Osteoporosis, a hushed disease characterized by a decrease in bone mass which results in bone fragility and increase risk of suffering from fractures.

Bones may feel rock solid, but they are actually living tissues made up of myriad layers of collagen, proteins and minerals. It is impressive that your frame is always in flux through something called bone remodeling, bones constantly breaks down and rebuild itself, giving a completely new skeleton every 10 years. On the same hand, it is disappointing that you lose more than you make after 30 years of your life.

Bones naturally becomes thinner as you grow older called Osteopenia, where bones lose minerals and become lighter, less dense and more porous. With further loss in bone, Osteopenia leads to Osteoporosis. Osteoporosis is a disease of the bones that is characterized by weakening of bone mass/density, and bone quality increasing the risk of fractures notable at hip, spine and wrist. Normal bone marrow has small holes within it, but a bone with osteoporosis will have much larger holes. Larger the holes, you are more vulnerable to fractures.

Signs and Symptoms

Osteoporosis is usually known as silent disease as you won’t discern you are osteoporosis victim unless your bone fractures. The only way to know that you have osteoporosis is through a test called bone mass density (BMD). This test should be repeated every 2-5 years depending upon the risk factors. The testing will help to determine if you are at risk of osteoporosis. From there, you can decide on whether you need to make certain lifestyle changes to prevent osteoporosis and fragile bones that are subject to fracture.

Osteoporosis can cause a vertebra to collapse. Many people especially women above 70 years old suffer from vertebra collapse. If you can relate, your grandmother and grandfather might be walking in a very awkward position, which is the closest example in your surroundings.

What are the causes of Osteoporosis

Age is the main cause of Osteoporosis. Although osteoporosis can occur in men, it is more common in women especially after menopause when estrogen level drops.

Other than age and menopause, the causes of this silent disease are:

• Long term use of certain medication, particularly corticosteroids and thyroid medications (carefully see warning and precautions section).

• Kidney failure

• Diseases of the thyroid or adrenal glands

• Not getting enough calcium, vitamin D, vitamin A and vitamin K. However, high intake of vitamin A may actually increase the risk of osteoporosis

• Anorexia nervosa

• Alcohol use disorder

Who are more at more risk of being victim of osteoporosis?

Numerous factors are associated with a higher risk of developing osteoporosis. Some of these risk factors are inherent and cannot be changed. These factors include:

• Having family history of osteoporosis or fractures.

• Being a female

• Being age 60 and older, the risk is same for men and women

• Late onset of menstruation or early menopause

• If you have too small or thin body

• Being Caucasian or Asian

• Smoking cigarettes, drinking too much caffeine or drinking alcohol regularly

• Dietary deficiencies in calcium and vitamin D

• Lack of exercise

• Low estrogen levels (from menopause or skipping menstrual periods) in women or low testosterone in men

• Having an eating disorder, particularly during the first 2 decades of life.

Prevention Care

I’m sure none of us want to break our own bones neither do we want to sit-walk-stand in a gauche position when everyone around us is standing straight and confident. We, often have the habit of ‘procrastination’. Hence, always tend to procrastinate the preventive method when we think have plenty of time. However, if you have this silent disease, all you can do is focus on prevention as osteoporosis’s medication is extremely challenging (long term intake of medication with certain lifestyle changes is required). Thus, prevention is not only the best method but the only method to keep osteoporosis away.

• Quit Smoking and drinking alcohol in excess

• Exercise, such as walking, climbing stairs, lifting weights or playing a sport

• Follow a healthy diet rich in calcium and vitamin D, such as dairy products and those with added calcium or by taking vitamin D pills. Increase the consumption of

 -    Calcium: Low-fat milk, cheese, broccoli

 -    Magnesium: Avocado, banana, honeydew, orange juice, potato, spinach

 -   Potassium: Whole grains, nuts spinach, oatmeal, peanut butter

 -   Vitamin D: Body exposure to sunlight also, found in fatty fish, fortified cereals and milk

 -   Vitamin K: Leafy greens, cauliflower

• Limiting caffeine to about 3 cups of coffee a day

Few days back, I went for BMD test at Suvekchya International hospital. They had organized a workshop for osteoporosis along with free BMD test. I was stunned when my test report was out. Being just 23 years old, I was already in the phase of Osteopenia (-1.3). I was more than bewildered to know that one of my sister who is 34 years old already has an osteoporosis (-3.4). Then, a teeny-weeny research on osteoporosis was must for me. Now, Finally I have decided to make some changes in my diet and my exercise to prevent from osteoporosis.

In the words of Dr. Rupesh K Vaidya

How can osteoporosis diagnose?

The common methods of diagnosis are through DEXA (Dual Energy X ray Absortiometry), Peripheral DXA, SXA, DPA, SPA, QCT, PQCT, QUS (Quantitative Ultrasound), Radiological assessment of vertebral fractures and Bone Turnover Markers (BTM). BTM are important in early estimation of treatment effect.

How can we cure osteoporosis?

The best treatment for osteoporosis is prevention. But for an osteoporosis victim, a number of effective medications are available such as Bisphosphonates, Calcitonin, Denosumab. However the use of these medications should be customize by changing the lifestyle.

Does osteoporosis medication have side effects?

Medication of osteoporosis are tailored to a person’s specific needs and used in conjunction with recommended lifestyle changes. So, if medication (Bisphosphonates) isn’t taken according to recommended changes, then it may cause gastric. Also, kidney should be functioning very well for taking Bisphosphonates.

Does medication taken for other illness causes bone loss?

Definitely! Medication for ‘asthma’ ‘organ transplants patient’, breast cancer drugs, even blood pressure drugs, and steroid medication can cause osteoporosis if taken for a long period of time.

How frequently should we test BMD?

It is recommended to have a BMD test at least once in two years for those who are above 60 years old. But for osteoporosis victim, we recommend to test at least once in a year especially to verify whether the medication is working or not.

What type of exercise is recommended for patients with osteoporosis?

Posture balance, coordination, and hip and trunk stabilization is recommended rather than general exercise. There are few exercises which osteoporosis victim should avoid such as sit-ups and excessive trunk flexion can cause vertebral crush fractures, golf swing, explosive loading can also cause fracture.

What is the most challenging thing for osteoporosis victim?

Staying on treatment is challenging. Treatment can work only if taken as recommended. It is common for victims to find taking medication difficult. As a result, half of the osteoporosis victims stop their treatment after one year because they do not see the immediate effect of the treatment.