Osteoporosis

A 65-year-old woman well past her menopausal period, was experiencing back pain. She developed a stooped posture over a period time. On consulting the doctor, diagnostic tests were conducted which revealed a broken vertebra that was causing the severe back pain. It was a clear case of osteoporosis.

Symptoms

There are a few symptoms of osteoporosis. They are:

  • Back pain caused by fracture
  • Loss of height overtime
  • Wrong posture

Support

Women who have crossed their menopausal stage should be aware of osteoporosis and its debilitating effects. By taking the necessary precautionary steps, one can strengthen the bones considerably.

Tips to keep bones strong

To keep bones strong and keep osteoporosis away, one must exercise regularly. Strength training exercises help in strengthening the muscles and bones of the upper spine and arms, whereas weight bearing exercises like jogging, stair climbing, skipping rope, walking and sports activities help in making the bones strong. The diet should contain at least 1000mg of calcium per day.Smoking should be strictly avoided as it decreases estrogen production in women which leads to bone loss.

Taking more than two alcoholic beverages decreases bone formation considerably.

Diagnosis

To check the bone density, a screening test known as dual X ray absorptiometry (DEXA) is done which checks the density of bones in the wrist, spine and hip. Other tests that help in measuring bone density are single photon absorptiometry, quantitative computerized tomography and ultrasound.

Calcium requirement

Calcium required by women before menopause is 1000mg of calcium per day. After menopause, if the woman is not taking estrogen, then calcium needed per day is 1500mg; while taking estrogen, it is 1000mg per day. Food sources that are rich in calcium include yogurt, cheese, milk, spinach, broccoli, pink salmon and dried beans. Vitamin D helps in absorption of calcium in the body. Hence, food sources rich in vitamin D should be taken like fish oils, saltwater fish, egg yolks, liver, and fortified milk.

Osteoporosis is a condition in which, due to loss of calcium, the bones become porous. This causes bone weakness and leads to breakage of bones in the course of time. It has been observed that osteoporosis occurs more in women, especially after menopause.

In the human body there is continuous remodeling of the bone which involves new bone being made and old bone lost. The bone mass increases when one is young as the amount of bone made is more than the amount of bone lost.

The peak bone mass is reached around 30 years of age. After which one starts losing bone more than one makes bone. After menopause or surgical removal of ovaries, the estrogen levels in women fall drastically which speeds up bone loss leading to osteoporosis.

The other risk factors of osteoporosis include

  • Menopause occurring before age 45 years
  • Surgical removal of ovaries
  • Deficiency of calcium
  • Family history of menopause
  • Belonging to Asian or Caucasian race
  • Sedentary lifestyle
  • Thin and small body frame
  • Alcohol abuse
  • Smoking
  • Anorexia nervosa ( eating disorder)
  • Hyperthyroidism (thyroid gland being overactive)
  • Medications used for hypothyroidism(thyroid gland being underactive)
  • Use of corticosteroid medications

Osteoporosis can manifest as severe back pain due to a fractured vertebra. There can be fractures in bones of the hip and wrist as well. The posture of the affected person is stooped and there is loss of height in time.

There are medications for the treatment of osteoporosis.

Biphosphonates: The biphosphonates help in increasing the density of bones in the spine and the hip, and help reduce the risk of bone fractures. They are taken in the form of intravenous injection or in the form of oral pills. People who have low calcium levels in blood, pregnant women, and people who are having kidney disease cannot take the biphosphonates. The side effects that can occur due to biphosphonates include esophageal irritation, vision problems, irregular heartbeats, osteonecrosis of jaw (bone loss in jaw), abdominal pain, and nausea.
Calcitonin: Calcitonin is a hormone produced by the thyroid gland which helps in slowing bone loss and prevents spine fractures. It is available in the form of an injection or nasal spray. There can be nasal irritation in some people due to the use of nasal spray. People who can’t take biphosphonates generally use it.
Raloxifene: Raloxifene gives the same beneficial effects of the hormone estrogen without causing any risks. It helps in increasing the bone density in postmenopausal women without causing any risks like uterine cancer or breast cancer. Raloxifene should not be used in people with a history of blood clots. Side effect of this drug is experiencing hot flashes.
Alendronate and risendronate: These medications decrease the rate of bone loss and thus reduce the risk of fracture. They are taken in the form of pills. The common side effect that may be experienced is a stomach upset.
Ibandronate: Ibandronate helps in increasing the density of bone and reducing bone resorption. The medication is given in the form of injection once in 3 months .If taken in the pill form it is available as a daily pill or a monthly pill. The side effects of the medication include bloody urine, chest tightness, shortness of breath and lower back pain.
Terparatide: This medication helps in bone growth. It is a form of synthetic parathyroid hormone. It is given in the form of injection into the abdomen or thigh in both men and women. The side effects that can be seen include loss of appetite, muscle weakness, abdominal pain, headache, and nausea.