Osteoporosis causes bones to weaken, so much so that a fall or even a slight strain such as bending or coughing can cause a fracture. Fractures related to osteoporosis often occur in the hips, wrists, and spine.
Bones are living tissues that are constantly broken down and replaced. Osteoporosis occurs when the generation of new bones is slower than the removal of old bones.
Osteoporosis affects men and women of all races. However, white and Asian women (particularly older women and menopausal women) are more at risk. Certain medications, a healthy diet, and exercises that include weight lifting can help prevent decreased bone mass and strengthen weak bones.
The early stages of decreased bone mass usually have no symptoms. But once your bones have been weakened by osteoporosis, you may have the following signs and symptoms:
- Back pain, caused by a fracture or collapse of a vertebra
- Loss of height over time
- Stooped posture
- A bone fracture that occurs much more easily than expected
- When to consult a doctor
You may want to talk to your doctor about osteoporosis if you had early menopause or if you’ve ever taken corticosteroids for several months in a row, or if either of your parents had a hip fracture.
Bones are in a constant state of renewal: new bones develop and old bones break down. When you are young, the development of new bones is faster than decomposition in the body, so bone mass increases. Most people reach peak bone mass shortly after their 20th birthday. As the body ages, the decrease in bone mass is faster than development.
Your chances of developing osteoporosis depend in part on how much bone mass you gained in your youth. The higher your peak bone mass, the more bone mass you have “on the bench” and the less likely you are to develop osteoporosis as you age.
A number of factors can increase your chances of developing osteoporosis, including age, race, lifestyle choices, conditions, and treatments.
Some risk factors for osteoporosis are out of your reach, among them:
- Sex. Women are much more likely to develop osteoporosis than men.
- Age The older you are, the greater your risk of developing osteoporosis.
- Race. White and Asian descendants are more likely to develop osteoporosis.
- Family history. If one of your parents or siblings has osteoporosis, you are at greater risk, especially if one of your parents suffered a hip fracture.
- Body size. Men and women with small bodies are often at greater risk because they have less bone mass to support them as they age.
- Hormone levels
Osteoporosis is more common in people who have a very high or very low level of certain hormones in their bodies. For example:
- Sex hormones. Low levels of sex hormones often weaken bones. Reducing estrogen levels in menopausal women is one of the biggest risk factors for developing osteoporosis. Men experience a gradual reduction in testosterone levels as they age. Prostate cancer treatments that reduce testosterone levels in men and breast cancer treatments that reduce estrogen levels in women are likely to accelerate the decline in bone mass.
- Thyroid problems. A very high level of thyroid hormone can lead to decreased bone mass. This can happen if you have hyperthyroidism or if you take a very high dose of thyroid hormone medication to treat hypothyroidism.
- Other glands. Osteoporosis was also associated with hyperactivity of the parathyrin and adrenal glands.
People with the following characteristics are more likely to develop osteoporosis:
- Low calcium intake. A lifelong lack of calcium plays a role in the development of osteoporosis. A low intake of calcium helps to reduce bone density, decrease bone mass at an early stage and increase the risk of fractures.
- Eating disorders. Significantly restricting food intake and having a low body weight weakens bones in both men and women.
- Gastrointestinal surgery. Surgery to reduce the size of the stomach or remove part of the intestines limits the area available to absorb nutrients, including calcium.
- Steroid and other medications
Prolonged use of oral or injected corticosteroid medications, such as prednisone and cortisone, interferes with the bone recomposition process. Osteoporosis has also been associated with medications used to fight or prevent it:
- Gastric reflux
- Transplant rejection
The risk of developing osteoporosis is higher in people who have certain medical problems, including osteoporosis:
- Celiac disease
- Inflammatory bowel disease
- Kidney or liver disease
- Multiple Myeloma
- Rheumatoid arthritis
Some bad habits can increase the risk of osteoporosis: For example:
- Sedentary lifestyle. People who spend a lot of time sitting are at greater risk of developing osteoporosis than more active people. Any exercise that involves carrying weight and activities that promote balance and good posture are beneficial to bones; walking, running, jumping, dancing, and lifting weights seem to be particularly beneficial activities.
- Excessive alcohol consumption. Regular consumption of more than two alcoholic beverages per day increases the risk of osteoporosis.
- Tobacco use. The exact role of tobacco in osteoporosis has not yet been clearly established, but tobacco has been shown to contribute to weakening bones.
Good nutrition and regular exercise are essential to maintaining healthy bones throughout life.
Protein is one of the fundamental elements of bones. While most people eat a large amount of protein in their diets, some do not. Vegetarians and vegans can get enough protein in their diets if they intentionally look for the right sources, such as soybeans, nuts, legumes, and dairy and eggs if allowed. Older adults may also eat less protein for different reasons. Protein supplementation is an option.
- Body weight
Being underweight increases the chances of decreased bone mass and fractures. It is now known that excess weight increases the risk of fractures in the arms and wrists. Thus, maintaining adequate body weight is as good for bones as it is for overall health.
Men and women ages 18 to 50 need 1000 milligrams of calcium per day. This daily amount increases to 1200 milligrams when women turn 50 and men turn 70. Good sources of calcium include:
- Low-fat dairy products
- Dark green leafy vegetables
- Canned salmon or sardines with bones
- Soy products, such as tofu
- Calcium-fortified cereals and orange juice
If you find it difficult to get enough calcium in your diet, consider taking supplements. However, excessive calcium intake has been associated with kidney stones. While it’s not yet clear, some experts suggest that too much calcium, especially in supplements, may increase the risk of heart disease. The Institute of Medicine recommends that total calcium intake, from supplements and diet combined, should not exceed 2000 milligrams daily for people over the age of 50.
Vitamin D improves the body’s ability to absorb calcium and improves bone health in other ways. Adequate amounts of vitamin D can be received from sunlight, but this is not a good resource if you live at a high latitude, if you are homebound, or if you use sunscreen regularly or avoid the sun altogether because of the risk of skin cancer.
Scientists still don’t know precisely the optimal daily dose of vitamin D for each person. A good starting point for adults is 600 to 800 international units (IU) per day, through food or supplements. For people without other sources of vitamin D and especially with limited sun exposure, a supplement may be necessary. Most multivitamin products contain between 600 and 800 IU of vitamin D. Up to 4000 IU of vitamin D per day is safe for most people.
Exercise can help build strong bones and slow the decline in bone mass. Exercises can benefit your bones no matter when you start, but it’s best if you start exercising regularly when you’re young and continue to do so throughout your life.
Combine strength training exercises with balance and weight-bearing exercises. Strength training helps strengthen the muscles and bones of the arms and upper spine, and weight-bearing exercises such as walking, jogging, running, climbing stairs, jumping a rope, skiing, and impact sports-mainly help the bones of the legs, hips, and lower spine. Balance exercises such as taichi help reduce the risk of falls, especially as you age.
Swimming, bicycling, and exercising with machines like elliptical ones can provide good cardiovascular work, but they are not as beneficial to improving bone health.