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FAQs:
What is Osteoporosis?
Osteoporosis is a bone disease that develops when bone mineral density and bone mass decrease, or when the structure and strength of bone change. This can lead to a decrease in bone strength that can increase the risk of fractures (broken bones).
Osteoporosis is a “silent” disease because you typically do not have symptoms, and you may not even know you have the disease until you break a bone. Osteoporosis is the major cause of fractures in postmenopausal women and older men. Fractures can occur in any bone but happen most often in bones of the hip, vertebrae in the spine, and wrist.
How is Osteoporosis Diagnosed?
A healthcare provider will diagnose osteoporosis with a bone density test. A bone density test is an imaging test that measures the strength of your bones. It uses X-rays to measure how much calcium and other minerals are in your bones. Healthcare providers sometimes refer to bone density tests as DEXA scans, DXA scans, or bone density scans. All of these are different names that refer to the same test.
A bone density test uses low levels of X-rays to measure the density and mineral content of your bones. It’s similar to a typical X-ray. It’s an outpatient procedure, which means you won’t have to stay in the hospital. You can go home as soon as you finish your test. There are no needles or injections in this test.
Checking for changes in your bone density is the best way to catch osteoporosis before it causes a bone fracture. Your provider might suggest you get regular bone density tests if you have a family history of osteoporosis if you’re over 50, or if you have osteopenia.
Which Age Group is at an Increased Risk of Osteoporosis?
Osteoporosis affects women and men of all races and ethnic groups. Osteoporosis can occur at any age, although the risk of developing the disease increases as you get older. For many women, the disease begins to develop a year or two before menopause. Other factors to consider include:
- Osteoporosis is most common in non-Hispanic white women and Asian women.
- African American and Hispanic women have a lower risk of developing osteoporosis, but they are still at significant risk.
- Among men, osteoporosis is more common in non-Hispanic whites.
Certain medications, such as some cancer medications and glucocorticoid steroids, may increase the risk of developing osteoporosis.
Because more women get osteoporosis than men, many men think they are not at risk for the disease. However, both older men and women from all backgrounds are at risk for osteoporosis.
Some children and teens develop a rare form of idiopathic juvenile osteoporosis. Doctors do not know the cause; however, most children recover without treatment.
Does Osteoporosis Cause Pain?
Osteoporosis itself isn't painful. But when the condition is severe, it can lead to fractures and other painful problems. It's important to have a long-term treatment plan. The pain is usually more severe than the aches many people feel as they get older. The most common cause of osteoporosis pain is a spinal compression fracture. Bones are fragile in osteoporosis. Fractures can happen even from simple movements that don't seem dangerous, for example lifting a bag of groceries, twisting to get out of a car, or tripping slightly on a rug. Fractures can take months to heal. The pain should start to go away as the bone begins to repair itself. However, for some people, osteoporosis pain can last longer. If you are hurt, talk to your doctor. They can help you find ways to manage it.
Is Osteoporosis Genetic?
Osteoporosis is a common disease with a strong genetic component characterized by low bone mass, microarchitectural deterioration of bone tissue, and an increased risk of fracture. Twin and family studies have shown that genetic factors play an important role in regulating bone mineral density and other determinants of osteoporotic fracture risk, such as ultrasound properties of bone, skeletal geometry, and bone turnover. Osteoporosis is a polygenic disorder, determined by the effects of several genes, each with relatively modest effects on bone mass and other determinants of fracture risk. It is only on rare occasions that osteoporosis occurs as the result of mutations in a single gene.
Can Osteoporosis be Reversed?
Osteoporosis is not reversible, but medication, a nutrient-dense diet, and weight-bearing exercise can help prevent further bone loss and rebuild bones.
Osteoporosis weakens bones so they are more likely to break. Bones consist of living tissueTrusted Source. As these tissues break down, the body discards them and creates new ones to replace them.
When a person has osteoporosis, there is a disruption to this balance. People lose too much old bone, do not create enough new bone, or both.
The condition typically progresses gradually over several years, and a person usually only receives a diagnosis after they have broken a bone. A doctor can also diagnose osteoporosis using a bone density scan, such as a dual-energy X-ray absorptiometry scan, in people at an increased risk of the condition.
Osteoporosis vs Osteopenia: What’s the Difference?
Osteopenia and osteoporosis are diagnoses that are used to label bones that have weakened over time. Bone strength can be measured with bone mineral density (BMD) scores. BMD measures the level of minerals — like calcium — in your bones, and a lower score means you’re at an increased risk of fractures or breaks.
Osteopenia can be considered the first step toward osteoporosis. Technically, it’s just a way of saying that your bone density is lower than normal, but not yet causing real problems.
Bone density peaks around age 35, and as your bone density decreases, you may be diagnosed with osteopenia. Typically, this begins to occur with no symptoms at all, but if you begin to break or fracture bones easily, your doctor may decide to measure your bone density.
If you have a lower-than-normal bone density score — between -1 and -2.5 — you have osteopenia. If your score is lower than -2.5, you may be diagnosed with osteoporosis.
Osteoporosis is the more serious progression of osteopenia. As bone density decreases, the honeycomb-like structure inside your bones becomes even more porous. The more open spaces there are inside your bones, the more density and strength they lose. The light, fragile bones that develop with osteoporosis can place you at a higher risk for fractures and breaks, even when you are doing simple daily activities.
Is Osteoporosis a Disease?
Osteoporosis is a bone disease that develops when bone mineral density and bone mass decrease, or when the quality or structure of bone changes. This can lead to a decrease in bone strength that can increase the risk of broken bones (fractures).
How Does Resistance Training Prevent Osteoporosis?
Resistance training may help prevent osteoporosis by increasing bone density. This type of exercise puts stress on the bones, and in response, the body creates denser bone tissue.
However, research has not conclusively proven that resistance training increases bone density substantially. A 2020 review states that it probably helps with osteoporosis prevention but that there is more evidence for this in some parts of the body than others.
Still, resistance training has a range of benefits in addition to potentially building stronger bones. It can strengthen muscles and may reduce the risk of falls in combination with other exercises.
Does Yoga Help Osteoporosis?
The short answer is YES! But there are some important factors to be aware of:
Osteoporosis is a disease in which bones become less dense, predisposing them to fractures. There are no obvious symptoms of the disease. Oftentimes, people are unaware they have it unless they’re tested for it, or unfortunately, they find out after they break a bone.
Exercise is an important component of the treatment plan for people with osteoporosis, but certain movements can increase the risk of fracture. Always check with your doctor to make sure it’s safe to proceed with exercise. In severe cases of osteoporosis, which are rare, yoga may not be advisable at all.
Yoga can be beneficial for people with osteoporosis. A small study in 2009 found that practicing yoga can increase bone density if done consistently and properly. Yoga also improves balance and flexibility, which can prevent falls and therefore prevent fractures.
Can Osteoporosis Be Cured?
There is no cure for osteoporosis, but the symptoms of your disease can be managed with medicines and lifestyle changes. Depending on your age, sex, and medical history, your doctor will recommend different treatments to help you. Treatment aims to strengthen your bones so that they are less likely to break and to prevent falls that could damage your bones.
Symptoms of Osteoporosis
Osteoporosis doesn’t have symptoms the way lots of other health conditions do. That’s why healthcare providers sometimes call it a silent disease. You won’t feel or notice anything that signals you might have osteoporosis. You won’t have a headache, fever, or stomachache that lets you know something in your body is wrong. The most common “symptom” is suddenly breaking a bone, especially after a small fall or minor accident that usually wouldn’t hurt you. Even though osteoporosis doesn’t directly cause symptoms, you might notice a few changes in your body that can mean your bones are losing strength or density. These warning signs of osteoporosis can include:
- Losing an inch or more of your height.
- Changes in your natural posture (stooping or bending forward more).
- Shortness of breath (if disks in your spine are compressed enough to reduce your lung capacity).
- Lower back pain (pain in your lumbar spine).
It might be hard to notice changes in your physical appearance. A loved one may be more likely to see changes in your body (especially your height or posture). People sometimes joke about older adults “shrinking” as they age, but this can be a sign that you should visit a healthcare provider for a bone density test.
What Causes Osteoporosis
Osteoporosis happens as you get older and your bones lose their ability to regrow and reform themselves.
Your bones are living tissue like any other part of your body. It might not seem like it, but they’re constantly replacing their cells and tissue throughout your life. Up until about age 30, your body naturally builds more bone than you lose. After age 35, bone breakdown happens faster than your body can replace it, which causes a gradual loss of bone mass.
If you have osteoporosis, you lose bone mass at a greater rate. People in postmenopause lose bone mass even faster.
Risk Factors for Osteoporosis
Several factors can increase the likelihood that you'll develop osteoporosis — including your age, race, lifestyle choices, and medical conditions and treatments.
Unchangeable Risks
Some risk factors for osteoporosis are out of your control, including:
1. Your sex. Women are much more likely to develop osteoporosis than are men.
2. Age. The older you get, the greater your risk of osteoporosis.
3. Race. You're at greatest risk of osteoporosis if you're white or of Asian descent.
4. Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father fractured a hip.
5. Body frame size. Men and women who have small body frames tend to have a higher risk because they might have less bone mass to draw from as they age.
Hormone Levels
Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Examples include:
1. Sex hormones. Lowered sex hormone levels tend to weaken bones. The fall in estrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis. Treatments for prostate cancer that reduce testosterone levels in men and treatments for breast cancer that reduce estrogen levels in women are likely to accelerate bone loss.
2. Thyroid problems. Too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive or if you take too much thyroid hormone medicine to treat an underactive thyroid.
3. Other glands. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.
Dietary Factors
Osteoporosis is more likely to occur in people who have:
1. Low calcium intake. A lifelong lack of calcium plays a role in the development of osteoporosis.
Low calcium intake contributes to diminished bone density, early bone loss, and an increased risk of fractures.
2. Eating disorders. Severely restricting food intake and being underweight weaken bone in both men and women.
3. Gastrointestinal surgery. Surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients, including calcium. These surgeries include those to help you lose weight and other gastrointestinal disorders.
Steroids and other medicines
Long-term use of oral or injected corticosteroid medicines, such as prednisone and cortisone, interferes with the bone-rebuilding process. Osteoporosis has also been associated with medications used to combat or prevent:
- Seizures.
- Gastric reflux.
- Cancer.
- Transplant rejection.
Medical Problems
The risk of osteoporosis is higher in people who have certain medical problems, including:
- Celiac disease.
- Inflammatory bowel disease.
- Kidney or liver disease.
- Cancer.
- Multiple myeloma.
- Rheumatoid arthritis.
Lifestyle Choices
Some bad habits can increase your risk of osteoporosis. Examples include:
1. Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than those who are more active. Any weight-bearing exercise and activities that promote balance and good posture are good for your bones, but walking, running, jumping, dancing, and weightlifting seem particularly helpful.
2. Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases the risk of osteoporosis.
3. Tobacco use. The exact role tobacco plays in osteoporosis isn't clear, but it has been shown that tobacco use contributes to weak bones.
How to Prevent Osteoporosis
To protect their skeleton, men and women of all ages should ensure they are:
- Consuming adequate amounts of calcium and vitamin D
- Following national nutritional guidelines for protein, fruit, and vegetable intakes.
- Increasing weight-bearing activity
- Limiting alcohol intake to moderate use or less
- Stopping smoking if you smoke
If you’re a woman who has gone through menopause or a man older than age 50, your doctor should follow National Osteoporosis Foundation guidelines and:
- Talk to you about your risk of osteoporosis and related fractures
- Recommend a diet rich in fruits and vegetables that includes adequate vitamin D and calcium, with supplements prescribed as necessary
- Recommend regular weight-bearing and muscle-strengthening exercises
- Assess fall risk and offer appropriate prevention
- Ask whether you smoke and how much alcohol you drink
- Measure your height each year
What Not to Eat If You Have Osteoporosis
Treating osteoporosis requires healthy lifestyle habits, such as taking prescribed medications as directed, participating in weight-bearing exercises, and eating a healthy diet rich in nutrients like calcium, vitamin D, and vitamin K, which support bone health. Here are the eight types of foods that are best avoided when you have osteoporosis.
1. High-sodium Foods
Sodium is an essential nutrient, but getting too much of it can adversely affect health, including bones. The current recommendation for sodium intake is no more than 2,300 milligrams per day for most healthy adults. One study among nearly 70,000 postmenopausal women in the Women's Health Initiative concluded that as long as sodium intake falls within the recommended dietary guidelines, it does not appear to affect bone health significantly. The problem is that most people consume more than the recommended amount of sodium in the form of salt. Salt is made up of sodium and chloride. The kidneys help remove excess chloride, but when it can't keep up, bones are broken down to release alkali and help maintain acid-base balance. This results in calcium loss from bones. More than 40% of Western sodium intake comes from 10 types of foods. These include bread and rolls, sandwiches, pizza, soups, lunch meat, burritos, tacos, chicken, cheese, eggs, and savory packaged snacks like chips and pretzels.
2. Red Meat
Research suggests that dietary fat intake may be an independent modifiable risk factor for osteoporosis. Some studies have found that both a low-fat and a high-fat diet may increase osteoporosis risk, while a moderate-fat diet may help support healthy bone density. Red meat is particularly high in saturated fat and omega-6 polyunsaturated fatty acids. Some research suggests that increased consumption of these types of fats may be associated with a higher risk for osteoporotic fractures. Examples of commonly consumed red meat include beef, pork, and lamb, which may come in the form of ground beef and hamburgers, as well as highly processed options like hot dogs, sausage, and bacon.
3. Sugary Treats
Excessive intake of added sugar is not beneficial for any aspect of health. Research has found an association between sugary beverage consumption, like soda, and worsened bone health.6 Most human studies have concluded that high-sugar diets negatively affect bone health and can promote a higher risk of fractures. Keep in mind that the natural sugars found in healthy foods, like whole fruits and vegetables, are different from added sugars. Added sugars, like those found in ultra-processed foods like packaged baked goods, desserts, and snack items, and sugary beverages like fruit juices, energy drinks, soda, and sweetened teas and coffees, should be minimized.
4. Oxalate-Rich Foods
Oxalates are compounds found in certain plant foods that bind to calcium as they leave the body. Over time, this can result in calcium loss and, ultimately, poorer bone mineral density, especially if you already have osteoporosis. Some of the most oxalate-rich foods are leafy greens and legumes like beans, peas, and lentils. However, these foods are also very healthy and shouldn't necessarily be eliminated from your diet. Research shows that cooking oxalate-rich foods can significantly reduce their oxalate content. Preparation methods like soaking, boiling, and steaming are best for removing oxalate. Additionally, pairing oxalate-rich foods with other calcium-rich foods can help increase the amount of calcium absorbed at one time.
5. Wheat Bran
Some evidence suggests that the naturally occurring sulfur in grain products like wheat bran may increase your body's overall acidity. When the pH balance is off, it can trigger bone loss as the body tries to regain its balance. Furthermore, wheat bran is high in phytates, other naturally occurring plant compounds that can inhibit calcium absorption, similar to oxalates. Phytic acid is found in all wheat products but is especially concentrated in wheat bran. This doesn't mean wheat bran is bad for you to eat. It just means you shouldn't eat it all the time, especially alongside other foods that contain your primary sources of calcium. Furthermore, soaking and boiling wheat bran can help reduce its phytate content.
6. Caffeine
Caffeine is a natural stimulant found in coffee beans, chocolate, and certain teas. It's best to keep your caffeine intake to a minimum with osteoporosis. Though some research shows some benefits to bones from a small amount of caffeine, too much caffeine may interfere with bone metabolism and potentially leach calcium from your bones. Instead, choose decaffeinated coffee, tea, and other naturally caffeine-free beverages, such as water or seltzer water.
7. Alcohol
It's a good idea to avoid alcohol when you have osteoporosis because it may interfere with your body's ability to rebuild and strengthen bones properly. This is especially problematic with excessive consumption. Drinking alcohol may inhibit the absorption of nutrients like calcium, magnesium, and vitamin D that support bone health. Alcohol may also alter the normal function of hormones in the body involved in keeping bones strong, like parathyroid hormone, growth hormone, and estrogen.
8. Soda
Over the years, human and animal research has found an association between drinking soda beverages and poorer bone mineral density. Specifically, colas have been found to have much more significant adverse effects on bone mineral density than other sodas. For example, studies have observed a link between cola consumption and a higher risk of hip fractures among postmenopausal women.
What to Eat if You Have Osteoporosis
Don't let the number of foods to avoid above discourage you. If you have osteoporosis, there are still plenty of foods you can enjoy that offer more benefits to your bone health. Instead of foods high in added sugar, sodium, and saturated fat, prioritize foods that contain important nutrients for your bones, such as vitamin D, vitamin K, potassium, and calcium, as well as fiber and healthy fats. For example, healthier foods to eat with osteoporosis include:
- Fruits
- Vegetables
- Nuts and seeds
- Whole grains, like quinoa, barley, oats, and brown rice
- Lean proteins, such as poultry and fish
- Legumes that have been soaked and cooked
Taking a vitamin D supplement can also be a good idea, as over 50% of the global population has been found to have insufficient levels of this important nutrient for bone health.18 Be sure to check your blood levels for vitamin D before adding a supplement to determine whether a maintenance dose is enough or if you need to correct a deficiency.
How to Treat Osteoporosis
Your healthcare provider will suggest a combination of treatments that slow down your bone loss and strengthen your existing bone tissue. The most important part of treating osteoporosis is preventing bone fractures. The most common osteoporosis treatments include:
1. Exercise: Regular exercise can strengthen your bones (and all the tissue connected to them, like your muscles, tendons, and ligaments). Your provider might suggest weight-bearing exercises to strengthen your muscles and train your balance. Exercises that make your body work against gravity like walking, yoga, Pilates, and tai chi can improve your strength and balance without putting too much stress on your bones. You might need to work with a physical therapist to find exercises and movements that are right for you.
2. Vitamin and mineral supplements: You might need over-the-counter or prescription calcium or vitamin D supplements. Your provider will tell you which type you need, how often you should take them, and which dosage you’ll need.
3. Medications for osteoporosis: Your provider will tell you which prescriptions will work best for you and your body. Some of the most common medications providers use to treat osteoporosis include hormone therapies like replacement estrogen or testosterone and bisphosphonates. People with severe osteoporosis or a high risk of fractures might need medications, including parathyroid hormone (PTH) analogs, denosumab, and romosozumab. These medications are usually given as injections.
Natural Remedies for Osteoporosis
Some natural treatments that help osteoporosis include the following:
1. Physical Activity
Doctors recommend weight-bearing exercises or physical activity to treat osteoporosis, such as brisk walking or jogging. They also encourage exercise that improves balance, such as yoga and tai chi. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)Trusted Source, good physical activities for bone health also include strength or resistance training.
2. Quitting Smoking and Drinking
Doctors recommend people with osteoporosis stop drinking alcohol. However, the NIAMS suggests people can drink alcohol in moderation. They recommend no more than 1 drink per day for people assigned female at birth or no more than 2 drinks per day for people assigned male at birth. A doctor may also recommend that a person quit smoking cigarettes where applicable, as nicotine can cause the body to lose more bone than usual. NIAMS also recommends avoiding secondhand smoke.
3. Nutrition
Consuming a balanced diet is an important part of treating osteoporosis. In a 2020 studyTrusted Source, scientists investigated nutritional and dietary patterns related to osteoporosis. They concluded people could reduce their osteoporosis risk with a diet that included:
- fruit
- vegetables
- whole grains
- poultry
- fish
- nuts and legumes
- low-fat dairy products
They also concluded people could gain bone health benefits from avoiding processed food products. A doctor can refer a person to a dietitian to help them create a suitable eating plan.
4. Calcium and Vitamin D
Doctors recommend people with osteoporosis intake calcium and vitamin D3. Both calcium and vitamin D are important nutrients for preventing and treating osteoporosis. Calcium helps a person with osteoporosis keep their bones strong. A person’s body cannot make calcium. Instead, it must absorb it from food. Vitamin D helps a person’s body absorb calcium efficiently.
People can eat certain foods to ensure they get enough calcium, including:
1. low-fat dairy products
2. dark leafy green vegetables, such as:
- bok choy
- collards
- turnip greens
- broccoli
- some fish, such as sardines and salmon
3. calcium-fortified foods such as:
- soy milk
- tofu
- orange juice
- cereals
- bread
4. Foods that contain good sources of vitamin D include:
- fatty fish
- fish oils
- egg yolks
- liver
Different Kinds of Osteoporosis Specialists Near Me
Several types of doctors and other healthcare professionals can help you manage osteoporosis. The best option for you will depend on many factors, including any underlying causes of your osteoporosis and other health needs you may have. Here’s a closer look at some of the professionals who can help.
1. Primary Care Provider
Your primary care doctor or family clinician you see for general health concerns and annual physicals may be a good starting point. Depending on their background and area of expertise, they may be able to help by recommending physical activity, nutrition, and lifestyle tips. They can also prescribe medication. Even if they don’t have expertise in this area, they can offer a referral to another specialist who does.
2. Endocrinologist
An endocrinologist specializes in hormone-related conditions. Hormonal changes, specifically decreases and testosterone and the reduction of estrogen after menopause, play a big role in primary osteoporosis. An endocrinologist can help correct hormone imbalances and recommend lifestyle changes to help treat osteoporosis.
3. Geriatrician
Geriatricians specialize in healthcare for older adults. The risk for osteoporosis increases with age, so geriatricians often have lots of experience with managing osteoporosis.
4. Rheumatologist
A rheumatologist is a specialist in musculoskeletal and autoimmune conditions. They diagnose and treat conditions affecting the bones and joints using nonsurgical methods. They might coordinate your treatment with a physical therapist, orthopedic surgeon, or other doctor.
5. Gynecologist
Gynecologists specialize in female reproductive health. The onset of menopause leads to a drop in estrogen, a hormone that plays a role in protecting your bones. This drop in estrogen can lead to osteoporosis. A gynecologist can offer guidance on managing menopause and some of its potential effects, including osteoporosis.
6.Physical Therapist
A physical therapist is a movement specialist. They can help you to improve balance, strength, and function through a specific exercise program. They can help you to choose and complete appropriate exercises and activities so you can improve your strength while living with osteoporosis.
7. Orthopedic Surgeon
Osteoporosis increases bone fracture risk. An orthopedic surgeon treats bone fractures, including those that result from osteoporosis. Although an orthopedic surgeon likely will not offer treatment and management recommendations for osteoporosis, you may be referred to one if you experience a fracture.
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