In our newest series of blog posts, we’ll be focusing our attention on osteoporosis, a disease that affects the health and wellbeing of millions of Americans. In the coming weeks, you’ll be able to visit the Rejuvé blog to learn more about osteoporosis, how it is treated, and what you can do to prevent it. We’ll have advice on health, nutrition, and much more — stay tuned!
What is osteoporosis?
Osteoporosis is a disease that causes bones to become weak and brittle; so brittle, in fact, that a fall or even a minor strain (like bending over) can cause a fracture. Your bones are living tissue that is continuously being absorbed and replaced. When you’re young, your body makes new bone faster than it removes old bone, increasing your bone mass. This can be true even after you reach your full adult height: Most people continue developing, and reach their peak bone mass, by their early 20s. The greater your bone mass, the lower your likelihood for developing osteoporosis.
Osteoporosis begins to occur when the removal of old bone outpaces the creation of new bone. The disease does not have observable symptoms in its early stages, but once you have experienced significant bone loss, symptoms can include loss of height, a stooped posture, easily fractured bones, and back pain (due to collapsed or fractured vertebra). Hip fractures are often the result of a fall, and can result in disability or even death from postoperative complications, especially in seniors. In fact, it has been found that 25% of elderly women will die within a year of suffering from a complication related to a hip fracture. Osteoporosis is a very serious disease.
How many people suffer from osteoporosis?
Given that we often think of many of the symptoms of osteoporosis as simply part of old age (for example, a stooped posture and decreased height), it is unsurprising that levels of osteoporosis are extremely high in the population. According to the National Osteoporosis Foundation, roughly 44 million Americans suffer from low bone density or osteoporosis. Of these, roughly ten million have the disease. Among the over-50 population, it is estimated that one in two American women, and one in four American men will experience an osteoporosis-related fracture during their lifetime. As the baby boom population ages, these numbers are only expected to increase. The frequency of osteoporosis-related hospital visits means it comes with a price tag (in addition to the costs to one’s health and wellbeing) — osteoporosis health care costs total approximately $14 billion per year in the United States.
What are the risk factors for osteoporosis?
Osteoporosis has numerous risk factors, some of which are under our control, and some of which are not. To make the risk factors easier to understand, they can be broken into categories.
Inherited Risk Factors
Some risk factors for osteoporosis are simply about who you are, and are unfortunately out of your control. These include:
- Sex: Osteoporosis is much more common among women than men
- Age: Osteoporosis risk grows as you age
- Race: People with a white or Asian background are more likely to develop osteoporosis
- Size: People with smaller frames often have a higher risk for osteoporosis, because they have less bone mass
- Family history: A parent, sibling or close relative with osteoporosis indicates that you are at a higher risk for developing the disease
Medication-Related Risk Factors
There are a number of medications that can increase your risk of developing osteoporosis. These commonly prescribed drugs are referred to as PPIs, or proton pump inhibitors. These drugs affect the absorption of calcium and magnesium, which are important to the production of new bone. This means that they can over time speed up loss of bone mass, because your body will not be creating enough new bone to replace your old bone. This, in turn, will increase your risk of fractures. PPIs include omeprazole (Prilosec and Prilosec OTC), esomeprazole (Nexium), pantoprazole (Protonix), lansoprazole (Prevacid), dexlansoprazole (Dexilant or Kapidex), and rabeprazole (Aciphex). These drugs are commonly used to treat diseases related to stomach acids, including heartburn, stomach ulcers, gastroesophageal reflux disease (also called acid reflux disease), esophageal damage, and Zollinger-Ellison syndrome. Large studies have been conducted which bear this out, and the FDA has issued a black warning label regarding the use of PPIs and the likelihood of fractures. These drugs are clearly marked with warning labels about the risk of fractures. That said, the level of increased risk may be related to the dose and the duration of PPI use. Talk with your doctor about weighing the benefits and risks of PPIs. If long-term PPI use is necessary, regular monitoring of bone density should be done.
Other types of medications have also been associated with an increased risk of osteoporosis. Long-term use of corticosteroid medications, such as prednisone and cortisone, interferes with the bone-rebuilding process, leading to reduced bone mass. Osteoporosis has also been associated with some medications used to combat or prevent seizures, depression, cancer, and transplant rejection. Again, it is best to talk with your doctor about the risks and benefits.
Hormonal Risk Factors
Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Lowered levels of sex hormones tend to weaken bones. The drop in estrogen levels at menopause is one of the strongest risk factors for developing osteoporosis. Men also experience a reduction in testosterone levels as they age. For both sexes, certain cancer treatments can also impact levels of sex hormones.
In addition to estrogen and testosterone, osteoporosis has also been associated with other hormone levels. An excess of thyroid hormone, either from an overactive thyroid or from treatment of an underactive thyroid, can increase the risk of osteoporosis. The disease has also been associated with overactivity in parathyroid and adrenal glands. If you are concerned about your hormone levels, consider coming to Rejuvé for hormone testing.
Dietary Risk Factors
Your likelihood of developing osteoporosis can be affected by what you do (or don’t) eat. In our third osteoporosis blog post, we’ll talk in much greater detail about what foods to eat (and what to avoid). For the moment, suffice to say that there are three categories of dietary risk factors that are most significant.
First, people who have a low calcium intake in their diet are more likely to development osteoporosis. Calcium deficiency contributes to reduced bone density, earlier bone loss, and increased risk of fractures. Eating disorders, particularly anorexia, give you a higher risk of osteoporosis. Restricting food reduces the amount of calcium in the diet, and amenorrhea (when the monthly period is stopped), a symptom of severe eating disorders, weakens bone. Last, people who have had gastrointestinal surgery that reduces the size of the stomach or intestine are at an increased risk for osteoporosis. This is because the reduced size of the organ limits the amount of surface area available for your body to absorb nutrients, including calcium.
Lifestyle-Related Risk Factors
Bad habits can also increase your risk of osteoporosis. Those with a sedentary lifestyle face a higher risk of osteoporosis than those who are more active. Drinkers are also more likely to develop osteoporosis. Possibly because alcohol can interfere with calcium absorption, regularly consuming more than two alcoholic beverages per day increases your risk of osteoporosis. Last, and unsurprisingly, smoking also contributes to weaker bones.
In our next post, part 2 in this series, we’ll look at how you can be tested for osteoporosis, and some of the common medical treatments both for the disease itself and to alleviate some of its risk factors.