What is Osteoporosis?

Causes of Osteoporosis

The causes of osteoporosis are diverse and can include:

• Calcium deficiency: Osteoporosis is primarily caused by a deficiency in calcium, phosphorus, and vitamin D, although other factors can contribute.

• Menopause: During menopause, ovaries stop producing estrogen, a hormone that plays a role in bone mass formation. The decrease in estrogen levels leads to bone loss.

• Endocrine diseases: Certain endocrine diseases like thyroid disorders or hypogonadism, resulting in insufficient production of sex hormones, can also cause bone loss.

• Rheumatic diseases: Conditions like rheumatoid arthritis and other rheumatic diseases can significantly decrease bone mass.

• Digestive diseases: Some digestive diseases, such as liver cirrhosis or malabsorption syndromes, can contribute to bone mass loss.

• Medications: Recent research has shown that certain medications like corticosteroids and heparin, when taken at high doses, can lead to osteoporosis. Some cancer medications may also have this side effect.

Symptoms and diagnosis of osteoporosis

Osteoporosis causes bone mass loss and bone weakening, but these symptoms are not visible to the naked eye. Often, the disease is only discovered after complications arise, which are characterized by visible symptoms. If a person experiences frequent fractures over a short period, osteoporosis may be suspected. Additionally, observing vertebral compression and a reduction in height may also indicate osteoporosis.

The diagnosis can be confirmed through a bone mineral density test, typically performed on the lumbar spine and upper femur. This test evaluates the mineral content in the bones.

Early detection through screening is crucial as it enables treatment to prevent the risk of fractures associated with this condition. Osteoporosis makes bones more porous and fragile, increasing the risk of fractures. Hence, early diagnosis upon the appearance of initial symptoms is essential.

Types of osteoporosis

There are two main types of osteoporosis: primary and secondary.

• Primary osteoporosis: There are three categories of primary osteoporosis:

• Idiopathic osteoporosis: Affects young individuals, including children, and has no identified cause.

• Type 1 osteoporosis: Occurs in people aged 50 and older, with a higher incidence in women after menopause. This type is often referred to as postmenopausal osteoporosis due to decreased estrogen production.

• Type 2 osteoporosis: Affects individuals aged 60 and older, particularly more women than men, and is known as senile osteoporosis.

• Secondary osteoporosis: Secondary osteoporosis is caused by other underlying medical conditions. It can result from thyroid gland diseases, digestive disorders, or liver cirrhosis. Secondary osteoporosis can also be caused by certain medications like anticonvulsants, anticoagulants, and high-dose corticosteroids.

Risk factors for osteoporosis

Several factors increase the risk of developing osteoporosis:

• Genetic predisposition: Studies have shown a genetic predisposition to osteoporosis, as individuals with a family history of the condition tend to have lower bone mass and an increased risk.

• Ethnicity: Ethnic background plays a role, with individuals of Asian and Caucasian descent being more prone to osteoporosis.

• Gender: Women are more susceptible to osteoporosis, particularly after menopause.

• Diet: Inadequate intake of calcium, phosphorus, and vitamin D can lead to reduced bone mass. The Mediterranean diet is recommended to combat osteoporosis.

• Lifestyle: Excessive alcohol and caffeine consumption can lead to calcium loss in urine, while smoking interferes with calcium absorption. Vitamin D, on the other hand, promotes calcium absorption.

• Physical activity: Long-term immobilization can cause bone loss, emphasizing the importance of regular physical activity throughout life in preventing osteoporosis.

Treatment for osteoporosis

The primary goal of treating osteoporosis is to rebuild bone mass using medication, supplements, and exercise. Fortunately, several medications are available to treat osteoporosis:

Medications for osteoporosis:

• Analgesics: These help manage pain associated with osteoporosis.

• Bisphosphonates: Medications like alendronate (Fosamax), risedronate (Actonel), etidronate (Didrocal), and zoledronic acid (administered through injections) are used to prevent bone loss. However, these drugs can have side effects, including atypical femur fractures and jaw osteonecrosis.

• Selective estrogen receptor modulators: Raloxifene (Evista) can prevent bone loss and reduce the risk of spinal fractures.

• Teriparatide: This hormone therapy stimulates bone formation and is recommended for women who have had more than two vertebral fractures, although it is costly.

• Hormone therapy: This treatment involves synthetic hormones like calcitonin (Miacalcin) and parathyroid hormone (PTH), which can slow bone loss and regulate calcium and phosphorus exchanges in the body. However, hormone therapy comes with risks, as bone mass can decrease significantly after treatment cessation.

Vitamins and minerals supplements in osteoporosis treatment:

In addition to medication, supplements of vitamin D and calcium are recommended as part of osteoporosis treatment. The appropriate dosage is determined after various examinations. Maintaining a diet naturally rich in calcium is also crucial.

Surgery for osteoporosis:

Surgery is considered in cases where osteoporosis-related fractures have caused significant damage. Approximately 10% of spinal fractures caused by osteoporosis require surgical intervention. Surgery aims to relieve pain, reconstruct severely fractured areas, correct deformities, and reduce spinal cord pressure.

In conclusion, various treatments are available to effectively combat osteoporosis, including medication, hormone therapy, dietary supplements, and, in some cases, surgery. Early diagnosis and proactive treatment are crucial in managing this condition.

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