What is it?
Osteoporosis means just as the name suggests – porous bones (also often called thinning of the bones). The number of women age 50 and older who have osteoporosis or are at risk for developing the disease will increase from almost 30 million in 2002 to over 35 million in 2010 and to approximately 41 million in 2020. Yet despite this, few people are aware of it or the damage it can lead to.
This may be because we tend to think of our bones as solid, static objects. But, in fact, our bones are an active, dynamic organ and – just like the rest of the body’s organs – they’re involved in a constant process of cell growth, repair and change. And this process can go wrong.
Rather than being solid objects, our bones are made from a honeycomb of strands formed by the protein collagen and hardened by calcium salts and other minerals. This honeycomb is filled with bone marrow and blood vessels and protected by a dense outer shell. Scattered throughout are millions of living bone cells, which continually break down and replace old bone. Our bones are completely renewed over a period of about ten years.
While we’re young, our bones continue to grow and get denser and stronger. They reach maximum strength at 25 to 30 years, known as peak bone mass. After this, sadly, it’s all downhill. Bone is lost faster than it can be replaced and the holes of the honeycomb become larger, leaving bones weaker and more likely to break. (Compare pictures of healthy bone with osteoporotic bones at the website of the National Osteoporosis Society.)
Unless you take special precautions, osteoporosis can develop, especially if you’re particularly vulnerable. Women are especially prone to the disease, owing to loss of oestrogen after the menopause.
In osteoporosis, fractures can occur anywhere in the skeleton, but especially in the wrist, spine and hip.
The risk factors for osteoporosis include:
Many people don’t discover they have osteoporosis until they break a bone as the result of a relatively minor fall. Screening tests – usually involving a bone density scan – do exist, although you may have to pay for them privately.
The most important thing you can do to prevent osteoporosis is keep your bones strong and healthy while you’re young. The aim is to maximise peak bone mass, reached at the end of your 20s. If this is high, you’ll have greater bone reserves to help you face the natural loss of ageing. If you’re already in your 30s, the priority is to maintain bone strength.
This can be achieved through:
- Getting older, although in some cases it can also affect children and adolescents.
- Loss of oestrogen as a result of the menopause (especially early menopause), hysterectomy (especially if the ovaries are removed), infrequent periods (especially linked to anorexia or excessive exercise)
- Long-term use of high-dose steroids
- Family history (ie, a genetic tendency)
- Lack of exercise
- Excessive alcohol consumption
- Low testosterone levels in men
Once you’ve lost bone mass, it can’t be regained. However, you can prevent further damage by:
- A calcium-rich diet.
- Exercise, especially weight-bearing. Tennis players, for example, have a 30 per cent higher bone density in their serving arm than in their non-serving arm. Try running, cycling or bouncing on a trampoline for at least 30 minutes three times a week. Simply jumping up and down 50 times a day will keep your bones strong. For more tips, click here.
- strengthening the remaining bone structure
- preventing further thinning
- Hormone replacement therapy (HRT) – the hormone oestrogen significantly reduces the risk of osteoporosis. However, research has shown that long-term use of HRT may be associated with significant risks as well as benefits, in particular doubling the risk of breast cancer and increasing the risk of heart disease and stroke. Therefore, each individual woman needs to weigh up the risks and benefits before deciding whether to use it.
- Bisphosphonates – these drugs, such as alendronate and etidronate, switch off the cells that break down bone, so bone building can take over.
- Calcium and vitamin D supplements – these are especially useful for those on a limited diet or who are housebound.
- Calcitonin – a hormone made by the thyroid gland, which inhibits the cells which break down bone.
- Testosterone supplements for men.
This article was last medically reviewed by Dr Trisha Macnair in August 2005.
First published in November 1997.
- Selective estrogen receptor modulators (SERMs) – these are a new type of drug that acts like a synthetic form of hormone replacement. They reduce the risk of osteoporosis and heart disease, but don’t increase the risk of breast or endometrial cancer.
Having a Mother with Osteoporosis Can Lead to Increased Risk for Spinal Fracture (Palatka Daily News) – (ARA) – Of the 10 million Americans with osteoporosis, 80 percent are women, and having a mother with osteoporosis puts a daughter particularly at risk for fractures.
Discovery of calcium taste bud could help scientists prevent osteoporosis (Daily Mail) – The discovery of a taste bud for calcium could help us to keep osteoporosis at bay. Scientists found that a mouse’s mouth is programmed to pick out the taste of calcium and it is likely our taste buds are similarly primed.
CORRESPONDENCE: Osteoporosis in Men (New England Journal of Medicine) – To the Editor: In his review of osteoporosis in men, Ebeling (April 3 issue)1 presents the World Health Organization (WHO) …
Discovery of calcium taste bud could help scientists prevent osteoporosis (Daily Mail) – The discovery of a taste bud for calcium could help us to keep osteoporosis at bay. Scientists found that a mouse’s mouth is programmed to pick out the taste of calcium.
Osteo Drug Stops Bone Loss From Breast Cancer Chemo (HealthDay via Yahoo! News) – THURSDAY, Aug. 21 (HealthDay News) — The osteoporosis drug Zometa (zoledronic acid) prevented bone loss at 12 months in premenopausal women undergoing chemotherapy after they had surgery for early stage breast cancer, a new study found.
How Rheumatoid Arthritis Causes Bone Loss (Science Daily) – Researchers have discovered key details of how rheumatoid arthritis destroys bone, according to a study published in the Journal of Biological Chemistry. The findings are already guiding attempts to design new drugs to reverse RA-related bone loss and may also address more common forms of osteoporosis with a few adjustments.
Drug Stops Bone Loss From Breast Cancer Chemo (HealthDay via Yahoo! News) – THURSDAY, Aug. 21 (HealthDay News) — Zometa (zoledronic acid) prevented bone loss at 12 months in premenopausal women undergoing chemotherapy after they had surgery for early stage breast cancer, a new study found.
Cascadia Consulting Group’s Bill Sipper Elected to National Osteoporosis Foundation’s Board of Trustees (PR Newswire via Yahoo! Finance) – Cascadia Consulting Group’s Bill Sipper has been unanimously elected to the National Osteoporosis Foundation’s Board of Trustees for a three-year term. Mr. Sipper has been working with the National Osteoporosis Foundation for the past two years.
New discovery on how rheumatoid arthritis destroys bone (News-Medical-Net) – Researchers have discovered key details of how rheumatoid arthritis (RA) destroys bone, according to a study published in the Aug. 22 edition of the Journal of Biological Chemistry. The findings are already guiding attempts to design new drugs to reverse RA-related bone loss and may also address more common forms of osteoporosis with a few adjustments.
Insurance gap leads some elderly to forgo medicine (AP via Yahoo! News) – Many people in Medicare with diabetes, high blood pressure and other chronic conditions stop taking their medicine when faced with picking up the entire cost of their prescriptions, researchers say.
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