Osteoporosis ("porous bone") is a disease that weakens bones, putting them at greater risk for sudden and unexpected fractures. Osteoporosis results in an increased loss of bone mass and strength. The disease often develops without any symptoms or pain, and it is usually not discovered until the weakened bones cause painful fractures. Most of these are fractures of the hip, wrist, and spine.
Although osteoporosis occurs in both men and women, women are four times more likely to develop the disease than men. After age 50, one in two white women, and one in four white men, will have an osteoporosis-related fracture in their lifetimes. Another 30 percent have low bone density that puts them at risk of developing osteoporosis (including African-Americans).
Osteoporosis is responsible for more than 2 million fractures each year, and this number continues to grow. There are steps you can take to prevent osteoporosis from ever occurring. Treatments can also slow the rate of bone loss if you do have osteoporosis.
There are many risk factors that increase your chance of developing osteoporosis:
Though the exact cause of osteoporosis is unknown, we do understand how the disease develops. Your bones are made of living, growing tissue. The inside of healthy bone looks like a sponge; this area is called trabecular bone. An outer shell of dense bone wraps around the trabecular, or spongy bone. This hard shell is called cortical bone. When osteoporosis occurs, the "holes" in the "sponge" grow larger and more numerous, which weakens the inside of the bone.
In addition to supporting the body and protecting vital organs, bones store calcium and other minerals. When the body needs calcium, it breaks down and rebuilds bone. This process, called "bone remodeling," supplies the body with needed calcium while keeping the bones strong.
Up until about age 30, a person normally builds more bone than he or she loses. After age 35, bone breakdown occurs faster than bone buildup, which causes a gradual loss of bone mass. A person who has osteoporosis loses bone mass at a greater rate. After menopause, the rate of bone breakdown occurs even more quickly.
Painless and accurate medical tests can give you information about your bone health before problems begin.
Bone mineral density (BMD) tests, or bone measurements, also known as dual X-ray absorptiometry (DXA) scans, are X-rays that use very small amounts of radiation to determine the bone density of the spine, hip, or wrist.
Your physician can order these tests for you. All women over the age of 65 should have a bone density test. The DXA scan is done earlier for women who have risk factors for osteoporosis.
Men over age 70, or younger men with risk factors, should also consider getting a bone density test.
Women whose bone density test shows T-scores of -2.5 or lower should begin therapy to reduce their risk of fracture. Many women need treatment if they have osteopenia, which is bone weakness that is not as severe as osteoporosis.
Your doctor might use the World Health Organization fracture risk assessment tool, or FRAX, to see if you qualify for treatment based on your risk factors and bone density results. . People who have had a typical osteoporosis fracture, such as that of the wrist, spine, or hip, should also be treated (sometimes even if the bone density results are normal).
Treatments for established osteoporosis include:
Your diet and lifestyle are two important risk factors you can control to prevent osteoporosis. Replacing lost estrogen with hormone therapy also provides a strong defense against osteoporosis in postmenopausal women.
Diet — To maintain strong, healthy bones, you need a diet rich in calcium throughout your life.
One cup of skim or 1 percent fat milk contains 300 milligrams of calcium. Besides dairy products, other good sources of calcium are salmon with bones, sardines, kale, broccoli, calcium-fortified juices and breads, dried figs, and calcium supplements.
It is best to try to get the calcium from food and drink. For those who need supplements, remember that the body can only absorb 500 mg of calcium at a time. You should take your calcium supplements in divided doses, since anything more than 500 mg will not be absorbed.
Vitamin D is also important because it enables the body to absorb calcium. The recommended daily allowances of vitamin D are listed below. Vitamin D can also be obtained from sunlight exposure a few times a week or by drinking fortified milk.
Please ask your doctor for more detailed handouts to learn about getting the right amount of calcium and vitamin D. In some cases, your doctor might recommend higher doses of vitamin D.
Lifestyle — Maintaining a healthy lifestyle can reduce the degree of bone loss. Begin a regular exercise program, and don’t use too much alcohol and tobacco. Exercises that make your muscles work against gravity (such as walking, jogging, aerobics, and weightlifting) are best for strengthening bones.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 10/04/2015