An Overview of Osteoporosis

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Osteoporosis, which means "porous bone", is a disease characterized by progressive bone thinning. The deterioration of bone tissue can lead to bone fragility and fracture, especially of the hip, spine, and wrist. Osteoporosis is very common. Approximately 50 million Americans have osteoporosis, the majority of them women. Osteoporosis is also referred to as "brittle bone disease."

Osteoporosis is a major public health concern. Osteoporosis is the cause of 1.5 million fractures each year. It has been estimated that one out of every two women and one out of five men will experience an osteoporosis-related fracture at some point in their life. Osteoporosis isn't just a woman's disease; by age 75, one third of all men will be affected by osteoporosis.

Osteoporosis is sometimes confused with osteoarthritis (the most common type of arthritis), but they are two different diseases.


Osteoporosis is regarded as a "silent disease," because it rarely causes symptoms. Since bone density is lost over a period of years, you can have osteoporosis for a long while without knowing it. The disease typically remains undiagnosed until it becomes so advanced that the weakened bones are easily fractured. Other subtle signs you may have osteoporosis are bone or joint pain, or a loss of height.

Since osteoporosis causes few to no symptoms, it's important to pay attention to your particular risk factors and take steps to build bone health.

Some broken bones can be treated without long-term issues. Others, like spine and hip fractures, need significant rehabilitation and can have long-term effects on your health.


Though osteoporosis is thought of as an older person's disease, it actually can strike at any age.

Your bones aren't static; older bone continuously breaks down while new bone is created. Throughout your teens and 20s, your body creates new bone faster than it's broken down. Once you reach your 30s, though, the process reverses: bone deteriorates faster than new bone tissue is created. You begin losing bone rather than gaining it. When women reach menopause, the rate of bone loss is further accelerated.

With osteoporosis, the bones become porous, with larger gaps in between the supporting structure of the bone. This creates weak, brittle bones that easily fracture.

It's important that people develop adequate bone mass throughout the teens and 20s to offset bone loss.

Risk Factors

There are certain risk factors involved which make some people more likely to develop osteoporosis than others:

  • advanced age
  • being female
  • family history of osteoporosis
  • thin or small frame
  • Caucasian or Asian race
  • early menopause, either naturally or surgically
  • men having low testosterone levels
  • amenorrhea
  • anorexia or bulimia
  • thyroid disease
  • rheumatoid arthritis
  • maladies involving blocked intestinal absorption of calcium
  • use of corticosteroid medications (use lowest possible dose to reduce risk of osteoporosis and other side effects)
  • use of anticonvulsant drugs
  • diet low in calcium
  • lack of exercise
  • cigarette smoking
  • excessive use of alcohol of caffeine


Early detection of osteoporosis is very important. If your doctor suspects osteoporosis or if you are at high-risk for developing the disease, there are tests which can detect bone density problems:

Standard x-rays do not detect osteoporosis until one-quarter of bone mass is already lost. By then susceptibility to fracture already exists. DEXA is an early detection tool and can detect as little as one percent of bone loss.

DEXA uses a low level of radiation, focuses on the hip and spine which are common sites of fracture, and is considered safe and comfortable for the patient. However, DEXA which has been called the "gold standard" of bone density tests may not be covered by some insurance plans. In that case, people at risk for osteoporosis should get one of the less expensive screenings done first. If there is evidence of bone loss the insurance company will likely pay for a DEXA test since it is then indicated.

Bone density tests are non-invasive, simple, and painless.


The goal of osteoporosis treatment is to prevent continued bone loss and help maintain bone density. Unfortunately, osteoporosis can't be cured but the progression can be slowed down.

There are several categories of drugs used to treat osteoporosis:

Depending on what drug is used you can slow bone loss, promote bone growth, and reduce the risk of fractures. Drugs used for osteoporosis include:

  • Actonel (Risedronate)
  • Boniva (Ibandronate)
  • Didronel (Etidronate)
  • Estrogens (Hormone Therapy)
  • Evista (Raloxifene)
  • Forteo (Teriparatide)
  • Fosamax (Alendronate)
  • Miacalcin (Calcitonin)

All medications come with the possibility of side effects. You'll have to weigh the pros and cons of each treatment. Your doctor will help determine the best treatment plan for you, and help you manage any side effects that may arise. Don't be shy about asking questions about your treatment.


The good news is there are things you can do to build bone health and help prevent osteoporosis. Obviously, some risk factors like your race or gender, are out of your control. But many lifestyle factors are effective at reducing your risk.

Prevention of osteoporosis is primarily tied to 3 things:

  • Proper nutrition, with sufficient amounts of calcium and vitamin D through diet or supplementation
  • Weight-bearing exercise
  • Lowering your risk by paying attention to modifiable risk factors (e.g., smoking)

Osteoporosis and Nutrition

Nutrition is among the factors that affect bone density. Calcium is an essential nutrient for bone health. Actually, 99 percent of the body's total calcium is found in bone. Calcium is also needed for proper function of the heart, muscles, nerves, as well as normal blood clotting.

There are other nutrients which are essential because they affect calcium absorption and calcium excretion. Vitamin D increases calcium absorption in the gastrointestinal tract and therefore positively influences calcium absorption. Sources of vitamin D include exposure to sunlight, fatty fish, eggs, liver, and fortified foods (including milk and multivitamins).

Protein is necessary in our diet because it plays a role in tissue growth, as well as tissue repair. Protein also is necessary for fracture repair and proper functioning of the immune system. Protein, though, increases calcium excretion which creates a need for more calcium to maintain the proper balance of nutrients in the body.

Sodium, along with chloride as the components of salt, also increase the excretion of calcium. People who typically have high salt intake require more calcium.

Oxalate is found in certain foods, such as spinach, rhubarb, and sweet potatoes. Oxalate interferes with calcium absorption from the same food source.

Phosphorus is a necessary mineral in our diet. Most of the phosphorus in our bodies is stored in the bones, with lesser amounts found in teeth, DNA, and cell membranes. Excessive dietary intake of phosphorus (e.g., cola or processed foods) may interfere with calcium absorption. Generally, this is not considered a problem in people with normal kidney function.

Beverages that contain caffeine can reduce calcium absorption, but not significantly. In fact, the reduction can be offset by including milk in your diet. Just be aware that caffeine does reduce calcium absorption and make it a point to offset that effect.

It's important to pay attention to nutrition. Adequate intake of nutrients helps to maintain bone health and lower your risk of developing osteoporosis.

A Word From Verywell

Osteoporosis is a common disease that can lead to serious bone fractures. Take steps to improve and maintain your bone health by eating a healthy diet and engaging in weight-bearing exercise. Also, understand that when you have osteoporosis, even minor trauma can cause a broken bone. Falling is the number one cause of osteoporosis-related fractures, so do take care to minimize your risk of falling (like doing exercises to prevent falls, for example.) Follow the treatment plan your doctor has for you, to protect your bone density and slow the progression of osteoporosis.

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