Osteoporosis is the loss of bone mass caused by insufficient new bone formation to replace bone resorption. Generally, as we age, the ability to form new bone decreases. Bones gradually become thinner, making them brittle, prone to fractures or collapse, and lose their weight-bearing capacity.
Osteoporosis is a silent threat because it shows no symptoms
Osteoporosis is truly a “silent threat” because it shows no symptoms until a fall causes a fracture, bone collapse, or until you notice a loss in height or a stooped back. When examined, it is diagnosed as osteoporosis. Medically, we can detect osteoporosis early by measuring bone mineral density.
Risk factors for osteoporosis
1. Gender Women are more likely to develop osteoporosis and at an earlier age than men, especially after menopause or after surgical removal of both ovaries due to the lack of female hormones, which causes gradual bone loss.
2. Age Bone mass gradually decreases after the age of 30, with
- Over 70 years old, about 20% have osteoporosis
- Over 80 years old, about 30% have osteoporosis
3. Genetics If parents have osteoporosis, their children have a higher chance of developing the disease.
4. Ethnicity White and yellow-skinned ethnic groups have a higher risk of osteoporosis.
5. Medications Long-term use of certain medications can reduce bone mass, such as steroids, thyroid hormones, and anticonvulsants.
6. Alcohol Drinking more than 3 glasses of liquor, beer, or wine per day increases the risk of osteoporosis.
7. Smoking Nicotine in cigarettes destroys bone-forming cells, causing bones to thin. Smoking more than 20 cigarettes per day increases the risk of osteoporosis.
8. Thin people Are more prone to osteoporosis than those with normal or overweight body types.
9. Nutritional deficiency Especially calcium, vitamin D, and protein, which are essential for bone formation.
10. Lack of exercise Increases the risk of osteoporosis.
11. Diet and drinking habits Consuming very salty foods, drinking more than 3 cups of coffee per day, or more than 2 cans of soda per day affects calcium absorption, increasing the risk of osteoporosis.
Osteoporosis screening
Screening is done by measuring Bone Mineral Density (BMD) using a special radiological device (Dual Energy X-ray Absorptiometer). The World Health Organization recommends measuring the lumbar spine and hip bones, which provides a numerical value indicating deviation from the standard bone density as follows:
- T-score > -1 indicates osteopenia (low bone mass)
- T-score > -2.5 indicates osteoporosis
Dangers of osteoporosis
- Bones fracture easily even with minor accidents
- Vertebral collapse causes a stooped back and height loss; if nerves are compressed, it causes back pain, radiating leg pain, and leg numbness
- In the elderly, it can lead to disability, inability to walk, or being bedridden
Prevention of osteoporosis
- Eat a balanced diet with all five food groups, especially protein and foods high in calcium such as green leafy vegetables, small fish, dried shrimp, milk, and black sesame seeds
- Exercise regularly
- Get sunlight exposure in the morning and evening
- Reduce alcohol consumption and quit smoking
- Get bone density tested when indicated or at risk
Who should get a bone density test?
- Postmenopausal women or women who have had both ovaries removed
- Men over 60 years old
- Those with a history of fractures from minor accidents
- Those with chronic diseases requiring long-term steroid use, such as autoimmune diseases (SLE), or patients on thyroid hormone supplements
- Those with diseases causing high parathyroid hormone levels, which increase bone resorption
- Those deficient in vitamin D, as bones become brittle and prone to fracture, possibly with concurrent osteoporosis; vitamin D levels should not be below 30
- Those with chronic diseases such as cirrhosis, chronic kidney failure, gastrointestinal diseases affecting absorption, or those who have had extensive intestinal surgery affecting nutrient absorption
- Those who have lost more than 2 cm in height per year
Preventing fractures in the elderly requires proper home environment arrangement
Most accidents in the elderly occur at home, such as falls and slips. Therefore, the risk of accidents should be reduced by arranging the environment appropriately as follows:
1. Walkways: Keep them free of clutter to prevent tripping and falling
2. Bathroom: Install grab bars and use non-slip mats in wet areas
3. Lighting: Ensure adequate lighting, especially in walkways
4. Stairs: Should not be slippery, steep, or overly inclined; provide handrails and sufficient lighting
6. Shoes: Wear shoes with non-slip soles
7. Medications: Some medications cause dizziness or drowsiness, increasing fall risk, so caution is needed when taking them
Osteoporosis treatment
Treatment varies depending on the physician’s judgment, such as:
- Calcium and vitamin D supplementation
- Bone mass enhancing drugs, available in oral and injectable forms
- Female hormones for postmenopausal women or those with hormone deficiency
- Drugs that inhibit bone resorbing cells, injected every 6 months
- Parathyroid hormone drugs
