed and to reduce fall risk by wearing supportive shoes and keeping floors clutter-free.

Cheer on fitness. Support your loved one’s efforts to stick with exercise routines recommended by the doctor or physical therapist.

Keep spirits high. If your loved one’s activities are more limited now due to osteoporosis, help her find new ways to socialize and enjoy life.


Definitions

Bone density: The amount of calcium and other minerals inside a section of bone. Strong bones contain a dense framework of protein strands coated with calcium. This support system thins with age, lack of exercise and low intake of calcium and vitamin D, among other reasons. Low bone density increases fracture risk.

 

Estrogen (es-truh-jen): Often referred to as the female sex hormone. Produced by the ovaries and adrenal glands, estrogen is really a group of hormones that regulate the menstrual cycle and affect tissues throughout the body, including the blood vessels and brain. As a medicine, estrogen replacement therapy is used to treat hot flashes due to menopause, vaginal dryness and bone thinning.

 

Risk factor: Anything that boosts your chances of getting a disease. For example, smoking is a risk factor for cancer, and obesity is a risk factor for diabetes.

 

Testosterone (tes-tos-tuh-rohn): One of the male sex hormones. Made by the testes (testicles), testosterone helps maintain muscle mass, red blood cells, bone strength, reproductive health and overall well-being. As men age, levels of this hormone decline, causing decreased sex drive, mood disturbances and other symptoms. Sometimes testosterone replacement therapy is used to treat these symptoms


Bone Loss and its Treatment | Pasadena Periodontics & Dental Implants | Periodontics & Dental Implants

What causes bone loss?

Bone loss is a common consequence of loss of teeth and chronic periodontitis. In the case of periodontitis, the bacteria gradually eats away at the underlying jawbone and at the periodontal ligaments that connect the tooth to the bone.

The most common cause of bone loss is tooth loss left unreplaced, especially multiple teeth. Jawbone is preserved through the pressure and stimulus of chewing. When that is removed through tooth loss, the bone “resorbs” (reabsorbs) into the body. In the first year after tooth extraction 25% of bone is lost, and this bone loss continues on.

Bone loss
Bone Loss Video

This bone loss occurs in the bone surrounding and supporting the tooth, known as alveolar bone. Alveolar bone forms the ridges in which the teeth are embedded. These ridges atrophy both vertically and horizontally.

Replacing teeth with full or partial dentures doesn’t solve the problem as the dentures exert a very small amount of chewing pressure on the bone compared to natural teeth, as low as 10% or less.

Removal of the molars in the upper jaw can cause additional resorption of the bone due to expansion of the sinus cavity. With no teeth in place, the air pressure in the sinus cavity can cause resorption of the bone lining the sinuses.

Other causes of bone loss
  • Bone loss can also be caused by misaligned teeth, creating a situation where normal chewing doesn’t occur, causing loss of the needed stimulus to the bone.
  • Bone can be lost through infection that damages the bone.
  • A large tumor in the face may require removal of the tumor and some of the jaw.

Bone loss and dentures

Dentures can accelerate bone loss by wearing away at the ridges of bone they are placed on. Every time you bite down or clench your teeth you are placing pressure on the ridge, resulting in its resorption. This is a primary cause of continual problems on getting dentures to fit, of sore spots and difficult or painful chewing.

People who wear dentures can experience another severe consequence of bone loss: collapse of the lower third of their face.

The loss of the ridge bone brings your chin closer to the nose, causing your jaw to jut out and your nose appears to stick out further because your upper lip has puckered in. Deep wrinkles appear around the mouth and the cheeks develop “jowls”— sagging skin. This facial collapse can appear to age you by many years!

Preventing bone loss

Bone loss can be prevented by giving the jawbone a replacement tooth with a root that can exert the same or similar pressure as natural teeth. This is done immediately after extraction by replacing single teeth with dental implants, or by using a fixed implant-supported bridge or denture.

A single-tooth implant or a dental bridge with three to four teeth supported by two implants provide a chewing power of 99% of natural bite force. A denture secured with dental implants, such as our Same Day Teeth procedure, provides about 70% to 80% of normal biting force and helps considerably in preventing bone loss.

What about loss of bone density?

When bones loses density it becomes more porous. Density loss is much less common than loss of bone volume, but is something we need to watch out for. Bone can lose density because of a variety of factors, including diet, hormonal imbalance, disease, lifestyle, and even tooth loss.

We can detect low density bone ahead of time using our 3D cone beam CT scanner to capture 3D images. The whiter the color of the bone in the X-ray, the denser it is. We can then avoid these areas of low density, or take precautions by using special implants with a surface that draws the bone to it, which creates denser bone around the implant.

Bone Grafting

Bone Grafting Video

In cases where bone has already been lost, bone grafting might be needed to provide enough bone for dental implant placement. We need enough height of the ridge for any teeth replacement with implants, and when replacing the back teeth (molars), we also need enough width.

We also use bone grafting to repair damaged and lost bone around teeth that have suffered from severe gum disease.

A bone graft not only replaces lost bone, it also stimulates the jawbone to regrow and eventually replaces the bone graft with the patient’s own, healthy bone. We use a variety of different types of bone graft material, depending on the patient, including new cutting-edge materials that require less healing time.

Minimally invasive

Our doctors explain the benefits of minimally invasive dental implants and how they can prevent bone loss.

Drs. Henriod and Hendry can often place the bone graft at the same time as the implant unless the bone loss is severe, in which case it might need to be done as a separate procedure. They use minimally invasive methods, including a gentle laser.

Sinus Lifts

When your upper back teeth have been removed, the ridge bone resorbs and the sinus cavity expands, so that eventually the bone separating the sinus cavity and the oral cavity is very thin.

Dental implants can’t be placed in such thin bone and in these cases Drs. Henriod and Hendry will do a sinus lift. The sinus is raised by gently pushing up the membrane lining the sinus away from your jaw and packing in bone graft material into the space where the sinus cavity was. Once the bone graft material has fully integrated with the jawbone, we can place your implants.

When bone loss doesn’t need bone grafting or sinus lifts

Our 3D cone beam CT scanner is a vital tool for evaluation of the bone density in the jaw and surrounding bone structures.

The good news is that we can help many patients get implants without any kind of bone grafting through the use of our 3D cone beam CT scanner. This breakthrough technology allows us to see the teeth, jaw and related structures in full 360º view. We can measure the exact width and height of your ridges and assess how much, if any, bone grafting is actually needed. In many cases we can find enough bone to use for implants.

The 3D scanner also permits us to perform procedures such as full-mouth teeth replacement, which can be done using just four implants per arch placed where we can take advantage of the bone available.

To make an appointment, call 626.796.5386 or click here to request an appointment online.

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Osteoporosis – NHS

Osteoporosis is a health condition that weakens bones, making them fragile and more likely to break. It develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a bone to break (fracture).

The most common injuries in people with osteoporosis are:

However, breaks can also happen in other bones, such as in the arm or pelvis. Sometimes a cough or sneeze can cause a broken rib or the partial collapse of one of the bones of the spine.

Osteoporosis is not usually painful until a bone is broken, but broken bones in the spine are a common cause of long-term pain.

Although a broken bone is often the first sign of osteoporosis, some older people develop the characteristic stooped (bent forward) posture. It happens when the bones in the spine have broken, making it difficult to support the weight of the body.

Osteoporosis can be treated with bone strengthening medicines.

Bone loss before osteoporosis (osteopenia)

The stage before osteoporosis is called osteopenia. This is when a bone density scan shows you have lower bone density than the average for your age, but not low enough to be classed as osteoporosis.

Osteopenia does not always lead to osteoporosis. It depends on many factors.

If you have osteopenia, there are steps you can take to keep your bones healthy and reduce your risk of developing osteoporosis.

Your doctor may also prescribe one of the bone-strengthening treatments that are given to people with osteoporosis, depending on how weak your bones are and your risk of breaking a bone.

Who’s affected by osteoporosis?

Osteoporosis affects over 3 million people in the UK.

More than 500,000 people receive hospital treatment for fragility fractures (bones that break after falling from standing height or less) every year as a result of osteoporosis.

Causes of osteoporosis

Losing bone is a normal part of ageing, but some people lose bone much faster than normal. This can lead to osteoporosis and an increased risk of broken bones.

Women also lose bone rapidly in the first few years after the menopause. Women are more at risk of osteoporosis than men, particularly if the menopause begins early (before the age of 45) or they’ve had their ovaries removed.

However osteoporosis can also affect men, younger women and children.

Many other factors can also increase the risk of developing osteoporosis, including:

  • taking high-dose steroid tablets for more than 3 months
  • other medical conditions – such as inflammatory conditions, hormone-related conditions, or malabsorption problems
  • a family history of osteoporosis – particularly a hip fracture in a parent
  • long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-oestrogen tablets that many women take after breast cancer
  • having or having had an eating disorder such as anorexia or bulimia
  • having a low body mass index (BMI)
  • not exercising regularly
  • heavy drinking and smoking

Read more about the causes of osteoporosis.

Diagnosing osteoporosis and osteopenia

If your doctor suspects you have osteoporosis, they can work out your future risk of breaking a bone using an online programme, such as FRAX or Q-Fracture.

Bone density scan (DEXA scan)

They may also refer you for a bone density scan to measure your bone strength. It’s a short, painless procedure that takes 10 to 20 minutes, depending on the part of the body being scanned.

Your bone density can be compared to that of a healthy young adult. 

The difference is calculated as a standard deviation (SD) and is called a T score.

Standard deviation is a measure of variability based on an average or expected value. A T score of:

  • above -1 SD is normal 
  • between -1 and -2.5 SD shows bone loss and is defined as osteopenia
  • below -2.5 shows bone loss and is defined as osteoporosis

Treating osteoporosis

Treatment for osteoporosis is based on treating and preventing broken bones, and taking medicine to strengthen your bones.

The decision about whether you need treatment depends on your risk of breaking a bone in the future. This will be based on a number of factors such as your age, sex and the results of your bone density scan.

If you need treatment, your doctor can suggest the safest and most effective treatment plan for you.

Read more about how osteoporosis is treated.

Preventing osteoporosis

If you’re at risk of developing osteoporosis, you should take steps to help keep your bones healthy. This may include:

Read more about preventing osteoporosis.

Living with osteoporosis

If you’re diagnosed with osteoporosis, there are steps you can take to reduce your chances of a fall, such as removing hazards from your home and having regular sight tests and hearing tests.

To help you recover from a fracture, you can try using:

Speak to your GP or nurse if you’re worried about living with a long-term condition. They may be able to answer any questions you have.

You may also find it helpful to talk to a trained counsellor or psychologist, or other people with the condition.

The Royal Osteoporosis Society can put you in touch with local support groups.

Read more about living with osteoporosis.

Osteoporosis support

The Royal Osteoporosis Society is the UK’s national charity for osteoporosis.

It has detailed information on osteoporosis prevention and treatment.

It can put you in touch with local support groups. It also has a free telephone helpline that may be particularly helpful if you’re newly diagnosed with osteoporosis.

Information:

Social care and support guide

If you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they’re ill, elderly or disabled, including family members

Our guide to care and support explains your options and where you can get support.

Page last reviewed: 18 June 2019
Next review due: 18 June 2022

90,000 Know the types of osteoporosis to have less painful aging

Did you know that there are different types of osteoporosis? Although white women are most at risk of osteoporosis, the disease is not discriminatory, and men, women and children of all skin colors and races can develop osteoporosis.

Women in their 50s are more likely than men to experience rapid bone loss. Of course, men over 60 will have this process and will develop pneumonia at the same rate.According to reliable statistics, more than two million men are currently suffering from osteoporosis, and another 12 million are at risk without knowing it. One in four men over 50 even have a bone fracture due to osteoporosis. Therefore, osteoporosis cannot be considered specific to women.

What is osteoporosis?

Osteoporosis involves the loss of bone mineral density, which leads to weakening of the bones. This problem can start at different ages and for different reasons, and the type of treatment depends on the type of osteoporosis.

What is osteopenia?

Osteopenia is a condition in which bones become thinner, but not as severe as in osteoporosis. Although a person with osteopenia does not yet have osteoporosis; but he is very prone to osteoporosis.

How is the difference between osteopenia and osteoporosis determined?

The difference between osteopenia and osteoporosis is usually determined by the results of the determination of bone mineral density (BMD). The result of the BMD test is known as the T score and the threshold for T scores is defined as follows:

  • Negative 1 or higher: Normal Bone Density
  • Less than minus one or more negative 2.5: osteopenia
  • Negative 2.5 and below: osteoporosis

Types of osteoporosis

Osteoporosis is divided into primary, secondary and rare.

Primary osteoporosis

Osteoporosis, which has no known cause and usually occurs with age, is known as primary osteoporosis. With age, the process of bone resorption becomes faster than bone regeneration (bone formation). This imbalance results in decreased bone mass and loss of structural integrity, leaving bones thin, weak, and prone to fracture.This type of osteoporosis is the most common type and is divided into two types: one (I) and two (II).

Primary osteoporosis of the first type

Osteoporosis type 1 is more common in women. This is why it is also known as menopausal osteoporosis. Osteoporosis type 1 usually develops gradually between the ages of 50 and 70, when the protective effects of estrogen disappear in women. This is especially true for white women and Asian women, especially women with small, thin bones.Fractures of the wrist and spine fall into this category.

Read more: Spine Surgery

Primary osteoporosis type 2

Osteoporosis type II is also known as senile osteoporosis. This type of osteoporosis occurs after age 70, and fractures of the pelvis and spine are very common with this type.

Of course, there is some overlap between type I and type II osteoporosis.

Secondary osteoporosis

When osteoporosis develops due to a health condition or medical treatment, it is called secondary osteoporosis.A disease or drug can directly or indirectly affect bone metabolism, leading to a decrease in bone density and the risk of osteoporosis.

Conditions including renal failure, celiac disease, irritable bowel syndrome, anorexia nervosa, gastric bypass surgery, leukemia, endocrine dysfunction, Cushing’s syndrome, cystic fibrosis, diabetes, homocystinuria, which is a genetic metabolic disorder such as hyperparathyroidism, hyperthyroidism, juvenile arthritis , leukemia, malabsorption syndrome, and osteogenesis imperfecta, sometimes called brittle bone disease, including thyroid disease.Causes secondary osteoporosis.

Collagen disorders that result in too much or too little collagen production in the body, such as osteoporosis and Marfan syndrome, autoimmune disorders in which bone growth is reduced or impaired, vitamin D deficiency, rheumatoid arthritis, ankylosing spondylitis, and multiple sclerosis. Kidney diseases are also diseases that lead to secondary osteoporosis.

Medical treatments that can cause osteoporosis include corticosteroids such as prednisolone, certain breast cancer medications, and deproprovera (medroxyprogesterone).

Rare types of osteoporosis

Some types of osteoporosis are rare, but knowing them can help.

Pregnancy Osteoporosis

Osteoporosis associated with pregnancy is rare. In this case, a healthy woman suffers from unusual fractures as a result of a decrease in bone mineral density during pregnancy or shortly after childbirth. Fractures associated with this type of osteoporosis are very painful and usually occur in the spine or hip.Women with gestational osteoporosis recover completely. It is unclear why some women develop osteoporosis during pregnancy.

Idiopathic

Idiopathic is a rare form of osteoporosis in children, the cause of which is still unknown. This condition of osteoporosis usually occurs before puberty. Of course, during puberty, some bones are rebuilt, but still their bones will not be as normal as the density of the bones of an adult.Whatever the cause, osteoporosis is a very serious condition in children and adolescents. Everyone between the ages of 18 and 20 builds about 90 percent of their bone mass. Bone loss during the peak years of ossification can put a child at serious risk of long-term complications such as permanent fractures.

Are the factors that influence osteoporosis genetic or environmental?

In most people, a combination of genetic and environmental factors leads to the development of osteoporosis (primary osteoporosis).In other cases, osteoporosis is caused directly by a disease or drug (secondary osteoporosis).

Age is the biggest risk factor for developing osteoporosis in every person. The risk of developing the disease usually increases after age 50. For women, lowering hormone levels after menopause increases the risk of osteoporosis. But there are other factors as well.

Genetics

Osteoporosis is somewhat inherited in families. Studies have shown that genetics can affect bone mineral density (BMD) by up to 75%.For this reason, people with a family history of osteoporosis are advised to have their bone density measured as soon as possible.

Half of women and a quarter of men over 50 suffer from osteoporosis. The higher incidence of osteoporosis in women is partly due to their thinner ossification, which can also be traced back to their genetic background.

Race also has some effect on osteoporosis. Studies have shown that women of Asian and European descent are more likely to develop osteoporosis than women of other races.

Environmental factors

Researchers have identified many environmental factors associated with osteoporosis.

Diet can be an effective factor in osteoporosis. Calcium and Vitamin D are essential for building strong bones. People who do not get enough of these nutrients in their diet or do not get enough of them in early adulthood when building bone mass are at risk of developing osteoporosis.

A sedentary lifestyle in early adulthood can lead to lower peak bone mineral density and a higher risk of osteoporosis.Excessive smoking also decreases bone mass.

Researchers have shown a strong association between chronic and excessive alcohol use and decreased bone density. Caffeinated beverages are also thought to reduce calcium absorption and bone loss.

Ovoferectomy (surgical removal of the ovary) causes menopause before age 45. With the removal of the uterus, the amount of estrogen decreases, and this decrease decreases bone mineral density.

Girls and young women who lose weight and exercise excessively may experience a delay in menstruation or even stop menstruation. This condition is called amenorrhea. When the menstrual cycle is not performed properly, the level of estrogen in the blood decreases and leads to osteoporosis.

A diet low in calcium and a lack of nutrients that affect bone density also play an important role in increasing osteoporosis in young women.For example, teenage girls who limit their diet to achieve their desired body size, young athletes who lose weight to run faster and dance better, and those who work professionally in sports such as gymnastics and ice skating, more prone to this. They have irregular periods or even no periods. These young women and girls may be normal in appearance, but they develop osteoporosis due to irregular or absent menstruation, and in many cases their bone fractures are due to this osteoporosis.About 30% of ballet dancers suffer from recurrent leg fractures, mainly due to osteoporosis.

What are the symptoms of osteoporosis?

Osteoporosis itself has no obvious pain or symptoms. Symptoms usually occur when the spine is unable to handle the stresses of daily life. For example, slowly falling or even lifting a bag of food from the trunk of a car. Sometimes they show completely unexpected symptoms. For example, a person falls to the ground or throws all their weight on the spine while sitting or standing, and suddenly a fracture occurs and the person feels pain.This type is called a “compression fracture.” “Progressive osteoporosis can lead to multiple compression fractures of the spine.

Fractures may be the first sign of osteoporosis. As a result of this fracture, the person gradually develops back pain and a hump in the upper back. Sometimes, even due to multiple vertebral fractures, a person’s height is shortened.

Other symptoms of osteoporosis include loss of mobility and instability during daily activities due to weak bones.

What can I do to prevent osteoporosis?

Exercise

Like muscles, your bones must work regularly to stay strong. Research shows that young women who practice athletics have the highest bone density. They also show that postmenopausal women who exercise regularly can prevent osteoporosis by about one percent per year.

Exercises recommended for patients with osteoporosis include walking, jogging, tai chi, yoga, pilates, tennis if possible, and leisurely dancing.

All of these exercises are suitable for patients with osteoporosis, but before starting a new exercise program, you should consult your doctor to ensure that the exercise is safe. If a person already has a fracture, his or her exercise options are usually limited to prevent further injury.

Eat healthy foods rich in calcium and vitamin D.

Adults (men and women) under the age of 50 need 1000 mg of calcium daily. All women over the age of 50 should get 1200 mg of calcium daily.Men aged 51 to 70 should receive 1000 mg of calcium and 1200 mg of calcium daily after age 70.

If you have a dairy restriction, your doctor may recommend supplements. Or, they recommend using other sources of calcium in your diet, including dark leafy vegetables (such as spinach, broccoli, and kale), and foods and juices that are high in calcium.

Men and women under the age of 70 need 600 IU of vitamin D daily.This level rises to 800 IU of vitamin D after age 70.

How is osteoporosis treated?

There is no cure for osteoporosis, but there are many treatments to control the condition and help slow the progression of bone loss, such as medications and hormone therapy. Early detection is very important to control osteoporosis.

Medications are only available with a doctor’s prescription because other medications and medical concerns must be checked before taking osteoporosis medications to ensure that the prescribed medication does not pose any other risk to the patient.These drugs are usually prescribed when a patient has severe osteoporosis and is relatively likely to have a fracture. These include bisphosphonates (Alendronate, Zoldronic acid, Ibandronate, and Risedronate), thyroid and parathyroid medications (calcitonin, abaloparatide, and Teriparatide), and estrogen medications.

What are the consequences of ignoring osteoporosis?

The earlier a disease is diagnosed, the more opportunities to prevent its development.If osteoporosis is diagnosed early enough, doctors can keep bones as strong as possible.

A person with osteoporosis is very susceptible to bone fractures. People with severe osteoporosis can have fractures or fractures, even with a slight fall, or even light movements such as sprains or coughs can lead to fractures.

Bone fractures in patients with weak or fragile bones can also be life-threatening. Many patients (20 to 40%) with osteoporosis who develop a hip fracture die.A hip fracture is very painful and very debilitating. This is because instead of breaking into large pieces, the bone breaks into smaller pieces due to the void. Broken bone is much more difficult to repair and heal.

Compression fractures of the spine are also a complication associated with osteoporosis. The vertebral discs in the spine can collapse, causing pain and hump in the upper back. These factors reduce growth by compressing the torso and abdomen.When the height is bent and short, the space required for cardio-respiratory activity is reduced, and sometimes a person has breathing and heart problems.

Result

Osteoporosis can occur for a variety of reasons. Primary osteoporosis is caused by natural age-related changes in bone density. Some cases of osteoporosis are caused by a disease or drug called secondary osteoporosis.

Clinical diagnosis allows you to determine whether the disease is primary or secondary.Because the treatments for primary and secondary osteoporosis are different, it is important to know if osteoporosis is age-related or caused by another underlying medical condition in order to find the best treatment.

Osteoporosis and postmenopause – gynecological clinic

La osteoporosis is probably more frequent metabolic disorders of bones , osteoporosis This implies a decrease in bone mass and deterioration of its microarchitecture, leading to an increase in bone fragility, which leads to an increased risk of fractures.Not to be confused with OSTEOPENIA which is the loss of a certain amount of bone tissue depending on age.

La bone loss at any age is the result of two variables: the amount of bone achieved during growth (maximum bone mass) and the subsequent rate of bone loss. Factors affecting maximum bone mass are of various origins, such as genetic, nutritional, hormonal, paracrine, and mechanical.Therefore, risk factors for osteoporosis they may be associated with factors associated with low bone mass and premature or accelerated loss.

Clinically, osteoporosis , characterized by a increased risk of fractures with respect to habitual movements and / or minimal or implicit trauma.
This is due to an imbalance between bone resorption (destruction), which increases, and formation, which decreases. However, postmenopausal osteoporosis It is not a homogeneous disease, and its prevalence in the population differs and varies depending on the various factors affecting it.In general terms, it can be argued that postmenopausal osteoporosis this will affect some groups more than others, depending on the so-called “risk factors and / or predisposing factors”.

Of all the risk factors, the most important and decisive in the pathogenesis of postmenopausal osteoporosis a, corresponds to estrogens, although to a greater or lesser extent associated with others. For this reason, although in the climacteric period almost all women experience a large loss of bone mass, it has been proven that not everyone will develop OSTEOPOROSIS .

The fact that this is an age-related disease due to the progressive aging of the population makes it increasingly important as it can affect 50% of women. postmenopausal. The main consequences of this process are fractures, the most typical for this process are: the spine (20% of women aged 70), the proximal femur (16% of women aged 70), the distal third of the radius, ribs, etc. humerus and pelvis. These fractures include: high immediate mortality, usually caused by complications such as pulmonary embolism and pneumonia; the consequences of disability and chronic morbidity in fractures of the proximal femur (16% of women aged 75) and vertebrates (20% of women aged 70) with consequences for the quality of life.

How to prevent osteoporosis

As for OSTEOPOROSIS Ideal treatment is treatment that prevents or slows down bone loss and prevents fractures:

GENERAL AND PREVENTIVE MEASURES

They should start as early as possible, during childhood and adolescence, and include:

  • THE RIGHT DIET : Reduce the amount of coffee and cola, because they interfere with the absorption of calcium and increase its loss in urine and feces.
    With regard to alcohol, it is recommended to reduce alcohol intake as much as possible because it increases bone loss due to impaired calcium and phosphorus metabolism, increased secretion of corticosteroids, malabsorption and altered liver vitamin D metabolism.
  • ADEQUATE CALCIUM ADMINISTRATION Although there is still discrepancy regarding the “recommended dietary allowance” for calcium in peri- and postmenopausal women, requirements are between 800 and 1200 mg.per day in perimenopause and between 1200-1500 mg. day in postmenopausal women. These recommendations should be adapted to individual needs and therefore changed if dietary habits reflect eating with limited calcium bioavailability or excessive sodium, protein, carbohydrate intake, or the use of calcium-lowering medications. The efficiency of calcium absorption and / or increase the loss of calcium in the urine.

A typical dairy-free diet contains about 300 mg.calcium, a glass of milk 240 mg. and 150 grams of fresh cheese 600 mg. In addition to milk and its derivatives, they contain calcium: cabbage, brokil, green beans, fresh and canned sardines, anchovies, vegetables, endives, endives, nuts, squid, shrimps, chickpeas.

There is no definite relationship between dietary calcium intake and urinary calcium excretion at doses of 1000-1500 mg. day; And there is no need to worry about the possibility of kidney stones in patients who are not initially predisposed to urinate.

Recommended calcium values:

National Institutes of Health:

  • in premenopausal women 25-50 years …………… .1000 mg / day
  • postmenopausal <65 years ……………… 1000 mg / day
  • in postmenopausal women without HRT ………………. 1500 mg / day
  • 90,021 women> 65 years of age ……………………………. 1500 mg / day

National Academy of Sciences:

  • Woman 31-50 years old ………………………. 1000 mg / day
  • 90,021 women> 50 years old ……………………………..1200 mg / day

HYGIENE AND PREVENTIVE STANDARDS

  • BURN UP (15-20 minutes) After this time, the reaction is saturated, so that ultraviolet light converts 7-dehydrocholesterol to vitamin D. This photochemical reaction occurs in the surface layer.
  • REMOVE TOBACCO : Promotes bone loss. Improves menopause by acting on the central nervous system (hypothalamus) and altering liver metabolism.Also by direct action on the ovaries, causing them to prematurely age.
  • AVOID FALLS : Use a cane if they feel insecure and women who wear glasses adjust the prescription as many times as necessary. Look after
    blood pressure, watch out for slippery floors, bath and shower, and stairs.

PHYSICAL EXERCISE

The effects of gravity on bones and the forces of contracted muscles help maintain a positive balance between bone formation and destruction.Physical inactivity increases resorption and decreases its formation. Numerous studies have shown that exercise programs, usually lasting several months, increase BMD by 90,181 postmenopausal women compared to non-exercisable controls.

Los
Benefits of Exercise on Bones They are located in the body, meaning strengthening the muscles in the back will strengthen the vertebrae, but not the bones of the forearm.

The duration of muscle activity, such as standing, may be more important than the strength or energy with which it is performed. This exercise should always be performed depending on the age, general condition and condition of the woman’s bones and, of course, previous sports habits.

Women without risk of fractures can engage in any kind of physical activity. Recommended for women at risk of fracture:

  • Walk : Faster than walking.At least 30 minutes a day. It combines stimuli of mechanical forces acting on the bones of the spine and lower extremities with impulses of periodic contractions of the muscles of the back.
  • Ciclismo : Preliminary instructions on posture, seat height, resistance and speed should be obtained from the physiotherapist. The pulse should be monitored to avoid overexertion.
  • Specific exercises : For the back to strengthen the extensor muscles of the spine.These muscles are attached directly to the vertebrae, so their contractions stimulate bone formation and reduce resorption. These exercises should be dynamic and repetitive.

Women with significant osteoporosis should not be allowed aerobic exercise or those that involve jumping or twisting. , as well as bending over their backs, they should not lift weights, when bending they should bend their knees, they will carefully get out of bed, first lying on their side

90,000 The fragile generation of Pepsi | Ministry of Health of the Chuvash Republic

In the capital of Chuvashia, on the basis of the Republican Clinical Hospital, a study of bone density was carried out in residents of the republic.It is too early to speak about the results of the survey, but the first data are depressing: the tendency to osteoporosis in young people is often higher than in women of Balzac’s age. What’s the matter here? Our correspondent tried to figure it out together with Doctor of Medical Sciences Igor Madyanov.
– Igor Vyacheslavovich, why did they talk so much about osteoporosis? After all, this is not cancer, not a heart attack, from which you can die pretty quickly?
– I’m afraid to upset you, but osteoporosis as a cause of death and disability in people over 50 is in fourth place after cardiovascular diseases, cancer and diabetes mellitus.What is this ailment? Imagine a bone. It has two components: organic and mineral. That is, bones are made up of proteins and minerals. If, for some reason, calcium is washed out of them, or the destruction of protein suddenly occurs, then the bone loses its strength. It breaks easily, but grows together, on the contrary, very badly. Every third woman and every fifth man after age 50 become victims of this disease. These are people full of strength and energy who cannot work for quite a long time, relatives have to take care of them, they often become disabled if a spine or hip fracture occurs, and even die.There is something to worry about.
– How does osteoporosis occur, what causes it?
– There are many reasons. Let’s go in order. At the age of up to 25 years, a skeleton is formed in a person. If a failure occurs at this age, then nothing can be corrected later. After 25 we use the stocks we made. If the child is poorly fed, not given enough protein, and this is not only meat, but also cottage cheese, milk, if it is not enough to keep the child outside, and not just outside, but in the sun to form vitamin D, then he will not be able to accumulate sufficient margin of bone strength.What we have? Our children are deprived of the southern sun due to geographical reasons, and there is nothing to be done about it, this is a given. Our children do not drink fish oil, as we did, forced by our parents, do not eat enough sea fish, because we have different eating habits. But our children, instead of cottage cheese and milk, adore salty chips and fizzy drinks. Why is that bad? Excess salt depletes calcium, and drinks containing caffeine contribute to poor absorption of calcium, even when it is ingested.In addition, children move little, and physical inactivity also causes a loss of calcium. And it is especially bad when girls, exhausted by diets, smoke: they already have problems, and then there is nicotine, which aggravates the situation.
– So that’s why the research found that girls in their twenties have low bone density?
– Alas! It may be too early to talk about osteoporosis in them, but there is no doubt that they suffer from osteopenia. And one can only grieve about what awaits them.After all, when they want to become mothers, first of all they will lose their teeth. They will have problems carrying and giving birth to a child. In addition, their children will have some pretty serious health problems. And, in addition, they become candidates for bone fractures in old age.
– Is the nation in danger?
– And in what kind. No wonder that schools banned the sale of cola-like drinks and fast food. The child should drink milk, kefir, eat cottage cheese, move a lot in the fresh air. In our republic there are no extreme forms of rickets, but there is a chronic vitamin D deficiency.
– Why do you put such an emphasis on movement?
– When our astronauts flew into space, no one worried that they would be immobilized. And the first thing the doctors faced after the return of their wards to the earth was the strongest loss of bone mass. I will not go into the details of the physiology, why this is happening, I will only say that the conclusions have been drawn: now the cosmonauts have special suits, simulators so that they can move.
– Is it really that simple: eat cottage cheese to get calcium and protein, lead a healthy lifestyle and you will be happy?
– As far as osteoporosis is concerned, in most cases this is the case.There are also reasons for its occurrence, but this already applies to not very healthy people. Vitamin D is activated in the liver and ends its cycle in the kidneys. And if you have problems with these organs, then you are a candidate for osteoporosis. If a person has had surgery on the stomach and intestines or has endocrine diseases, problems cannot be avoided either. Also on this list are people who have been taking corticosteroid hormones for more than three months.
– How to determine if osteoporosis has already appeared or not? Does he have any symptoms? After all, when a person begins to break his arms, legs, spine, it will be too late.
– The very first symptom of the disease is not fractures, you are right, but back pain. When a person suffers from back pain, it is poorly removed by non-steroidal anti-inflammatory drugs, then one should look not for osteochondrosis, but osteoporosis. From a lack of calcium, there can be cramps in the calf muscles, lethargy, fatigue, which is attributed to chronic fatigue syndrome, who knows where it comes from stoop.
– Igor Vyacheslavovich, is it possible to reverse the disease?
– If you are over 25 years old, you can prevent worsening of the condition.But this is not bad either, because a person’s safety margin is quite high. But you still need to start from childhood.

Osteoporosis

Osteoporosis is a bone disorder in which the skeletal elements become thin and brittle. With this ailment, cavities are formed inside the bones, the inner space begins to resemble a sponge. Osteoporosis patients are often hospitalized with fractures of the hip, wrist, and spine.These injuries significantly affect daily activities, and can lead to forced changes in lifestyle.
On x-rays, it is easy to distinguish thinned bone after suffering certain diseases from a healthy element of the skeleton.
Osteoporosis affects millions of adults. This disease most often makes itself felt after 60 years. Women suffer from osteoporosis more often than men.

What are the causes of osteoporosis?
During childhood and adolescence, new bone tissue grows much faster than the body dissolves old cells.After 30 years of life, this ratio of the activity of the processes of growth and dissolution of osteocytes changes. The processes of forming new cells and replacing old ones are normal stages of aging, during which bones become thinner. Persons whose bone mineralization in youth has not reached the required level are more prone to osteoporosis.
Bone loss is accelerated in postmenopausal women as the ovaries decrease the production of estrogen, a hormone that prevents calcium from being leached from the bones.Men are protected from the decrease in bone mineralization by another hormone called testosterone. In representatives of a strong half of humanity, osteoporosis occurs after 65 years, when the level of the main male hormone decreases with aging. The older a person becomes, both a woman and a man, the higher the likelihood of developing osteoporosis.
Insufficient calcium in food and inadequately low production of vitamin D by the human body accelerates the process of thinning of bone structures.In addition, the propensity to lose bone mass can be passed on from parent to child.

What are the symptoms of osteoporosis?
In the early stages of the development of the disease, a person may not notice any changes in his body. The progression of osteoporosis leads to the appearance of specific symptoms of bone thinning:
• Back pain
• Decreased stature and stoop
• Curvature of the back circumference (“widow’s hump”)
• Fractures of bones from minimal physical impact.Most often, injuries are localized in the thigh, spine and wrist.
• Compression fractures of the vertebrae, resulting in very severe back pain. Only sometimes, the aforementioned injuries are accompanied by minor discomfort or do not make themselves felt at all.

What is the root of the disease?
In a healthy person, bones are continuously dissolved and re-created. In adolescence, new bone tissue appears much faster than the body has time to destroy it, which is why a person grows and gains bone mass.By the age of 30, the process of skeletal formation ends. The more bone mass you can build up in youth, the less chances you have to get osteoporosis in old age.
After age 30, men and women lose a small amount of bone each year. Due to the fact that the stronger sex has a more developed skeleton, osteoporosis occurs much later than in women.
Thinning bone leads to a decrease in bone mass (osteopenia), which can develop into osteoporosis over time.
Thin bones lose their strength and often break. Most often, damage is localized in the following parts of the skeleton:
• Spine. More than half of the fractures due to osteoporosis occur in the spine. Men and women who have suffered a vertebral injury at one point are at increased risk of spine injury in the future. When the vertebrae are weakened in osteoporosis, compression fractures can occur when the aforementioned bones collapse and press into each other.Compression injuries of the ridge are manifested by pain, stoop, decreased growth, curvature of the back surface (“widow’s hump”).
• Hip. Hip fractures are extremely common in older women, especially in falls. These injuries are classified as very serious injuries and often require complex surgical treatment. After the occurrence of a hip fracture, complications such as thrombosis, bedsores, pneumonia are often observed.
• Wrist and forearm. Fractures of this localization cause limitation of hand mobility and working capacity in general.
Bone loss in women accelerates after menopause when the ovaries reduce the secretion of estrogen, a hormone that prevents calcium from being leached from the skeleton.
The hormone testosterone protects men from osteoporosis. A pathological decrease in bone mass is observed in the stronger sex after 65 years.

What are the risk factors for osteoporosis?
The likelihood of developing this ailment increases significantly with age, when the bones of all people become thinner.After 30 years, the rate of dissolution and absorption of bone tissue begins to exceed the rate of creation of new osteocytes. This natural process results in a small amount of bone loss every year.
After 45 years, the dissolution of bones is accelerated due to the lack of the hormone estrogen in women and testosterone in men. The first symptoms and problems appear closer to 60 years of age.
The occurrence of osteoporosis depends on the degree of skeletal mineralization in youth, nutrition, physical activity throughout life.
Factors that accelerate the development of osteoporosis in men and women include:
• Family predisposition. If parents or siblings suffered from osteoporosis, sudden bone fractures with little physical impact, then the risk of these problems in close relatives is very high.
• Life style. These include:

  • smoking. Smokers lose bone mass much faster than non-smokers.
  • Alcohol abuse.Drinking alcohol slows down the formation of the skeleton and its mineralization, increases the likelihood of falls. Abuse is considered to be more than 2 servings of alcohol by men and more than 1 serving of alcohol by women.
  • Sedentary lifestyle. Any physical activity that affects the skeleton, such as walking, climbing stairs, dancing, carrying things, maintains the strength and health of bones and muscles. A variety of movements improve coordination of movements and prevent sudden loss of balance and falls.
  • Lack of calcium and vitamin D in food.

Additional risk factors for osteoporosis:
• Prolonged immobility, bed rest treatment.
• Excessive dietary habits, eating disorders such as anorexia nervosa.
• Engaging in women’s athletics with an irregular menstrual cycle due to insufficient body fat.
Postmenopausal women are at greatest risk due to a pronounced decrease in ovarian estrogen secretion.This hormone protects against the leaching of salts from the bones. Women who stop their menstrual cycle with age or after surgery are at greater risk of developing osteoporosis.
If the doctor suspects the presence of osteoporosis in a patient, then the patient will be prescribed screening tests to clarify the diagnosis. This set of diagnostic measures is shown in the following cases:
• Frequent bone fractures with minimal physical impact
• Concomitant diseases leading to bone loss
• Presence of risk factors or symptoms of osteoporosis

You must refrain from eating for 2-3 hours.

bone loss – Translation into Russian – examples English


These examples may contain rude words based on your search.


These examples may contain colloquial words based on your search.

At first I thought her severe muscle atrophy and bone loss was a side effect of the disease.

At first, I thought her severe muscular atrophy and bone loss were a side effect of the disease.

In addition, causes bone loss and muscle and increasing lean body mass.

It also causes bone loss and muscle and muscle gain.

And eventually, you’re looking at bone loss .

Okay, extreme soft-tissue damage and massive bone loss in here.

Extreme soft tissue injury and extensive bone loss .

Understanding the mechanism of bone loss , or osteoporosis, induced by both microgravity and functional disuse could also make a contribution to aging societies.

Understanding the mechanism of bone loss or osteoporosis, caused by both microgravity and functional inactivity, may also be important in countries where societies are “aging”.

Denosumab is used for those with osteoporosis at high risk for fractures, bone loss due to certain medications, and in those with bone metastases.

Denosumab is used for osteoporotic patients who are at high risk for fractures; Bone loss due to certain medications and in people with bone metastases.

Due to the effects of microgravity you and your passengers may have suffered some … slight bone loss , but I am sure a few laps around the ship’s jogging track will get you get you back in shape in no time We have a jogging track?

Due to the effects of microgravity, you and your passengers may have suffered some… a slight bone loss , but I’m sure a few laps on the ship’s treadmill will get you back in shape in no time. We have a treadmill?

Bone loss is a common side effect.

The initial rationale for their use in humans was their potential in preventing the dissolution of hydroxylapatite, the principal bone mineral, thus arresting bone loss .

The rationale for medical use is their ability to prevent dissolution of hydroxyapatite, a major bone mineral, thereby reducing bone loss .

Judging by the bone loss from the cuts, a saw blade about two-millimeters thick.

Judging by the amount of bone tissue lost during the cut, the saw blade was approximately 2 millimeters thick.

From astronauts’ experiences in space, we know that spending time in a microgravity environment means bone loss , muscle atrophy, cardiovascular problems, among many other complications that range for the physiological to the psychological.

From the experience of astronauts in space, we know that being in microgravity leads to decreased bone mass , muscle atrophy and cardiovascular problems, as well as many other complications, from physiological to psychological.

(a) Research on aging, including research on muscle loss, bone loss , neurovestibular changes and vision impacts;

a) research into the problems of aging, including research into muscle dystrophy, bone loss tissue, neurovestibular disorders and visual impairment;

But the effects of microgravity, you and your passengers may have suffered some slight bone loss .

Perhaps due to microgravity … you yourself and your passengers have lost their former slenderness. Well, it doesn’t matter!

90,000 Osteoporosis in the elderly: diagnosis, treatment, prevention

What is osteoporosis? Why does this disease more often affect women? How to get diagnosed and where to get help in treating the disease?

Osteoporosis is a chronic pathology, as a result of which the density decreases and the structure of the bone tissue is disturbed.Failure occurs due to improper metabolism in the body. Osteoporosis in women and men results in fragility of bones, which leads to fractures even with minimal exposure.

Statistics show that in Russia, on average, every fourth person over 50 is sick with osteoporosis. The WHO ranks osteoporosis as the fourth most common non-communicable disease. It is a “silent killer” with subtle symptoms in the early stages of the disease.No more than 1% of patients know about its appearance in their bodies.

Osteoporosis – what is this disease

It is accepted to distinguish primary and secondary osteoporosis. The first occurs in 80-85% of cases, the second accounts for no more than 15-20%. The primary form of osteoporosis is divided into 4 types:

  1. In postmenopausal osteoporosis, bone mass decreases rapidly with primary damage to the trabecular bone. During illness, fractures of the bones of the distal forearm often appear.
  2. In senile osteoporosis, age-related bone loss occurs. The skeleton suffers from increased fragility in the spine, thighs, and forearms.
  3. In juvenile osteoporosis, the disease affects the bones of young people aged 8-14 years.
  4. In idiopathic osteoporosis, the skeleton becomes fragile and prone to fracture.

Secondary osteoporosis is more likely to get sick with the following diseases: genetic pathologies, renal hypercalciuria, Gaucher disease, muscoviscidosis and other disorders.

Causes of osteoporosis

There are a number of risk factors that must be considered in order to prevent the development of osteoporosis. These are reasons that are easy for women and men to influence, as well as unchangeable conditions. The first are:

  • Lack of calcium in the body.
  • Lack of vitamin D.
  • Physical inactivity, lack of good physical activity (especially in elderly women).
  • High risk factors for falls (frequent and severe dizziness, poor vision).
  • Bad habits and low weight (dystrophy).

The unchanging reasons for the development of osteoporosis in women include: a tendency to fracture in close relatives, early onset of menopause, taking prednisolone, bedding due to trauma and other reasons. With these risk factors, increased attention should be paid to the possible symptoms of osteoporosis.

Osteoporosis: symptoms, diagnosis and treatment

Osteoporosis in women and men does not manifest itself at the onset of the disease.The disease generally develops after 50 years of age and does not show any specific symptoms. Most often, osteoporosis in women over 50 is found after fractures. Seeing a doctor becomes a reason for diagnosing the bone apparatus. At this point, patients learn about the need for osteoporosis treatment.

Symptoms of osteoporosis are veiled, but in women, fractures more often occur in the vertebrae, femoral neck, shoulder area. Other symptoms of osteoporosis become apparent later.They manifest themselves in a decrease in growth, a protruding stomach, heartburn, a drop in weight indicators, and limited movement. Also, symptoms of osteoporosis can be considered pain in the back and hips. A clear sign of osteoporosis is an increase in the distance from the wall to the back of the head when a person leans back against its flat surface.

Degrees of osteoporosis

The degrees are divided depending on the changes in the density of the bone apparatus. There are three stages of development of osteoporosis:

  1. Normal – Bone Mineral Density greater than 1 SD on DXA analysis.
  2. Osteopenia – the first changes in osteoporosis in women, in which the bone density is 1-2.5 SD. Osteopenia does not always become osteoporosis, but it is the first serious signal to take action.

Osteoporosis Stage – Density 2.5 or less.

Sometimes pathology is classified as osteoporosis of the joints, determining the class of lesions according to the degree of disruption of the joints, but this is incorrect. In osteoporosis of the joints (knee, hip and others), the disease affects the bones, and is not limited to the joint capsules.

Diagnostics for osteoporosis

When osteoporosis is detected with women and men, a survey is conducted to find out the history. The doctor finds out the risk factors that contribute to the development of the disease. During the diagnosis of osteoporosis, pay attention to the following parameters:

  • Osteoporosis can affect people who do not have the prerequisites for the development of the disease.
  • If osteoporosis is detected before symptoms appear, there is a chance to halt the progression of the disease.
  • If a postmenopausal woman or an elderly patient is examined, the causes of the secondary development of pathology must be excluded.

The 10-year chance of developing osteoporosis is assessed using the FRAX instrument. Early detection of osteoporosis plays a role in good treatment of osteoporosis. They also pay attention to prevention.

Osteoporosis: Treatment and Prevention

Beginning osteoporosis treatment to prevent fractures.To do this, increase bone density, strengthen joints. Prevention of osteoporosis includes special exercises, vitamin D and calcium intake.

In drug treatment there are biophosphonates, Denosumab, Teriparatide, analgesics. It is forbidden to engage in self-treatment, the doctor must give appointments for taking medications. He is also responsible for the prevention of osteoporosis, so the recommendations of a specialist are paramount. The treatment protocol is advised to include the wearing of orthopedic corsets that contribute to the correct distribution of the load.

By taking timely treatment, you can minimize the risks of complex fractures, after which people often do not recover. To make an appointment with a doctor, you can call the phone number indicated on the website or place an online application yourself. Experienced specialists with extensive experience in clinical practice are engaged in the treatment of osteoporosis in our clinic.

  • NASA
  • Photo author, Getty Images

    Caption,

    Astronaut Peggy Whitson3 906 shortly after landing For thousands of years, travelers and discoverers have faced the problem of nutrition.And astronauts are no exception.

    During a stay in space, which often lasts for months, it is extremely important to provide the crew members with all the food the human body needs.

    But modern dietetics goes much further. It aims to optimize the performance of astronauts and at the same time to protect against the harmful factors of weightlessness and cosmic radiation.

    Such close attention to the nutritional problems of a handful of people working in space may seem excessive, but solving these problems is of practical importance for all of humanity.

    Vision problems and infertility: what they have in common

    Some astronauts and cosmonauts return to Earth after a long stay on the ISS with vision problems. They suffer, in particular, from the so-called “cotton spots” on the retina and inflammation of the optic nerve.

    In other words, people go into space with excellent eyesight, and on their return they need to prescribe glasses.

    Previously, the reason for this was thought to be the effect on the vascular system of microgravity, in particular, fluctuations in the body’s water balance and an increase in intracranial pressure.

    But these theories are not able to explain why only 30-40% of those who have been in space have vision problems.

    It is believed that the functioning of the vascular system is largely dependent on genetic factors.

    In combination with abrupt changes in the body’s water balance under microgravity conditions, this leads to an increase in the permeability of the blood vessel walls in the eye.

    And this leads to an increase in pressure, which in turn causes vision problems.

    Photo author, NASA

    Photo caption,

    International Space Station

    It turned out that such people have a significantly higher concentration of the amino acid homocysteine ​​in their blood, not only in space, but also before flight.

    Homocysteine ​​is present in almost every cell of the human body. It is one of the most important components of biochemical processes throughout a person’s life. Several types of vitamin B are required for homocysteine ​​production.

    People who complain of eye problems while in space need higher doses of these vitamins due to their genetic makeup.

    Photo author, NASA

    Photo caption,

    Astronaut Karen Nyberg undergoing an eye examination

    A puzzling element in this theory is the fact that women with polycystic ovary syndrome (PCOS) usually also have higher levels of homocysteine, and also circulatory problems similar to those seen in male astronauts with vision problems.

    PCOS syndrome affects ovarian function in women. This is the main cause of infertility, affecting up to 20% of women.

    The causes of this disease are not fully understood and there is currently no cure. However, it is possible that women with PCOS need to take increased doses of B vitamins.

    So far, there is no convincing evidence of such a relationship, but NASA and doctors at the Mayon Clinic in Minnesota are currently conducting research in this direction.

    These studies can not only solve the problem of one of the main risk factors for long-term human stay in space, but also shed light on the nature of the disease from which millions of people suffer.

  • conditions of limited resources and complicated by the factor of zero gravity, or, as scientists say, microgravity
  • Similar terrestrial studies are sometimes carried out on ordinary people who spend weeks or months lying in a hospital bed with an inclination to the side of the head
  • This simulates the effects of microgravity and allows you to monitor the rate of reduction in the mass of muscle and bone tissue
  • Photo author, NASA

    Caption to the photo,

    Volunteers spend months on their beds in the course of some research

    Little sun

    Vitamin D is formed in human skin under the influence of sunlight.This vitamin is essential for maintaining healthy bones, teeth and muscles.

    Astronauts are not getting the amount of sunlight they need in orbit, which leads to vitamin D deficiency, which is not replenished with food.

    Studying the effect of insolation deficit, we examined polar explorers who winter at the American McMurdo station in Antarctica, where the sun goes below the horizon for six months.

    Photo by Getty Images

    We did experiments there to see if vitamin D supplementation could replace sunlight.

    According to preliminary data, small supplements of these vitamins lead to an increase in the level of vitamin D in the body, but increasing the dose no longer brings noticeable benefits.

    We also found that the response to vitamin supplements depends on weight or body weight. The higher the body weight, the less effective such supplements are.

    This is because fat absorbs vitamin D and prevents it from remaining in the blood.

    The results of our study, along with many other studies, helped scientists at the US National Academy of Medicine develop recommendations for vitamin D intake for North Americans.

    Photo Credit, Getty Images

    In our second study, we looked at how stress affects the immune system. This is true for both astronauts and polar explorers wintering in Antarctica.

    We have come to the conclusion that such a relationship exists. People who have biochemical symptoms of stress and low blood levels of vitamin D are more susceptible to viral infections, such as herpes, which is always dormant in the body.

    In such studies, carried out under normal conditions, it is necessary to take into account the inevitable exposure of the subjects to solar radiation, which can distort the results.

    Our research in Antarctica allowed us to rule out this factor and conclude that new recommendations for vitamin supplementation levels make sense, and further dose increases do not bring significant benefits.

    Bone density

    A long-standing problem in space medicine is the decrease in bone density during prolonged stay in space.Astronauts lose about 1% of bone mass per month. Patients with osteoporosis lose this volume in a year.

    This mass loss occurs as a result of a decrease in the gravitational load on the skeleton. It usually takes years for bone mass to recover after returning to Earth.

    After many years of trial and error, it turned out that certain changes in the space diet have a positive effect on the health of the bone tissue.

    Photo author, NASA

    Photo caption,

    Expedition to the ISS: lunch break

    Astronauts who received more fish, such as salmon and mackerel, lost bone mass more slowly in orbit.It was also found that increased nutrition of fruits and vegetables also helps preserve bone mass.

    At the same time, eating foods high in salt and iron accelerates bone loss.

    Subsequent data showed that those astronauts who ate healthy, maintained adequate blood levels of vitamin D, and exercised did not experience bone loss during their six months in space.

    For the first time in 50 years of manned space flight, it has been proven that astronauts can maintain normal bone density through diet and exercise.

    These results are of immense value to everyone on earth, as similar dietary changes can help alleviate many health problems.

    Photo author, Getty Images

    Photo caption,

    Astronauts are also prescribed vitamin-rich vegetables

    On the threshold of the solar system

    Now, on the threshold of the sixth decade of manned space flights, we are preparing for long-distance space missions.

    The risk factors remain significant, but we now know that proper nutrition can help maintain the health of the crew of a ship that travels to Mars and more distant planets.

    We need to boldly use and expand the 21st century space nutritional data that will not only help future space exploration, but also improve the health of millions of our planet’s inhabitants.