Symptoms of Bone health and Osteoporosis | Endocrinology

Bone Health and Osteoporosis

What is osteoporosis?

Osteoporosis is a condition that affects the bones. Its name comes from the Latin “porous bones”. The inside of a healthy bone has tiny holes like a honeycomb. Osteoporosis increases the size of these areas, causing loss of strength and bone density. Also, the outside of the bone becomes weak and thin.

Osteoporosis can occur at any age, but it is more common in adults, especially women. More than 53 million people in the United States have or are at risk of developing osteoporosis. People with osteoporosis are at risk for fractures or fractures when they perform normal activities such as standing or walking.  The most commonly affected bones are the ribs, hips, and bones of the wrist and spine.

Bone is biological tissue that is constantly being degraded and replaced. Osteoporosis occurs when the creation of new bone does not sustain the loss of old bone. Osteoporosis affects men and women of all races. But white and Asian women, especially older menopausal women, are at the highest risk. Medications, a healthy diet, and exercise with weights can help prevent bone loss or strengthen already weak bones.

What can I do to keep my bones healthy?

You can take some simple steps to prevent or delay bone loss. For example:

Include a lot of calcium in your diet. For adults ages, 19 to 50 and for men ages, 51 to 70, the recommended daily allowance (RDA) is 1,000 milligrams (mg) of calcium per day. The recommended dose is 1200 mg per day for women over 50 and men over 70.

Good sources of calcium are dairy products, soy products like almonds, broccoli, kale, canned salmon, sardines, and tofu. If you find it difficult to get enough calcium from your diet, ask your doctor about supplements.

Take care of vitamin D Your body needs vitamin D to absorb calcium. For adults ages 19 to 70, the RDA for vitamin D is 600 international units (IU) per day. For adults 71 and older, this recommendation increases to 800 IU per day.

Good sources of vitamin D are fatty fish such as salmon, trout, white fish, and tuna. Also, mushrooms, eggs, and fortified foods such as milk and whole grains are good sources of vitamin D. Sunlight also contributes to the body’s production of vitamin D.

Include physical activity in your daily routine. Weight-bearing exercises, such as walking, jogging, and stair climbing, can help you build strong bones and decrease bone loss.

Stay away from drug abuse. Do not smoke. If you are a woman, have no more than one drink a day. If you are a man, avoid drinking more than two drinks a day.

Importance of bone health

Your bones are constantly changing: new bone is forming and old bone is breaking. As a child, your body makes new bone faster than it breaks down old bone and increases your bone mass. Most people reach bone mass in their 30s. After that, the bone reconstruction will continue, but you will lose a little more bone mass than you gained.

A condition that causes bones to become weak and brittle (how likely you are to develop osteoporosis) depends on how much bone mass you gain when you reach your 30s and how quickly you lose it after that. At your peak bone mass, you have more bone on the “bank” and are less likely to develop osteoporosis as you age.

Does it affect bone health?

Bone health is affected by many factors. For example:

The amount of calcium in your diet. A diet low in calcium contributes to a decrease in bone density, a risk of early bone loss and fractures.

Physical activity: Those who are physically inactive are at a higher risk of developing osteoporosis than their active counterparts.

Tobacco and alcohol: Research suggests that tobacco use contributes to weak bones. Similarly, more than one alcoholic drink a day for women on a regular basis or two alcoholic drinks a day for men increases the risk of osteoporosis.

Gender: If you are a woman, you are at risk of developing osteoporosis because women have less bone tissue than men.

Size: If you are very thin (with a body mass index of 19 or less) or have a small body frame, you are at risk because your bone mass is lower than your age.

Years: As you get older, your bones become thinner and weaker.

Ethnic and family history: If you are white or of Asian descent, you are at risk of developing osteoporosis. Also, having parents or siblings with osteoporosis puts you at higher risk, especially if you also have a family history of fractures.

Hormone levels: Too much thyroid hormone can cause bone loss. In women, decreasing estrogen levels can significantly increase bone loss at menopause. The absence of premenopausal amenorrhea also increases the risk of osteoporosis. In men, low testosterone levels lead to loss of bone mass.

Eating disorders and other conditions: People with anorexia or bulimia are at risk for bone loss. Also, conditions such as stomach surgery (gastrectomy), weight loss surgery, and Crohn’s disease, celiac disease, and Cushing’s disease can affect the body’s ability to absorb calcium.

Some drugs: Long-term use of corticosteroid medications such as prednisone, cortisone, prednisolone, and dexamethasone can cause bone damage. Other medications that increase the risk of osteoporosis include aromatase inhibitors, selective serotonin reuptake inhibitors, methotrexate, phenytoin (Dilantin), and some anti-seizure medications such as phenobarbital and proton pump inhibitors to treat breast cancer.

Symptoms of osteoporosis

In general, there are no symptoms of osteoporosis. This is why it is sometimes called a silent disease. However, you should look for the following:

  • Loss of height (decrease of an inch or more)
  • Change of posture (stooping or leaning forward)
  • Piri of respiration (capacity of the small lungs due to compressed discs)
  • Bone fractures
  • Pain in the lower back

Causes of osteoporosis

Your bones are in a constant state of restoration: new bone is formed and old bone is broken. When you are a child, your body makes your bone faster than it breaks an old bone, and your bone mass increases. This process slows down in their early 20s, and most people reach their peak bone mass in their 30s. As people age, bone mass is lost faster than it was created.

How likely you are to develop osteoporosis depends on the amount of bone mass you have achieved as a youth. Peak bone mass is inherited in some way and the species group also varies. At your peak bone mass, you have more bone on the “bank” and are less likely to develop osteoporosis as you age.

Risk factors of osteoporosis

There are many risk factors that increase your chances of developing osteoporosis, two of which are sex and age.

Osteoporosis is a disorder that affects more and more people. However, women over the age of 50 or postmenopausal women are at higher risk of osteoporosis. During the first 10 years after menopause, women experience a rapid loss of bone mass because menopause reduces the production of a hormone called estrogen, which protects against excessive loss of bone mass.

Age and osteoporosis affect men too. You might be surprised that men over the age of 50 are more likely to develop osteoporosis-induced fractures than those with prostate cancer. An estimated 80,000 men a year break their hips and women are more likely to die in the year following a hip fracture.

The risk of developing osteoporosis is also related to race. Caucasian and Asian women are more likely to develop osteoporosis. However, African American and Hispanic women are still at risk. In fact, African American women are more likely than white women to die after a hip fracture.

Another factor is bone structure and body weight. Small and thin people are at higher risk of developing osteoporosis because they lose less bone than people with higher body weight and larger frames. Family history also influences the risk of osteoporosis. If your parents or grandparents have signs of osteoporosis, such as a broken hip after a minor fall, you are at risk for the disease.

Finally, certain medical conditions and medications can increase your risk. If you have any of the following conditions, some of which are related to irregular hormone levels, you and your healthcare provider may want to consider screening for osteoporosis.

  • An overactive thyroid, parathyroid, or adrenal glands.
  • History of bariatric surgery (weight loss) or organ transplantation.
  • History of hormone therapy or missed periods due to breast or prostate cancer.
  • Celiac disease or inflammatory bowel disease.
  • Blood diseases such as multiple myeloma.

Some medications can cause side effects that can damage bones and lead to osteoporosis. These include steroids, breast cancer treatments, and medications to treat seizures. You should talk to your healthcare provider or pharmacist about the bone effect of your medication.

Each risk factor may seem related to something beyond your control, but it is not. You have control over some of the risk factors for osteoporosis. You can discuss drug-related problems with your healthcare provider. And you are responsible for:

Eating habits: If your body does not have enough calcium and vitamin D, you are more likely to develop osteoporosis. Although eating disorders such as bulimia or anorexia are risk factors, they can be treated.

Lifestyle: People who lead a sedentary (inactive) lifestyle are at risk of developing osteoporosis.

Tobacco use: Smoking increases the risk of cracking.

Alcohol consumption: having two drinks (or more) a day increases the risk of osteoporosis. 

Treatment for osteoporosis

If your test reveals that you have osteoporosis, your doctor will work with you to create a treatment plan. Your doctor can also prescribe medications and lifestyle changes. These lifestyle changes can increase your intake of calcium and vitamin D, as well as get adequate exercise.

There is no cure for osteoporosis, but proper treatment can help protect and strengthen your bones. These treatments can help slow bone breakdown in your body, and some treatments can increase the growth of new bone.

Medications for osteoporosis: The most common medicine used to treat osteoporosis is called bisphosphonates. Bisphosphonates are used to prevent bone loss. They can be taken orally or by injection. Among them are:

  • Alendronate (Fosamax)
  • Ibandronate (Boniva)
  • Rhysdronate (octonel)
  • Zoledronic acid (regeneration)
  • Other medications can be used to prevent bone loss or to stimulate bone growth. Among them are:
  • Testosterone
  • In men, testosterone treatment can help increase bone density.

Hormonal therapy: For women, the estrogen used during and after menopause can help reduce bone density. Unfortunately, estrogen therapy also increases the risk of blood clots, heart disease, and some types of cancer.

  • Raloxifene (Evista)
  • Although there is still a risk of blood clots, these drugs have been found to provide the benefits of estrogen without much risk.
  • Denosumab (Prolia)
  • This injection is given by injection and is more promising than bisphosphonates in reducing bone loss.
  • Teriparatide (Forteo)
  • This medicine is also given by injection and stimulates bone growth.
  • Calcitonin Salmon (Fortical and Miocalcin)
  • This medicine is taken as a nasal spray and reduces bone resorption. Talk to your doctor about the risk of cancer with this drug.
  • Romosozumab (evidence)

The drug was approved by the FDA in April 2019 to treat women experiencing menopause and at risk of fractures.

12 medications are given under the skin in two injections (in one session) once a month for 12 months or less. It has a “black box” warning because it increases the risk of heart attack or stroke, so it is not recommended for people with a history.

Natural remedies for osteoporosis: Since osteoporosis medications can cause side effects, you can try other treatments instead of medications. Many supplements such as red clover, soy, and black cohosh can be used to help promote bone health.

However, before using these supplements, be sure to speak with your doctor or pharmacist. This is for two main reasons. There are very few studies to support the use of these substances in the treatment of osteoporosis. As a result, we have no evidence that they work.

These medications can cause side effects in addition to interacting with the medications you are taking. You need to make sure you know what side effects are occurring and if you are taking medications that can interact with the supplement.

All of them report good results with natural treatments.

Exercises for osteoporosis: What you can do to help keep your bones healthy is not the right thing to do. Exercise is very important, especially exercises with weights.

Weight-bearing exercises involve placing your feet or hands on the floor or another surface. Examples:

  • Climbing stairs
  • Leg presses
  • Squats
  • Lizards
  • Resistance bands
  • Dumbbells
  • Heavy-duty exercise machines

These exercises help because they make your muscles push and pull on your bones. This action tells your body to form new bone tissue, which makes your bones stronger.

This isn’t your only benefit from exercise, however. In addition to its many positive effects on weight and heart health, exercise can also improve your balance and coordination, which can help you avoid falls.

Prevention of osteoporosis

Your bones need good nutrition and regular exercise to stay healthy throughout your life.

Protein: Protein is one of the building blocks of bones. However, there is conflicting evidence on the effect of protein intake on bone density. Most people eat a lot of protein in their diet, but some don’t. Vegetarians and vegans can deliberately get enough protein in their diet if they want adequate sources such as soy, nuts, legumes, seeds for vegetarians and vegans, and dairy and eggs for vegetarians.

Older people can eat less protein for a number of reasons. If you think you are not getting enough protein, ask your doctor if supplementation is an option.

Bodyweight: Being underweight increases your risk of bone loss and fractures. Being overweight now increases your risk of arm and wrist fractures. Therefore, maintaining appropriate body weight is good for your bones, as well as your overall health.

Calcium: Women between the ages of 18 and 50 need 1,000 milligrams of calcium per day. This daily increase to 1,200 milligrams when women turn 50 and men turn 70.

  • Good sources of calcium
  • Low-fat dairy products
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Soy products like tofu
  • Calcium-fortified whole grains and orange juice

If you find it difficult to get enough calcium from your diet, consider taking calcium supplements. However, too much calcium is associated with kidney stones. Although it is not yet clear, some experts suggest that calcium may increase the risk of heart disease, especially in supplements.

The Department of Health and Medicine of the National Academy of Sciences, Engineering, and Medicine (formerly Institute of Medicine) recommends that total calcium intake, including supplements and diet, should not exceed 2,000 milligrams per day for those over 50 years.

Vitamin D: Vitamin D improves your body’s ability to absorb calcium and improves bone health in other ways. People can get some of their vitamin D from sunlight, but it is not a good source if you live in high latitude, are at home, or use sunscreen regularly, or avoid the sun due to the risk of skin cancer.

To get enough vitamin D to maintain bone health, it is recommended that adults ages 51 to 70 take 600 international units (IU) and 800 IU after age 70 through diet or supplements. Those who have no other sources of vitamin D and especially those with limited sunlight need supplementation. Most multivitamin products contain 600 to 800 IU of vitamin D. Up to 4,000 IU of vitamin D per day is safe for most people.

Exercise: Exercise can help you build strong bones and slow them down. Exercise can benefit your bones when you start out, but there are many benefits to you if you start exercising regularly as a child and continue to exercise throughout your life.

Combine strength training exercises with weight lifting and balance exercises. Strength training can help strengthen the muscles and bones in your arms and upper spine. Weight-bearing exercises (walking, jogging, running, stair climbing, rope skiing, skiing, and impact sports) primarily affect the legs, hips, and backbones.

Balance exercises like tai chi reduce the risk of falls, especially as you age. Swimming, cycling, and exercising on machines like ellipticals provide good cardiovascular exercise, but they do not improve bone health.

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