Osteoporosis - Causes, Prevention, and Treatment

What is Osteoporosis?

Osteoporosis is a condition that is characterized by a decrease in bone mass and an increase in the porosity and fragility of bones. What this means is that the bones become more fragile and porous and will break more easily than before. It is a silent disease - meaning that the symptoms are not always apparent until a significant amount of bone mass has been lost.

Risk factors associated with osteoporosis are being female, having a thin frame, family history of osteoporosis, lack of exercise, deficient calcium, vitamin D, or magnesium intake, smoking, and alcohol abuse.

Certain medications can also influence bone density. For example, taking Synthroid, which is commonly prescribed for hypothyroidism, is an increased risk factor for osteoporosis.

Although women are much more likely to develop osteoporosis than men, men can also be affected. The most common sites of bone fractures due to osteoporosis are the hip and spine, but any bone can be affected.

The following You Tube video demonstrates and explains the process in which osteoporosis occurs.

Consequences of Untreated Osteoporosis

If left untreated, osteoporosis can lead to significant disability and/or deformity and even loss of life. Fractures of the spine, which commonly occur in people with osteoporosis, are particularly troubling. Spine fractures can lead to severe back pain, loss of height, and the formation of a dowager's hump. A dowager's hump is characterized by an abnormal curvature of the upper spine caused by bone loss and compression of the vertebrae of the upper back. We've all seen little old ladies who are hunched over with rounded shoulders. This condition is caused by osteoporosis.

Watch the You Tube video below that explains the consequences of untreated osteoporosis.

Prevention and Treatment

Most of the literature on prevention of osteoporosis will simply tell you to get more dietary calcium and vitamin D, and to perform weight bearing exercises, such as walking.

It is often recommended to take estrogen replacement therapy because low levels of sex hormones are thought to be one of the risk factors for osteoporosis.

However, women have been taking calcium supplements, walking, and taking hormone replacement therapy for years, and they still develop osteoporosis.

Supplementing women with small amounts of testosterone has shown better results in decreasing osteoporosis than estrogen replacement therapy, however, most women (and most doctors) are reluctant to to take or to give women testosterone because it is thought of as only a man's hormone.

So, how can this disease be prevented?

Obviously, getting enough dietary calcium and walking are good advice, however, to ensure the health of your bones as you age you need to perform weight bearing exercises for your entire body, including your back muscles. The best way to do this is through progessive resistance weight training. You can engage in progressive resistance training at a gym or even from home.

By building up your muscle strength and mass and making them stronger you will also increase the bone mass in your body. This is because it takes strong bones to support strong muscles and an increase in muscle mass will also increase the activity of osteoblasts, which are the cells responsible for building bone. Research has substantiated this claim. For example, Itoi et al. (1990) found that in elderly subjects with spinal osteoporosis, back muscle strength was a significant predictor of bone mineral density of the spine.

What this means is that to help prevent or even treat spinal osteoporosis that increasing one's back strength may help.

Walking may help to improve bone density of the hip, but by embarking on a weight training program to increase overall body muscle mass you will help to prevent osteoporosis.

Women are often reluctant to have anything to do with increasing their muscle mass for fear they will end up looking like men. However, women are unlikely to be able to build huge, bulky muscles (for more on this see the article Women and Muscle). Remember that building up a little muscle is going to be much better than ending up as a hunched over or disabled elderly person. In addition, increased muscle tone is more attractive than weak sagging muscles.

As people age, they lose more and more muscle. This leads to a number of problems, one of these is that you also lose bone along with the muscle. Strong muscles need strong bones to support them, but weak muscles only need weak bones to support them. The human body has evolved so that it gets rid of anything that it thinks it doesn't need. If you have weak, rarely used muscles, then your body is going to respond by only keeping enough bone to support those very weak muscles.

The alternative of not building muscle could be the development of osteoporosis and disability.

However, if you are not used to working out or exercising please see a physician before engaging in physical activity.

Also, if you are approaching or past menopause it is probably a good idea to talk to your doctor about getting a bone density scan.

REFERENCES

Itoi, E. et al. (1990).Bone mineral density and back muscle strength in spinal osteoporotics. Journal of Bone and Mineral Metabolism 8: 7-10.