OSTEOPOROSIS

WHAT IS OSTEOPOROSIS?

Osteoporosis is a health condition in which our bones become weak and brittle, making them easily susceptible to fracture even with a mild or trivial stress/trauma. These fracture-related injuries commonly occur in the hips, wrists and spine (Vertebral column). 

Like any other organ in the body, our bone is also a living tissue that gets its nutrition and oxygen supply through the blood. In our day-to-day life, our bone tissues constantly get broken down and replaced with a new bone tissue (Constant state of renewal), which is necessary to maintain its optimum health and keep them stronger. In a young, growing and healthy individual, the rate of new bone formation is faster than the rate of bone removal, which increases the bone mass and keeps them strong. The growth of an individual gets completed approximately around the age of early 20s. At this stage, the peak bone mass is attained. Once a person starts ageing, the rate of bone removal exceeds that of bone formation; thus, bones start losing their density and become increasingly thin and brittle. 

A similar process occurs in osteoporosis; the rate of bone removal exceeds that of new bone formation resulting in significant loss of bone mass, making them weak and brittle. 

Other than older age, multiple risk factors can play a significant role in developing osteoporosis, especially at a relatively younger age.  

THE RISK FACTORS ARE 

• OLDER AGE:  

As we have already seen, with the increasing age, bone formation lags behind the pace of old bone removal; it reduces bone density, making them weak and brittle. 

• FEMALE GENDER:  

The severity of osteoporosis also depends upon the peak bone mass attained at adulthood. Women have low peak bone mass as compared to men of the same age group. Additionally, women are at a higher risk of suffering from osteoporosis after menopause due to hormonal deficiency (Low Oestrogen levels). 

• FAMILY HISTORY OF OSTEOPOROSIS:  

Having a relative (parent or a sibling) with osteoporosis puts an individual at the risk of suffering from it in the future. 

• SMALL BODY FRAME:  

Small body frames are associated with less bone mass, thus increasing the risk of osteoporosis. 

• LOW LEVELS OF TESTOSTERONE AND OESTROGEN IN MEN AND WOMEN, RESPECTIVELY:  

In women, the hormone oestrogen is essential for healthy bones; after menopause, oestrogen levels fall, leading to a rapid decrease in bone density (Osteoporosis). Similarly, in men advancing age, medications or other diseases can reduce hormone testosterone levels necessary for bone health, increasing the risk of suffering from osteoporosis. 

• OVERACTIVE THYROID GLAND (HYPERTHYROIDISM):  

The overactive thyroid gland produces excess thyroid hormones, which is more than usual. The excess thyroid hormones stimulate the activity of cells participating in the removal of bone. It creates an imbalance between bone growth and bone removal; thus, reducing bone density and increasing the risk of osteoporosis. 

• CALCIUM DEFICIENCY:   

Calcium is one of the main minerals present in the bone. Inadequate calcium intake or loss of calcium from the body due to any health condition can reduce the bones' mineral density, making them weak and brittle (Osteoporosis). 

• LOW VITAMIN-D LEVELS:  

Vitamin D is necessary for the absorption of calcium in our body. It also maintains the rate of bone formation more than that of bone removal, which helps maintain healthy bone density. Thus, vitamin- D deficiency makes bone brittle and weak (Osteoporosis).  

• EATING DISORDERS: 

Disorders like Anorexia nervosa or bulimia can make our bones weak in multiple ways, e.g., Due to anorexia, the quantity of food consumed is less, leading to nutritional deficiencies like calcium and phosphorus (Key minerals of our bone). Also, it triggers the excess secretion of cortisol, which disturbs the balance of bone renewal, increasing the loss of bone increasing the risk of osteoporosis.  

• GASTROINTESTINAL SURGERY (Reduces the absorption of some nutrients, e.g., Calcium): 

Any major surgery in the gastrointestinal tract may reduce the capacity to absorb certain nutrients from the food or through oral supplements. E.g., Calcium. Which can result in an early reduction in bone mineral density and an increase in the risk of osteoporosis. 

• PROLONGED IMMOBILITY DUE TO INJURY OR ILLNESS:  

Prolonged immobility makes the cells that participate in bone removal more active than those in new bone formation. As a net effect, the effective bone mass and density get reduced, thus increasing the risk of osteoporosis. 

• CERTAIN MEDICATIONS: 

1. Steroids 
2. Antiepileptics 
3. Chemotherapeutic agents, etc. 

• MEDICAL CONDITIONS LIKE: 

1. Digestive diseases (Insufficient absorption of nutrients) 
2. Inflammatory bowel diseases 
3. Kidney or liver diseases 
4. Cancers (Breast, Prostate, etc.) 
5. Multiple myeloma 
6. Rheumatoid arthritis 

• UNHEALTHY LIFESTYLE CHOICES: 

1. Sedentary lifestyle.  
2. Lack of regular exercise or walking 
3. Smoking 
4. Excessive alcohol consumption.  

It results in a decrease in the activity of bone formation and an increase in the activity of bone removal coupled with a reduction in the density of bone minerals such as calcium, phosphorus, etc.; thus, increasing the risk of suffering from osteoporosis.

WHAT ARE THE SYMPTOMS OF OSTEOPOROSIS? 

Clinically only a few symptoms or signs exhibited by the person can help in suspecting osteoporosis, e.g., 

• Back pain or neck pain due to a fractured or collapsed vertebra. 
• Loss of height over time (Compressed vertebrae) 
• A stooped posture 
• Fractures from a trivial trauma or mild injury 

A person needs to be checked thoroughly by a physician with appropriate supporting investigations to confirm a diagnosis of osteoporosis. The investigations can involve calculating bone mineral density, spine X-rays, X rays of hip and wrist joints, Serum Calcium and Vitamin D levels, etc.  

Osteoporosis not only makes our bones weak but also leads to some health-related complications. The weak bones are susceptible to fractures even with mild or minimum trauma, especially the bones of our hip joint, vertebral column, wrist joint, etc. These fractures can further lead to disability, immobility, further loss in bone density and other health-related consequences.  

TIPS TO PREVENT OSTEOPOROSIS: 

• INCREASE DIETARY CALCIUM INTAKE OR TAKE SUPPLEMENTS IF REQUIRED. 

Calcium is necessary for healthy bones as it is an essential bone mineral. Normal calcium levels help keep the density of our bones normal and reduce the risk of suffering from osteoporosis. The foods that are rich in calcium are: 

1. Milk 
2. Yoghurt 
3. Cottage cheese 
4. Cheese 
5. Spinach 
6. Other green leafy vegetables 
7. Ragi (Nachani) 
8. Rajma 
9. Chickpeas 
10. Almonds 
11. Walnuts 
12. Coconut 
13. Drum stick leaves 
14. Sesame seeds 
15. Amaranth (Rajgira) 

• GET ENOUGH VITAMIN- D 

Vitamin D is essential for maintaining the bone renewal process balance and the efficient absorption of calcium in our body. Calcium is a vital bone mineral. Its sufficient levels are necessary for maintaining bone strength; thus, getting enough Vitamin D either by adequate Sun exposure or supplements is essential for healthy bones. 

• TAKE REGULAR WALK 
• BE ACTIVE, DO REGULAR EXERCISES APPROPRIATE FOR THE AGE AND HEALTH STATUS SUCH AS: 

1. Dancing 
2. Swimming 
3. Aerobics 
4. Jogging 
5. Yoga 
6. Outdoor sports 
7. Running 
8. Strength training, etc.). 

Walking and other exercises like jogging, aerobics, etc., helps in strengthening our bones, the surrounding muscles, ligaments, etc. It also slows down bone loss and helps in improving bone density. 

It is essential to understand that those already suffering from osteoporosis and have weak bones should adopt the exercise regimen as per the individual health status after consulting the doctor/healthcare professional to reduce the chances of bone injuries like fractures, etc. 

• AVOID SMOKING 

Smoking increases the activity of cells that break down the bone than the bone-forming cells; thus, it reduces bone density and increases the risk of osteoporosis; therefore, it is advisable to stop smoking.  

• AVOID EXCESSIVE ALCOHOL CONSUMPTION. 

Excessive alcohol consumption reduces bone density and makes our bones weak thus; it is advisable to reduce or stop alcohol consumption to reduce the risk of osteoporosis 

• CONSULT A DOCTOR FOR THE TREATMENT OF UNDERLYING HEALTH CONDITIONS RESPONSIBLE FOR OSTEOPOROSIS. 

As mentioned in the risk factors, many underlying health conditions like digestive diseases, inflammatory disorders, etc., may be responsible for weakening the bones. Therefore, it is essential to visit a doctor and treat these conditions if there is no improvement despite taking up the diet and lifestyle modifications.