Prevent osteoporosis, when does it start?

Among the diseases linked to the passage of time is osteoporosis, a disorder that produces skeletal weakening because the bone becomes more porous. But, how can we prevent osteoporosis and when does it start?

Although it can occur in children, adolescents, men of any age and women in pre-menopausal stages, osteoporosis is usually more common with the passage of age and in the female population with the onset of menopause.

The Spanish population is aging at a great pace, above the average of the European Union. It is estimated that by 2050, there will be 17.5 million people over 60 in our country, which means that they will be 42 percent of the population; 6.5 million people will be 80 years old and more than 75,000 will be centenarians. Faced with this situation, the pathologies and problems that develop with age will be a matter of public health more priority if possible.


It is estimated that some Two million women suffer from osteoporosis, with one case in four in postmenopausal. But being a disease without apparent signs or symptoms, those affected do not usually realize until they suffer one of its most serious consequences: a bone fracture of the vertebra or the hip, mainly due to a fall. Therefore, it is important to know what it is and how it can be detected.

What is osteoporosis?

The osteoporosis is the most common type of bone disease, in which more bone is destroyed than it is formed, so it becomes more porous, facilitating its weakening.


The fact that it affects more women is based on that in them, the maximum amount of bone mass, which is reached by 30 or 35 years, is lower than in men. To this is added the arrival of menopause, a stage of life in which the production of sex hormones ceases, which causes an acceleration in the fall of bone density.

But there is also the osteoporosis of the elderly, in which aging and the alteration of the metabolism of vitamin D play an important role. Alcohol, certain medications, endocrine pathologies, blood diseases, liver problems or inflammatory rheumatic disorders can also trigger an acceleration in the decline of bone mass.

Symptoms, how to recognize osteoporosis?

Osteoporosis is known as a silent disease because it has no symptoms until the bone is so fragile that it breaks as a result of a blow or fall. Each year, there are about 25,000 fractures due to this disease, usually in the vertebrae and the hip.


However, there are signs that may indicate its presence:

-   repeated fractures in long bones, like the femur or the humerus, by small blows
- vertebral fractures by slight movements or without apparent explanation
- change in the constitution of the body (loss of height of up to 15 centimeters) or deformities (hump on the back or swelling of the abdomen, for example), usually the result of fractures of the vertebrae

Risk factors for osteoporosis

It is possible that the person suffering from osteoporosis does not take the calcium or vitamin D necessary to maintain healthy and strong bones or it can also happen that the body does not absorb the necessary volumes, for example, after a gastric bypass operation.

Before fractures occur, the suspicion of osteoporosis increases if any of its risk factors occur:

- postmenopause, due to the decrease in estrogen
- reduction of testosterone in the case of men with aging
- early withdrawal from menstruation
- loss of the period after the removal of the ovaries
- body constitution, mainly under weight
- genetic and hereditary factors
- certain pathologies (endocrine, inflammatory, rheumatic)
- alcohol abuse
- eating disorders, such as anorexia nervosa
- treatments with high doses of cortisone
- being in bed for a long time due to a prolonged pathology, a situation that affects mainly the bones of children

How is osteoporosis diagnosed?

The Densitometry is a technique used to measure bone density of people with whose data the risk of fracture can be predicted in patients who have not yet suffered any broken bones. It also helps doctors evaluate the response of the patient's skeleton to the treatment prescribed for osteoporosis.

There are values ​​to examine the loss of bone density as the levels of bone alkaline phosphatase or osteocalcin among others, measurable substances in the blood that rise when the fractures are healed or remain low in the context of osteoporosis.

Also the decreased presence of vitamin D in the blood, the increase of the hormone of the parathyroid gland or the malfunction of liver or kidney are possible indicators of the disorder.

How to prevent osteoporosis

To help slow down bone loss, it is recommended;

- an adequate intake of calcium, which varies according to age, sex and the risk of developing osteoporosis, through foods such as milk and milk products or supplements or medicines under medical supervision.

- maintain good vitamin D levels, which is formed mainly when the sun's rays penetrate the skin. Although there are foods that provide this vitamin, such as fish oils.

Treatment of osteoporosis

In addition to abandoning habits such as smoking and alcohol and having healthy lifestyles during youth, such as exercising and taking adequate amounts of calcium, once the problem arises due to unchangeable issues, such as hereditary factors, there are medications to reduce fractures that the specialist can prescribe.

However, the recovery of lost bone is not yet possible, since currently existing drugs only slow down their reabsorption, with some small achievement of increasing their density. It is also known that after 5 years of pharmacological treatment the main objective of this one is not improved: the decrease in fractures attributable to osteoporosis.

On the other hand, exercise is essential to preserve bone mass in the elderly, for example through physical activities such as walking, running, dancing, playing tennis, tai chi, yoga, free weights and machines or rowing, avoiding at all times those that may lead to falling or high-impact trauma.

Dr. Ismael Said Criado. Internal Medicine Service of La Milagrosa Hospital

Video: Preventing, Diagnosing and Treating Osteoporosis Video – Brigham and Women’s Hospital


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