Osteoporosis Risk factors

Medically Reviewed By : Dr Sravya, MBBS, MS

Introduction

The name ‘osteoporosis’ literally means ‘bones with holes’ or also called ‘porous (spongy) bones’. It weakens your bones to the point that they can break easily. It basically occurs when your bones lose calcium more rapidly, that your body also cannot replace them at that rate. So, this is the reason why they become less dense, lose strength and break easily.

Osteoporosis has a nickname called ‘silent disease’–which means people who develop it may not notice that they have osteoporosis until a bone breaks. The fractures caused by osteoporosis mostly occur on the wrist, hips and spine. It mainly affects women who are in their menopause phase and men are also affected up to some extent.

In This Article

Risk factors of osteoporosis

Women are more at risk/prone to osteoporosis compared to men because their bones are smaller and less dense than male bones. The risk for osteoporosis increases during the menopause phase as the levels of oestrogen steadily decline.

The major risk factors of osteoporosis include:

1.As you get older, your bone strength decreases, your bones become less dense and thinner and age is considered as one of the greatest risk factors of osteoporosis. When you are in your 30’s, your bones break down faster than they usually do and your body can’t replace them at that speed and this leads to more prone to breakage.

2.There’s something interesting that you need to know! Men who are in their 50’s are more likely at risk for osteoporosis related fractures than to get prostate cancer.

3.Women in menopause or post-menopausal women are at more risk of developing osteoporosis due to the change in hormone levels. A rapid bone loss will be seen in the first 10 years after entering the menopause as it slows down the production of oestrogen which protects against excessive bone loss leading to osteoporosis.

4.Being an Asian or Caucasian (North-American)woman, you must be cautious of acquiring osteoporosis since the risk of developing the disease is also linked to ethnicity. Studies show that Asian or Caucasian women are likely to develop osteoporosis. But it doesn’t mean other ethnicities are safe. African-American and Hispanic women are also at risk for osteoporosis to some extent. They are more likely to die as a result of hip fracture than White women.

5.Skinny and petite(small) people are at greater risk of developing osteoporosis than those who have more body weight because they have less bone to lose.

6.Having a family history increases your risk for osteoporosis. You are more likely to develop the disease if your parents or grandparents have experienced any fracture after a minor fall.

7.Some medical conditions may increase your risk for osteoporosis. There are few medical conditions that you should be cautious of, because some of them are related to irregular hormone levels so you should consult your doctor and consider early diagnosis.

Blood diseases such as multiple myeloma
History of missed periods (amenorrhoea).
Hormone treatment for breast or prostate cancer.
History of organ transplant
History of weight loss surgery (bariatric)
Overactive thyroid, parathyroid or adrenal glands

8.The medications you take may cause side effects that may damage your bone and lead to osteoporosis but not all the medications may show side effects.

Some medications like steroids, medications for treating seizures, breast cancer may cause side effects which may lead to osteoporosis. Consult your physician or pharmacist to know about the effect of medications on your bones.

Other risk factors of osteoporosis may include:

Smoking
Excessive alcohol consumption
Anorexia or bulimia (an eating disorder– eating excessively and then puking on purpose or use any laxatives or medications in order to lose weight)
Lack of exercise
Calcium and vitamin D deficiency
Long term use of certain medications or drugs like glucocorticoids and some anticonvulsants
Having small or thin bones

You can control some of these osteoporosis risk factors like eating habits–anorexia or bulimia and intake of calcium and vitamin D containing foods, lifestyle changes, smoking and alcohol consumption. You can discuss these issues with your physician and help you with it.

How common is osteoporosis?

Around 200 million people worldwide are estimated to have osteoporosis. Studies have shown that around 54 million people are affected by osteoporosis in the United States.

Women are 4 times more likely than men to suffer from osteoporosis. Approximately, 2 million men suffer from osteoporosis in the United States and an additional 12 million men are thought to be at risk. Every year around 2 million cases of osteoporosis related fractures are seen worldwide and this number continues to grow.

It’s kind of scary, isn’t it? But don’t you worry! There’s some good news for you. You can’t prevent all the risk factors of osteoporosis but you can prevent and control some of them by getting an early diagnosis, lifestyle modifications and getting treated early.

What are the symptoms of osteoporosis?

As I mentioned earlier, in most of the cases osteoporosis does not show any signs and symptoms and this is why most of the people don’t know they have the condition until they have a fracture.

However, it does increase the risk of some serious fractures and you should watch out for the following:

Getting shorter by an inch or more
Bone fractures
Weakened grip strength
Pain in the lower back
Stooping or bending forward
Receding gums
Weak and brittle nails

How is osteoporosis diagnosed?

Steps for diagnosing osteoporosis is as follows:

Taking medical history: The doctor will ask you questions about your past medical history, past medication history, family history, your diet, social history like–smoking and drinking habits, surgeries if done, any recent trauma or falls which you’ve experienced. Because these risk factors may eventually lead to osteoporosis. The doctor may also ask about your symptoms currently, like if you have any back pain or if your posture has changed recently, etc.
A physical examination: Height loss is one of the symptoms of osteoporosis and your doctor will take your height measurements and compare it with your previous measurements. Your doctor may ask you if you have trouble getting up from a seated posture without using your arms to lift yourself.
Bone density test: If your doctor finds that you are at risk for osteoporosis, a bone density test will be performed. Most commonly DEXA (dual energy x-ray absorptiometry) scan is used to measure the bone density and it can detect the risk of fractures. It also helps in monitoring the patient’s response to the treatment.

How can I get treated for osteoporosis?

There’s no cure for osteoporosis but there are few treatment options which can help you to protect and strengthen your bones. Treatment options for osteoporosis may include medications and lifestyle changes. These lifestyle changes include increasing the intake of calcium and vitamin D, also weight-bearing exercises (strengthening exercises).

1. Intake of calcium and vitamin D:

There are certain nutrients that you should include in your diet which helps you to strengthen your bones and the most important are calcium and vitamin D.Calcium helps in strengthening your bones whereas your body needs vitamin D to absorb the calcium. The recommended amount of calcium is 1000-1200 mg/daily. It can be taken as a supplement or included in diet form. Too much calcium intake can lead to kidney stones.

People with osteoporosis should consume 600-800 international units of supplemental vitamin D everyday. People living with osteoporosis and vitamin D deficiency may need higher doses. Foods rich in vitamin D may include cereals, dairy products, fortified food, fatty fish and fish liver oils.

2. Weight-bearing exercises:

Eating the right food is not the only way to strengthen your bones or control osteoporosis. Exercise plays an important role in osteoporosis management, especially weight-bearing exercises. For example:

But, exercises such as swimming will not help you gain bone strength but it can help increase your core strength and help reduce the risk of falls. These exercises will cause your muscles to push and pull against your bones and strengthen your bones. It not only helps in increasing your bone strength but also helps you to avoid falls.

3. Medications for osteoporosis:

Most of the medications are used for both prevention and treatment of osteoporosis and the most frequently used medications are bisphosphonates which are helpful in treating and preventing all types of osteoporosis. It helps in preventing bone fractures and bone loss. It is considered as the first line therapy for osteoporosis. Other medications may include:

Calcitonin–helps in relieving pain caused by vertebral fractures. Usually taken by nasal spray.
Hormonal therapy(oestrogen)- maintains bone density in women and preferably used for prevention and treatment.
Raloxifene– helps in preventing and treating bone loss. This drug is used in people who cannot or prefer not to take bisphosphonates. It reduces the risk of fractures and invasive breast cancer also.
Denosumab– prevents bone loss. It is given as an injection under the skin twice a year.
Romosozumab– increases bone density in the hips and the spine. It also reduces the risk of fractures in postmenopausal women. It’s given as an injection once a month every year.
Anabolic agents(Teriparatide & Abaloparatide)– increases bone density and formation of new bone. Decreases the risk of fractures. They are self-injected daily.

How can I prevent osteoporosis?

As I said before, it is not possible to control all the risk factors of osteoporosis, but you can take some preventive measures to avoid getting affected by osteoporosis.

Some of the best ways you can do to prevent osteoporosis may include:

Increase intake of calcium and vitamin D.
Stopp Smoking
Avoid drinking too much alcohol.
Weight-bearing exercises
Hormonal therapy– helps replacing lost oestrogen in postmenopausal women
Do not consume excessive amounts of caffeine

Beware, take care!

We all know that there’s no cure for osteoporosis and there are many risk factors associated with it. It can lead to fractures and may lead to other complications.

So, if you don’t want osteoporosis to ruin your life, please be aware of your diet, lifestyle, fractures and falls. Even though you can’t control all the osteoporosis risk factors, you can still prevent and control it to some extent by doing weight-bearing exercises, following a healthy diet and lifestyle modifications.

But if you experience any kind of minor fall or a fracture, consult your doctor and get an early diagnosis to avoid further complications. Take the best care of your health.