Osteoporosis
Osteoporosis weakens bones, making them more susceptible to sudden and unexpected fractures. The disease often progresses without any symptoms or pain, and is not found until bones fracture. You can take steps to prevent this disease, and treatments do exist.
Causes
Researchers understand how osteoporosis develops even without knowing the exact cause of why it develops.
Your bones are made of living, growing tissue.
The inside of healthy bone looks like a sponge.
This area is called trabecular bone. An outer shell of dense bone wraps around the spongy bone. This hard shell is called cortical bone.
When osteoporosis occurs, the
holesin thespongegrow larger and more numerous, which weakens the inside of the bone.Bones support the body and protect vital organs.
Bones also store calcium and other minerals.
When the body needs calcium, it breaks down and rebuilds bone. This process, called bone remodeling, supplies the body with needed calcium while keeping the bones strong.
Symptoms
Usually, there are no symptoms of osteoporosis. That is why it is sometimes called a silent disease. However, you should watch out for the following things:
Loss of height (getting shorter by an inch or more).
Change in posture (stooping or bending forward).
Shortness of breath (smaller lung capacity due to compressed disks).
Bone fractures.
Pain in the lower back.
Diagnosis
Your healthcare provider can order a test to give you information about your bone health before problems begin.
Bone mineral density (BMD) tests are also known as dual-energy X-ray absorptiometry (DEXA or DXA) scans.
These X-rays use very small amounts of radiation to determine how solid the bones of the spine, hip or wrist are.
Regular X-rays will only show osteoporosis when the disease is very far along.
All women over the age of 65 should have a bone density test.
The DEXA scan may be done earlier for women who have risk factors for osteoporosis.
Men over age 70, or younger men with risk factors, should also consider getting a bone density test.
Treatment
Hormone and hormone-related therapy
This class includes estrogen, testosterone and the selective estrogen receptor modulator raloxifene (Evista).
Because of the potential for blood clots, certain cancers and heart disease, estrogen therapy is likely to be used in women who need to treat menopause symptoms and in younger women.
Testosterone might be prescribed to increase your bone density if you are a man with low levels of this hormone.
Raloxifene acts like estrogen with the bones. The drug is available in tablet form and is taken every day.
In addition to treating osteoporosis, raloxifene might be used to reduce the risk of breast cancer in some women. For osteoporosis, raloxifene is generally used for five years.
Bisphosphonates
Bisphosphonate osteoporosis treatments are considered antiresorptive drugs. They stop the body from re-absorbing bone tissue.
You may be able to stop taking bisphosphonates after three to five years and still get benefits after you stop. Also, these drugs are available as generic drugs.
Of these products, Boniva and Atelvia are recommended only for women, while the others can be used by both women and men.
Biologics
Denosumab (Prolia) is product that is available as an injection given every six months to women and men. It is often used when other treatments have failed. Denosumab can be used even in some cases of reduced kidney function.
Anabolic agents
These products build bone in people who have osteoporosis. There are three of these products currently approved:
Romososumab-aqqg (Evenity) has been approved for postmenopausal women who are at a high risk of fracture.
The product both enables new bone formation and decreases the breakdown of bone. You will get two injections, one right after the other, once per month.
The time limit is one year of these injections.
Teriparatide (Forteo) and Abaloparatide (Tymlos) are injectable drugs given daily for 2 years. They are parathyroid hormones, or products similar in many ways to the hormones.