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Osteoporosis | The Cause, Risk Factors, Prevention And Management

Summary

Osteoporosis is a progressive bone disease that is characterized by a reduction in bone mass and density which can lead to an increased risk of fracture. Osteoporosis literally means ‘bones with holes’. It occurs when bones lose minerals such as calcium more quickly than the body can replace them. Most people don’t realise they have osteoporosis until a fracture happens, as there are usually no signs or symptoms. Osteoporosis particularly affects women after menopause and in their later years, although some men are also affected. Activity and a healthy diet rich in calcium and vitamin D can help prevent osteoporosis.

Causes and risk factors

Like the rest of the body, bone is constantly being broken down and renewed. It is living tissue that needs exercise to gain strength, just like muscle. Sex hormones, such as oestrogen and testosterone, have an essential role in maintaining bone strength in men and women. The fall in oestrogen that occurs during menopause results in accelerated bone loss. Although osteoporosis causes no specific pain or symptoms, when bone mineral density (BMD) is reduced it does increase the risk of serious or debilitating fractures.

There are many risk factors for osteoporosis:

  • female sex
  • age - your risk goes up as you get older
  • hereditary link - Osteoporosis tends to run in families
  • race - people of European and Asian background are most likely to get osteoporosis
  • inadequate amounts of dietary calcium
  • low vitamin D levels
  • cigarette smoking
  • alcohol intake of more than two standard drinks per day
  • caffeine intake of more than three cups of tea, coffee or equivalent per day
  • lack of weight bearing physical activity
  • previous bone fractures or breaks
  • early menopause (before the age of 45)
  • long-term use of medications such as corticosteroids for rheumatoid arthritis and asthma.

Some conditions also place people at a higher risk of osteoporosis. These conditions include:

  • thyroid disease or an overactive thyroid gland
  • rheumatoid arthritis
  • chronic liver and kidney disease
  • conditions that affect the body’s ability to absorb nutrients, such as Crohn’s disease, coeliac disease and other inflammatory bowel conditions.

Prevention and management

The risk of osteoporosis fractures can be reduced with lifestyle changes and in those with previous osteoporosis related fractures, medications. Lifestyle change includes diet, exercise, and preventing falls.  Medicine for osteoporosis aims to reduce bone loss and to build bone thickness. Both men and women can take steps from a young age to prevent osteoporosis by making sure that they:

  • have a healthy and varied diet with plenty of dairy, fresh fruit, vegetables and whole grains
  • eat calcium-rich foods - if there is not enough calcium in the blood, your body will take calcium from the bones
  • absorb enough vitamin D - we obtain most of our vitamin D from the sun
  • avoid smoking
  • limit alcohol consumption
  • limit caffeine
  • do regular weight-bearing and strength-training activities.