Osteoporosis: Symptoms, Treatments, and Prevention

What is osteoporosis?

Osteoporosis is a condition where your bones become weak and brittle, making them more prone to fractures. It occurs when the body loses too much bone, makes too little bone, or both. This condition primarily affects older adults but can occur at any age and is more common in postmenopausal women due to hormonal changes. 

Symptoms of osteoporosis

Osteoporosis often has no symptoms in its early stages. As bones weaken, symptoms may include:

• Back pain: 

  • Often due to fractured or collapsed vertebrae.

• Loss of height over time:

  •  Caused by weakened vertebrae that collapse.

• Stooped posture:

  • Results from spinal compression.

• Frequent bone fractures: 

  • Bone fractures occur more easily, especially in the hip, wrist, or spine.

These symptoms often appear after a fracture, making osteoporosis a “silent” disease. 

If you are suffering from the symptoms of osteoporosis, consult with a specialist  from Thomson Medical to discuss which treatment plan suits you best.

Gender-specific manifestations

• Osteoporosis in men: 

  • While commonly associated with women going through menopause, osteoporosis is also a concern in older men. Although a man’s bone density generally declines more gradually, fractures in men often result in higher mortality rates due to poorer recovery.

• Hormonal factors beyond estrogen: 

  • For women, losing estrogen is a well-known risk for osteoporosis. But men can also be affected because a drop in testosterone can impact bone health in both men and women. Treatments that replace these hormones are being looked at more closely because they may help with both osteoporosis and other age-related health issues.

Causes and risk factors of osteoporosis

• Hormonal factors:

  • Estrogen deficiency (especially post-menopause)

  • Low testosterone in men

• Age:

  • Bone density naturally decreases with age, especially after 50.

• Genetics:

  • Family history of osteoporosis can increase risk.

• Lifestyle factors:

  • Sedentary lifestyle

  • Poor diet (low in calcium and vitamin D)

  • Excessive alcohol and caffeine intake

  • Smoking

• Medications:

  • Certain medications, like corticosteroids, can lead to bone loss.

• Other medical conditions:

  • Conditions like rheumatoid arthritis, lupus, and celiac disease can affect bone health.

Diagnosis of osteoporosis

Osteoporosis is diagnosed through:

• Bone density test (DEXA scan): 

  • Dual-Energy X-ray Absorptiometry, often known as DEXA scan, helps measure  bone density in various parts of the body (usually focused on the hip and spine). It uses low-dose X-rays to determine how much calcium and other minerals are present in your bones.

• FRAX score (Fracture risk assessment tool): 

  • An online tool to assess fracture risk in the next 10 years. It calculates the probability of fractures based on factors such as age, sex, weight, height, smoking status, alcohol use, history of fractures, family history of osteoporosis, and bone density (if available). 

Both tools help assess the risk level and determine the appropriate treatment.

Treatment Options

Medications:

• Bisphosphonates: 

  • Slows down bone loss (e.g., Alendronate, Risedronate).

• Denosumab: 

  • An injectable medication that prevents bone loss.

• Hormone replacement therapy (HRT): 

  • For postmenopausal women.

• Selective estrogen receptor modulators (SERMs): 

  • Mimic estrogen’s effects on bone density.

• Parathyroid hormone (PTH): 

  • Increases bone formation (e.g., Teriparatide).

• Romosozumab: 

  • A newer option that stimulates bone formation.

Lifestyle modifications

• Exercise: 

  • Weight-bearing and muscle-strengthening exercises (walking, hiking, stair climbing, resistance training) improve bone strength.

• Diet: 

  • Increasing the amount of high calcium (dairy products, green leafy vegetables) and vitamin D (sunlight exposure, fortified foods) rich foods in your diet.

• Limit unhealthy habits: 

  • Activities such as alcohol and smoking can accelerate bone loss, increasing the risk of osteoporosis.

Supplements:

• Calcium and vitamin D:

  • Necessary for bone health, especially if dietary intake is insufficient.

Fall prevention strategies:

• Modify your home to minimise fall risk by installing grab bars, using non-slip mats, removing tripping hazards, and ensuring adequate lighting.

Prevention of osteoporosis

Get adequate calcium and vitamin D:

• Calcium: 

  • 1,000 mg/day for adults; increases to 1,200 mg/day for women over 50 and men over 70.

• Vitamin D: 

  • 600-800 IU daily, often higher based on individual needs and sunlight exposure.

Other nutritional considerations 

• Other essential nutrients: 

  • Magnesium, zinc, and boron are gaining attention for their role in bone health. They assist in bone remodelling and influence mineralisation.

• Protein intake: 

  • In the past, people believed that eating a lot of protein could cause loss of calcium. However, studies now show that getting enough protein actually helps keep bones strong, especially for older adults. The important thing is to balance your protein intake with enough calcium.

Exercise regularly:

• Engage in weight-bearing, balance, and muscle-strengthening exercises, like brisk walking, dancing, and resistance training.

Maintain a healthy weight:

• Low body weight increases fracture risk, while excessive weight can also stress bones.

Limit Alcohol and Avoid Smoking:

• Smoking reduces estrogen levels, which protects bones in women, and alcohol can interfere with bone density.

Routine Screenings:

• Regular bone density tests are recommended for women over 65, men over 70, and anyone at high risk.

Other lifestyle factors 

• Importance of sleep:

  • Getting good quality sleep is important for strong bones, especially for women after menopause. Conditions like sleep apnoea, which causes breathing problems during sleep, may also increase the risk of osteoporosis. 

• Sedentary lifestyle:

  • Sitting for long periods without moving can negatively impact bone health. Taking short breaks to stand or walk, even if you exercise regularly, can help keep bones strong. 

Osteoporosis is a serious issue, but not a fatal one. With proper medical guidance and lifestyle changes, many patients experience significant improvement in their quality of life. To discuss the best treatments suitable for your lifestyle, request for an appointment with our experienced specialists at Thomson Medical. 

FAQ

What is the main cause of osteoporosis?

One of the main causes of osteoporosis is believed to be a lack of calcium. Not eating enough calcium can lead to issues such as diminished bone density, early bone loss, and increased risk of fractures—all of which are linked to osteoporosis. 

Can you live a long life with osteoporosis?

Yes, osteoporosis is not a fatal condition, though it increases the risk of bone fractures. With proper treatment and lifestyle adjustments, individuals with osteoporosis can manage their condition and maintain a normal, active life.

What is the difference between osteopenia and osteoporosis?

Osteopenia is a condition where bone density is lower than normal but not low enough to be classified as osteoporosis. It can progress to osteoporosis without preventive measures.

Can osteoporosis be reversed?

While it is not fully reversible, treatments can help strengthen bones, reduce fracture risk, and improve bone density.

Is osteoporosis hereditary?

Yes, a family history of osteoporosis can increase the risk, although lifestyle factors and other conditions play a significant role too.

How much calcium and vitamin D should I take if I have osteoporosis?

Generally, 1,200 mg of calcium and 800-1,000 IU of vitamin D are recommended daily, but it is best to consult a doctor for personalised recommendations.

What are some foods rich in calcium?

Dairy products (milk, cheese, yoghurt, etc.), leafy greens (kale, spinach, etc.), fortified foods, and certain fish (sardines, salmon, etc.) are high in calcium.

Can men get osteoporosis?

Yes, men can also develop osteoporosis, especially as they age or if they have low testosterone levels.

How does menopause affect osteoporosis risk?

Estrogen protects bones, and estrogen levels drop significantly after menopause, increasing the risk of osteoporosis in women.

Are there natural remedies for osteoporosis?

While diet and exercise are key, some people use herbs like red clover or soy to support bone health. However, these should not replace conventional treatments.

How can I prevent falls if I have osteoporosis?

Engage in balance exercises, ensure your home is safe, and use assistive devices if needed.

What is a vertebral compression fracture?

It is a type of fracture commonly seen in osteoporosis where the bones in the spine collapse, leading to pain, height loss, and a stooped posture.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.