Pharmacist focus
Patient Education Series May 2007
Osteoporosis
What Causes Osteoporosis?
The exact cause of osteoporosis in unknown; however, we do know how the disease develops. Your bones are made of living, growing tissue. Trabecular bone, a sponge-like bone, is encased by an outer shell of dense bone. When a bone is weakened by osteoporosis, the "holes" in the "sponge" grow larger and more numerous, which weakens the internal structure of the bone.
Until a person is about age 30, more bone is built than is lost. After age 35, bones breakdown faster than they are built, causing a gradual loss of bone mass. Once a person loses a certain amount of bone, he or she has osteoporosis.
Is Osteoporosis Related to Menopause?
Yes, there is a direct link between the lack of estrogen after menopause and the development of osteoporosis. Loss of bone mass can be caused by early menopause (before age 45), prolonged periods with low hormone levels, and menstrual periods that are absent.
What Are the Common Symptoms of Osteoporosis?
Osteoporosis is referred to as the "silent disease" because bone loss occurs without any signs or symptoms. People may not know they have the disease until their bones become so weak that a sudden strain, bump, or fall creates a fracture or causes vertebrae to collapse. Severe back pain, height loss, and stooped posture may be an initial sign of collapsed vertebrae.
Who is at Risk?
- Age. Bone mass begins to naturally decline after age 30.
- Race. Research has shown that Caucasian and Asian women are more likely to develop osteoporosis. Furthermore, Caucasian women are more likely to have hip fractures than black women.
- Gender. Women over the age of 50 are at the greatest risk of developing osteoporosis. Studies show that women are four times more likely than men to develop osteoporosis, due to women's lighter, thinner bones and longer life spans.
- Bone structure and body weight. People (men and women) who are petite and thin have a greater risk of developing osteoporosis because they have less bone to lose than others with larger frames and more body weight.
- Family history. Heredity is one of the most important risk factors for osteoporosis. If your parents or grandparents have any signs of osteoporosis, you may be at greater risk of developing the disease.
How Can I Find Out if I Have Osteoporosis?
A painless, accurate test can provide information about your bone health before problems begin. Bone mineral density (BMD) tests, or bone measurements, are X-rays that use very small amounts of radiation to determine bone strength.
How Is Osteoporosis Treated?
Treatments for established osteoporosis include:
- Estrogen replacement therapy
- Medications such as Actonel, Calcimar, Evista, Fosamax and Micalcin
- Calcium and vitamin D supplements
- Weight-bearing exercises (which make your muscles work against gravity)
- Injectable Forteo
How Can I Prevent Osteoporosis?
There are a variety of ways you can protect yourself against osteoporosis, including:
- Exercise
- Eat foods high in calcium
- Supplements. Consider taking calcium carbonate and calcium citrate supplements. Check with your doctor or pharmacist.
- Vitamin D. Your body uses vitamin D to absorb calcium. Being out in the sun for a total of 20 minutes every day helps most people's bodies make enough vitamin D. Vitamin D can also be found in eggs, fatty fish like salmon, cereal and milk fortified with vitamin D, as well as supplements.
- Medications. Actonel, Calcimar, Evista, Fosamax and Micalcin are drugs available to prevent and treat osteoporosis.
- Estrogen. Estrogen helps protect against bone loss. Bone loss can be slowed and the body’s abilities to absorb and retain calcium can be improved by replacing estrogen lost after menopause.
- Avoid certain medications. Steroids, drugs used to treat seizures, blood thinners, and thyroid medications all increase the rate of bone loss if not used as directed. If you are taking any of these medications, speak with your doctor or pharmacist about how to reduce your risk of bone loss through other changes.
- Other preventive steps. Limit alcohol consumption and do not smoke.
What Are Weight-Bearing Exercises and How Do They Help Strengthen Bone?
Weight-bearing exercises are activities that make your muscles work against gravity, such as walking, hiking, stair climbing, or jogging. A healthy diet and at least thirty minutes of regular exercise 4 days a week may increase peak bone mass in younger people. Regular exercise may also decrease bone loss or increase bone mass in older women and men.
Does Stress Affect Osteoporosis?
Stress can cause your body to experience hormonal changes that adversely affect the skeleton; however, the level of stress must be overbearing for a extended period of time (15 to 20 years) to produce any problems associated with osteoporosis.
If I Have Osteoporosis, What Can I Do to Protect Myself From Fractures?
Take the following safety measures to make your home safe:
- Remove loose household items, keeping your home free of clutter.
- Install grab bars on tub and shower walls and beside toilets.
- Install proper lighting.
- Apply treads to floors and remove throw rugs.
Source: WebMD Medical Reference in collaboration with the Cleveland Clinic
