osteoporosis

What Is Osteoporosis?

Osteoporosis is a silent and progressive disease characterized by a decrease in bone density and alterations in bone microarchitecture. This leads to increased bone fragility, raising the risk of spontaneous fractures or fractures from minor trauma.

This condition primarily affects postmenopausal women due to declining estrogen levels, but it can also occur in older men and other at-risk populations.

Causes and Risk Factors of Osteoporosis

Osteoporosis results from an imbalance between bone formation and bone resorption. Several factors can contribute to its development:

Hormonal and Age-Related Factors

• Reduced estrogen levels in postmenopausal women, accelerating bone loss.
• Decreased testosterone levels in aging men, although the effect is more gradual than in women.
• Natural aging leads to a decline in calcium absorption and vitamin D synthesis.

Nutritional and Lifestyle Factors

• Calcium and vitamin D deficiency, essential for bone mineralization.
• Excessive alcohol and caffeine consumption, which promotes calcium loss.
• Smoking, which impairs bone regeneration and reduces calcium absorption.
• Sedentary lifestyle and lack of exercise, as mechanical stress on bones stimulates their renewal.

Medical Conditions and Medications

• Long-term corticosteroid use (cortisol, prednisone), which accelerates bone resorption.
• Chronic diseases such as rheumatoid arthritis, hyperthyroidism, or digestive disorders, which impair nutrient absorption.

What Are the Symptoms of Osteoporosis?

Osteoporosis is often asymptomatic until a fracture occurs. However, some warning signs include:

• Loss of height over time, due to vertebral fractures compressing spinal discs.
• Chronic back pain caused by microfractures in the spine.
• Spontaneous fractures or fractures after minor impacts, particularly in the hip, wrist, or vertebrae.

How to Prevent Osteoporosis?

Optimize Calcium and Vitamin D Intake

Calcium is the primary mineral in bones, while vitamin D enhances its absorption. Recommendations include:

• Consuming 1,000 to 1,200 mg of calcium daily through dairy products, almonds, green vegetables (broccoli, kale), and fatty fish.
• Regular sun exposure to naturally synthesize vitamin D.
• Taking supplements under medical advice in cases of deficiency.

Engage in Appropriate Physical Activity

Exercise helps maintain bone and muscle strength:

• Weight-bearing exercises like walking, running, or dancing stimulate bone formation.
• Strength training, especially with light weights, reduces the risk of falls.
• Balance and coordination exercises (yoga, tai chi) improve stability and prevent fractures.

Adopt a Healthy Lifestyle

• Limit alcohol, salt, and caffeine intake, as they increase calcium loss.
• Quit smoking, which inhibits bone formation.
• Avoid a sedentary lifestyle, since lack of mechanical stimulation weakens bones.

Undergo Preventive Screening

A bone density scan (DEXA scan) is recommended for at-risk individuals (postmenopausal women, family history, prolonged corticosteroid use). This test assesses bone mineral density (BMD) and helps tailor prevention strategies.

What Are the Treatments for Osteoporosis?

Medications

If osteoporosis is diagnosed, several treatment options are available:

• Bisphosphonates (alendronate, risedronate): slow bone resorption and prevent fractures.
• Selective estrogen receptor modulators (SERMs): prescribed for certain postmenopausal women at risk.
• Teriparatide (parathyroid hormone analog): stimulates bone formation in severe cases.
• Calcium and vitamin D supplements, always combined with treatment.

Fall Prevention

Fractures associated with osteoporosis often result from falls. To prevent them:

• Secure the home environment (proper lighting, non-slip rugs, grab bars).
• Wear stable shoes and avoid slippery surfaces.
• Regularly check balance and vision.

FAQ About Osteoporosis

1. At What Age Should Bone Health Be Monitored?

Prevention should start as early as 40-50 years old, especially for postmenopausal women or those at risk.

2. What Foods Are Good for Bone Strength?

Dairy products, green vegetables, almonds, sardines, salmon, and tofu are rich in calcium.

3. Can Osteoporosis Be Cured?

No, but it can be slowed down and managed through lifestyle changes and medical treatment.

4. Why Are Women More Affected Than Men?

Estrogen decline after menopause accelerates bone loss, making osteoporosis more prevalent in women.

5. Is Osteoporosis Hereditary?

Yes, a family history of osteoporosis or early fractures increases the risk.

6. How Can I Know if I Have a Vitamin D Deficiency?

A blood test can measure vitamin D levels and determine if supplementation is needed.

7. What Sports Should Be Avoided in Osteoporosis?

High-impact activities like jumping, intense running, or contact sports should be approached with caution.

8. Does Osteoporosis Cause Pain?

It is generally painless, except in cases of vertebral fractures, which can lead to chronic back pain.

Early prevention and regular medical follow-up are essential to preserving bone health and reducing the risk of long-term fractures.