Osteoporosis and Osteopenia

Osteoporosis is a bone loss disease in which bones lose their mineral density and become fragile, and thus more likely to break. Untreated osteoporosis can progress painlessly until a bone fractures. In osteoporosis the bone microarchitecture is disrupted and the amount and variety of proteins in bone is altered. Specifically, the cancellous bone or trabecular (spongy) bone, demineralizes. Bone density lose through demineralizing decreases the structural integrity of the bone. Healthy bones remodel and rebuild themselves constantly throughout life. This process slows and becomes insufficient with osteoporosis.

Osteoporosis is most common in women after menopause, when it is called postmenopausal osteoporosis, but may also develop in men. This may occur in anyone in the presence of particular hormonal disorders and other chronic diseases or as a result of medications, specifically glucocorticoids when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP). Given its influence in the risk of fragility fracture, osteoporosis may significantly affect life expectancy and quality of life.

Osteopenia is the condition where bone mineral density is lower than normal and is considered a precursor for osteoporosis. However, not every person diagnosed with osteopenia will develop osteoporosis. At this stage, many bone loss treatment and prevention techniques can reverse the progression of the disease.

Signs and Symptoms

There are no obvious signs or symptoms. Usually the first sign of osteoporosis is a fragility fracture, or a fractured bone from a situation where a heathy adult would not normally break a bone. Any bone can be affected, but most common are the hip, rib, spine, and wrist. Of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person’s ability to walk unassisted and may cause prolonged or permanent disability. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity.

Common Causes

There are many contributing factors to the development of osteoporosis, the most important are age, female gender, and estrogen deficiency, especially in aging women after menopause. Other factors are dietary or lifestyle choices in origin. Poor or malnutrition, excessive alcohol consumption, smoking, and vitamin D deficiency have all been linked to loss of bone density and an increased incidence of osteopenia and osteoporosis. Over consumption of dietary protein is another often neglected cause of osteoporosis. The excess protein causes calcium to be taken from the bones and excreted in the urine.

Excessive physical exercise can also lead to constant damage to the bones which can cause exhaustion of the structures as described above. There are many examples of marathon runners who developed severe osteoporosis later in life. In women, heavy exercise can lead to decreased estrogen levels, which predisposes them to osteoporosis. In addition, intensive training without proper compensatory increased nutrition increases the risk.

Bone Loss Prevention & Treatment

The best way to prevent osteoporosis is to maintain a healthy lifestyle with proper nutrition and a normal exercise plan. Establishing a high bone density through a balance in resistive weight training and a challenging regular cardio workout will help keep your bones remodeling and laying down new mineral structures. Eating foods rich in calcium and getting enough vitamin D will give your body the materials for bone remodeling and keep your skeleton strong.

After a diagnosis of osteoporosis is made, there are several medications used to treat it, depending on gender. Medications themselves can be classified as antiresorptive or bone anabolic agents. Antiresorptive agents work primarily by reducing bone resorption, while bone anabolic agents build bone rather than inhibit resorption. Many women are placed on estrogen replacement therapy and some people are put on bisphosphonates.

Questions and concerns about osteoporosis, osteopenia and diagnostic scanning are good questions for your doctor. Ask about the most popular method for scanning: the dual energy X-ray absorptiometry (DXA or DEXA) scan. Blood tests and X-rays may also reveal early signs.