• Osteoporosis


    Osteoporosis is a disease marked by decreasing bone mass and density, making bones weak and brittle. If left unchecked, it can lead to fracture . Any bone can be affected. Fractures of special concern are of the hip , spine , and wrist .
    osteoporosis bone
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    Osteoporosis is caused by an imbalance between bone loss and bone formation (known as bone remodeling). After age 30, bone loss occurs more quickly. Many factors over the course of a lifetime can influence bone remodeling.

    Risk Factors

    Osteoporosis is more common in older adults. It is more common in women than in men. People of Caucasian, Asian, or Hispanic ethnicity are more likely to get osteoporosis.
    Osteoporosis is more likely to occur if full bone mass was not achieved during your bone-building years. Other factors that may increase your chance of osteoporosis include:
    • Low weight
    • Smoking
    • Alcohol abuse
    • History of falls
    • Family history of osteoporosis
    • Postmenopausal status
    • Certain health conditions, such as:
    • Certain medications, such as antidepressants, corticosteroids, anticonvulsants, or long-term use of heparin or proton-pump inhibitors
    • Low hormone levels (low estrogen levels in women, low testosterone levels in men)
    • Inactive lifestyle
    • Certain restrictive diets that may result in a deficit of calcium or vitamin D
    • Too little sunlight—the effect of sun on the skin is a primary source of vitamin D
    • Certain cancers, including lymphoma and multiple myeloma


    In most cases, people with osteoporosis remain symptom-free until there is a fracture. In those who do have symptoms, osteoporosis may cause:
    • Severe back pain
    • Loss of height with stooped posture— kyphosis
    • Shortness of breath
    • Constipation
    • Abdominal pain
    • Loss of appetite or feeling full soon after eating
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    You will be asked about your symptoms and medical history. A physical exam will be done. Tests may include:
    • Blood tests
    • Urine tests
    Osteoporosis can be seen with bone mineral density (BMD) tests of the hip, spine, wrist, or other site. These may include:


    The treatment and management of osteoporosis involves lifestyle changes and medications. Although osteoporosis is highly preventable, it cannot be cured. Treatment focuses on reducing the incidence of fractures and slowing bone loss.

    Lifestyle Changes

    Decrease your intake of alcohol. Eat a balanced diet rich in calcium and vitamin D. Calcium is in:
    • Dairy products
    • Green leafy vegetables
    • Canned fish with bones
    • Calcium-fortified products
    Do not smoke. If you smoke, talk with your doctor about ways you can successfully quit .
    Exercise improves bone health. It also increases muscle strength, coordination, and balance. Do weight-bearing and strength-training exercises for maximum benefit. Balance training may help prevent falls and fractures.
    Dietary Supplements
    People who cannot eat enough calcium from food might want to take calcium supplements. Vitamin D and other supplements may also be advised. Talk with your doctor before taking herbs or supplements.
    Safety Measures
    Falls can increase the chance of fracture in someone with osteoporosis. Here are ways to prevent falls:
    • Floors—Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
    • Bathrooms—Install grab bars and non-skid tape in the tub or shower.
    • Lighting—Make sure halls, stairways, and entrances are well lit. Install a night light in your bathroom. Turn lights on if you get up in the middle of the night.
    • Kitchen—Install non-skid rubber mats near sink and stove. Clean spills right away.
    • Stairs—Make sure treads, rails, and rugs are secure.
    • Other precautions—Wear sturdy, rubber-soled shoes. Keep your intake of alcoholic beverages to a minimum. Ask your doctor whether any of your medications might cause you to fall.


    Certain medications can help prevent bone loss, increase bone density, and reduce your risk of fractures. These may include:
    • Bisphosphonates
    • Medications with estrogenic effects
    • Other medications, such as parathyroid hormone or bone resorption inhibitors


    Building strong bones throughout your early years is the best defense against osteoporosis. Getting enough calcium, vitamin D , and regular exercise can keep bones strong throughout life.
    To help reduce your chance of osteoporosis:
    • Eat a balanced diet rich in calcium and vitamin D.
    • Perform weight-bearing exercises.
    • Live a healthy lifestyle—avoid smoking and drink alcohol only in moderation (2 drinks per day for men, 1 drink per day for women).
    • If you are a postmenopausal woman at high risk for bone fractures, medications may be appropriate to prevent osteoporosis.


    NIH Osteoporosis and Related Bone Diseases National Resource Center http://www.niams.nih.gov

    National Osteoporosis Foundation http://www.nof.org


    Osteoporosis Canada www.osteoporosis.ca

    Women's Health Matters http://www.womenshealthmatters.ca


    Clinician's guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation website. Available at: http://www.nof.org/files/nof/public/content/file/950/upload/523.pdf. Updated 2013. Accessed June 4, 2015.

    Ho-Pham LT, Nguyen ND, et al. Effect of vegetarian diets on bone mineral density: a Bayesian meta-analysis. Am J Clin Nutr. 2009;90:943-950.

    Khosla L, Melton LJ. Clinical practice: osteopenia. N Engl J Med. 2007;356:2293-2300.

    Making a diagnosis. National Osteoporosis Foundation website. Available at: http://nof.org/articles/8. Accessed June 4, 2015.

    Osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 15, 2015. Accessed June 4, 2015.

    Osteoporosis causes and risk factors. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 7, 2014. Accessed June 4, 2015.

    Sambrook P, Cooper C. Osteoporosis. Lancet. 2006;367:2010-2018.

    10/6/2006 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Cockayne S, Adamson J, Lanham-New S, et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166:1256-1261.

    5/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Screening for osteoporosis in men: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;148:680-684.

    1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009;180:32-39. Epub 2008 Dec 10.

    12/29/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Hippisley-Cox J, Coupland C. Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. BMJ. 2009;339:b4229.

    6/4/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA approves new injectable osteoporosis treatment for postmenopausal women. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm214150.htm. Published June 1, 2010. Accessed June 4, 2015.

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