Osteoporosis

Osteoporosis causes bones to become weak and brittle. Even mild stresses such as bending over or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

Bone is living tissue. It is constantly being broken down and replaced with new bone. Osteoporosis occurs when the amount of bone breakdown is too high. It affects women more than men.

Symptoms

• Back pain caused by a fractured or collapsed vertebra
• Loss of height over time
• A stooped posture (hunched back)

Causes

How likely you are to develop osteoporosis depends on how much bone mass you build in your youth. Peak bone mass is partly inherited and is usually reached by the age of 30–35.

What are the risk factors?

• Female sex
• Older age
• Family history
• Low body weight
• Early menopause
• Receiving treatment for prostate cancer (in men)
• Receiving treatment for breast cancer (in women)
• Toxic goiter
• Type 1 diabetes
• Overactivity of certain endocrine glands
• Low calcium intake
• Eating disorders
• Having had obesity surgery
• Use of corticosteroids and certain other medications
• Celiac disease
• Inflammatory bowel disease
• Rheumatic diseases
• Certain types of cancer
• A history of organ transplantation
• Chronic bronchitis (COPD)
• A sedentary lifestyle or prolonged immobility for other reasons
• Alcohol and tobacco use

Complications

Bone fractures, especially in the hip and spine, can cause permanent disability and even death. Hip fractures usually occur after a fall. Spinal fractures can occur even without a fall, for example when coughing or sneezing.

Prevention

A daily calcium intake of 1,000–1,200 mg/day is recommended. Including diet and supplements, this amount should not exceed 2,000 mg/day.

Vitamin D: people can get some of their vitamin D from sunlight. For bone health, adults over 50 should take a vitamin D supplement of 600–800 units per day. Up to 4,000 units per day is considered safe.

Exercise is one of the most effective ways to prevent bone loss. Exercises such as walking, running and weight lifting are very beneficial for bone health. However, exercises that are not weight-bearing, such as swimming and cycling, have little effect on osteoporosis.

Diagnosis and Treatment

After the necessary blood tests and a measurement of bone mass (bone densitometry), a treatment plan is made for the patient. Along with adequate calcium and vitamin D supplementation, bisphosphonates (alendronate, zoledronate), denosumab and teriparatide can be used for treatment.