Osteoporosis

Osteoporosis I  Kōiwi ngoikore

Osteoporosis is a bone disease characterised by decreased bone density and increased fragility, leading to a higher risk of fractures. This condition is often called the "silent disease" because it can progress without symptoms until a fracture occurs.

Symptoms of osteoporosis

In the early stages, osteoporosis may not cause any symptoms. However, as bones weaken, the following signs may become apparent:

1. Bones that break easily: Fractures occur more easily than expected, such as from minor falls or even simple actions.
2. Back pain: Caused by a fractured or collapsed vertebra.
3. Loss of height over time: Spinal fractures can lead to a shorter stature.
4. Stooped posture: Also known as kyphosis, a curved upper back due to spinal compression fractures.

Causes and risk factors

Osteoporosis is influenced by several factors, some of which are controllable while others are not.

Unchangeable risk factors:

• Age: Bone mass typically peaks in the early 20s and starts to decline after age 30.
• Gender: Women are more likely to develop osteoporosis, partly due to menopause-related hormonal changes.
• Family history: A family history of osteoporosis increases risk.
• Ethnicity: Osteoporosis occur in all ethnicities, but is more common among European and Asian women in Aotearoa

Other risk factors:

• Dietary factors: Low calcium intake, some eating disorders, or some gastrointestinal surgeries of the stomach or bowel can reduce calcium absorption.
• Lifestyle choices: Sedentary lifestyle, excessive alcohol consumption, and tobacco smoking.
• Medications: Long-term use of steroids and other medications that can affect bone health.
• Hormonal conditions: Reduced sex hormones, increased thyroid hormone, and overactive parathyroid and adrenal glands.

Your doctor can assess your risk for osteoporosis from your medical history and by asking you about your lifestyle. They may suggest an x-ray or a bone density scan (also called DEXA scan) to assess your bone health.

Managing osteoporosis

Treatment for osteoporosis is decided on a case by case basis and depends on the results of scans and other factors such as your age, gender, medical history and severity of the condition.

Lifestyle changes:

• Balanced diet: Ensure adequate intake of calcium and vitamin D. Dairy products, leafy green vegetables, and fortified foods are good sources.
• Regular exercise: Weight-bearing exercises like walking, running, and strength training can help strengthen bones.
• Quit smoking and limit alcohol: Both smoking and excessive alcohol can weaken bones.

Medical treatments:

• Calcium and vitamin D supplements: Essential for bone health.
• Medications may include:
  • Bisphosphonates: These are the preferred medicines to treat osteoporosis and theyHhelp prevent loss of bone mass.
  • Selective Estrogen Receptor Modulators (SERMs): Mimic estrogen's beneficial effects on bone density.
  • Hormone therapy: Replacement of estrogen for women who are undergoing menopause can help, though it's not suitable for everyone.
  • Denosumab: An injection given twice a year to reduce bone loss.
  • Parathyroid hormone-related protein analogs: Help build bone.

When to seek medical advice:

• If you experience any symptoms like unexpected fractures or significant height loss, consult a healthcare provider for evaluation and possible bone density tests.

Conclusion

Osteoporosis is a serious condition that can significantly impact quality of life. Understanding the symptoms, risk factors, and effective management strategies can help prevent fractures and maintain bone health. For personalised advice and treatment options, it's essential to consult with a healthcare professional.

External resources: https://bones.org.nz/ 

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