What is osteoporosis, and how do I treat it?
Medically Reviewed By : Dr Sravya, MBBS, MS
Introduction
Osteoporosis—have you come across this term nowadays? Then let’s see what is osteoporosis and what is its treatment Osteoporosis is a weakness of the bones and a loss of strength, making them spongy, brittle, and prone to breakage. Osteoporosis poses a risk for fracture, disability, and immobility, so treatment of osteoporosis is essential as soon as it is diagnosed.
What is osteoporosis?
Osteoporosis is a medical condition in which bones become fragile, spongy, and porous, prone to breakage and fracture. So it is called osteoporosis. Doesn’t that sound horrible? But these patients do not even sense this internal pathological process, as it is not apparent through signs and symptoms, and their bones become weaker inside.
Are you in your 40's?
It’s a common disease in both women and men. Most women in their 40s, especially those who are menopausal, Don’t be afraid! Here is the answer! First of all, not all people are affected. If you are aware of its symptoms, If you are prone to it or if it is hereditary, early screening, diagnosis, early treatment of osteoporosis, and taking preventive measures are possible. What happens to bones in osteoporosis?
What are the symptoms?
Bones constitute minerals like calcium, phosphorus, collagen fibers, and important proteins. There is a natural cycle of the formation of new bone cells and the resorption of old ones. This cycle is regulated by many mechanisms involving hormones. So, deficiency in any of the above components can result in osteoporosis.
What if there is a deficiency?
Especially calcium, vitamin D, and the hormone estrogen deficiency can lead to osteoporosis. It’s an aging process; as age advances, bone demineralization occurs in postmenopausal women, and estrogen levels decrease. The result of this is a disturbed natural cycle of bones.
As discussed earlier, there is a cycle of formation and resorption of bone cells. Bone cells are of two types:
- Osteoblasts, which are responsible for the generation of bone cells
- Osteoclasts, which are responsible for resorption, are replacing old cells
Due to demineralization or deficiency, the osteoblasts do not produce new cells, and osteoclasts continue replacing the old ones. So, it results in typical symptoms of osteoporosis: weak, fragile bones that are not strong enough to bear the weight of the body, resulting in fractures.
How should you know that you have osteoporosis?
There are various ways to diagnose osteoporosis so that a doctor can plan the treatment of the disease accordingly Nowadays, social media promotes calcium supplements after 40. But do not blindly follow this treatment.
If you want to start with calcium supplements, you need to check laboratory findings. To diagnose whether you have osteoporosis or not. If you have a significant family history, then you must consult a doctor to perform some tests.
1.A proper case history is taken to rule out the risk of osteoporosis. The people at high risk are either postmenopausal, with a strong family history of fractures or bone cancer, or suffer from prolonged illness, men or women who have crossed 70 years of age; or have a condition like osteogenesis imperfecta (tendency to form brittle bones).
2.Accordingly, physical examination is carried out by doctors to see the symptoms and signs of osteoporosis, like
- Height, weight
- Peripheral joint mobility
- Examination of big joints like the hip, knee, etc
- Any limp associated
- Joint movements
- Balance of movements like walking, running, etc.
3.Blood samples for calcium and vitamin D are taken to detect whether they are low on parameters; generally, women after 40 have low counts but there are exceptions.
4. If all the above supports the risk of osteoporosis, then generally DXA scan (Dual-energy X-ray absorptiometry) is done to rule out a final diagnosis of osteoporosis and helps in treatment.
What is a DXA scan?
The scan is generally done in an imaging center where the patient is made comfortable and various X-ray images are taken to view the bone. It measures your bone density. The X-ray images are obtained from peripheral bones, joints of the hands and feet, and big joints like the hip and knee. The reliable source is the loss of bone density in the big joints of the body, especially the hip, and vertebral structures. If BMD (bone mineral density) is on the lower side compared to the otherwise healthy bones of healthy people, it proves osteoporosis. The degree of loss of bone density helps to decide the treatment for osteoporosis.
Have you been diagnosed with osteoporosis recently?
Do you know? Around 1 in 3 of the middle-aged female population suffers from osteoporosis symptoms. So you are not alone. Treatments are available for osteoporosis, and with some lifestyle changes, it’s possible to slow it down.
What treatment and lifestyle changes do you need to make?
Treatments
- Intake of calcium and vitamin D3 supplements
- Bisphosphonates are the drug of choice in osteoporosis in men and women and to prevent fractures
They are taken orally or intravenously, that is, in injection form.
1.Alendronate or risedronate It has to be taken orally on an empty stomach in the morning with 8 ounces of water. It is advised as it should not get stuck in the esophagus and to minimize the risk of oesophagitis or gastritis.
2.Zoledronic acid and Ibandronate is infused intravenously. Patients who cannot tolerate oral bisphosphonates or develop side effects are given injections of bisphosphonates.
3.Etidronate is a drug of Choice in Paget’s disease, a medical condition in which new bone formation is abnormal. The new bone is brittle and spongy.
4.Parathyroid hormone is given to people with repeated calcium deficiencies. The parathyroid gland secretes parathormone. It helps regulate calcium levels in the blood. If the gland is underactive, parathormone secretion is hampered, which can lead to high levels of calcium in the blood, due to which calcium is not taken up by bones, thus making them brittle and porous.
Which Lifestyle changes can prevent osteoporosis?
Being aware of osteoporosis is an important step in taking action to prevent it.
- Exercise daily can help strengthen the bones and thus promote the new formation of bones by releasing hormones and minerals.
- Vitamin D supplementation can help prevent damage to a certain extent
- Calcium supplementation is again a major factor in the prevention of osteoporosis
- Not only supplements can help, but natural sources like green leafy vegetables, calcium-rich foods, and vitamin D-rich foods can bring about a major change.
- Taking hormonal replacement therapy in menopausal women can help them prevent osteoporosis
- Last but not least, awareness of early screening and early diagnosis can also play a vital role in stopping further damage to the bones and emerging as an early treatment option for osteoporos.