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Osteoporosis

Osteoporosis occurs when your body’s creation of new bone does not keep up with the loss of old bone, causing bones to become weak and brittle. Osteoporosis can make a fall, or even mild stresses such as bending over or coughing cause a fracture. These fractures are most likely to occur in the hip, wrist, or spine.

While osteoporosis affects men and women of all races, white and Asian women, especially those past menopause, are at the highest risk. Medications, a healthy diet, and weight-bearing exercises can help prevent bone loss and strengthen already weak bones.

Osteoporosis

Symptoms of Osteoporosis

There are usually no symptoms during the early stages of bone loss.

Once bones have been weakened, the following symptoms can occur:

  • Back pain caused by a fractured or collapsed vertebra
  • Loss of height or a stooped posture over time
  • A bone that breaks much more easily than expected

Bones are in a constant state of building up and breaking down. When you are young, your body makes new bone faster than it breaks down old bone. But, after your early 20s, this process slows down. Most people reach their peak bone mass at age 30. After 30, bone mass is lost faster than it is created.

Causes of Osteoporosis

Your bones are constantly renewing themselves — old bone tissue breaks down while new bone tissue forms. In your youth, the creation of new bone outpaces the breakdown of old bone, leading to an increase in bone mass. This process decelerates after your early 20s, with most people reaching their peak bone mass by around age 30. As you age, bone loss occurs more rapidly than bone creation.

The likelihood of developing osteoporosis is partly determined by the amount of bone mass you accumulated in your youth. Peak bone mass is influenced by genetics and varies among different ethnic groups. A higher peak bone mass means you have more bone “in reserve,” reducing the risk of osteoporosis as you grow older.

Risk Factors for Osteoporosis

How likely you are to develop osteoporosis depends partially on how much bone mass you obtained in your younger years. Peak bone mass is somewhat inherited and varies by ethnic group.

Risk factors also include:

  • Your sex: women are more likely than men to develop osteoporosis
  • Age: the older you are, the greater your risk
  • Race: white and Asian people are at greater risk
  • Family history: having a parent or sibling with osteoporosis puts you at higher risk, especially if your mother or father had a fractured hip
  • Body frame size: smaller body frames tend to have a higher risk because they have less bone mass to draw on as they age
  • Sex hormones levels: lowered sex hormone levels tend to weaken bone. The reduction of estrogen levels in menopause is one of the most substantial risk factors for osteoporosis. Treatments for breast cancer that reduce estrogen levels in women are likely to increase bone loss. Men have a gradual reduction in testosterone levels as they age. Treatments for prostate cancer that reduce testosterone levels in men can accelerate bone loss.
  • Hormones: overactive thyroid, parathyroid, or adrenal glands 
  • Low calcium intake: a lifelong lack of adequate calcium
  • Eating disorders: severely restricted diets and being underweight 
  • Gastrointestinal surgery: reducing the size of your stomach or intestines limits the surface area that can absorb calcium and other nutrients
  • Steroid use: long-term use of oral or injected corticosteroid medications interferes with bone-rebuilding
  • Medications for the treatment of the following: cancer, seizure, gastric reflux, transplant rejection
  • Certain medical conditions: celiac disease, inflammatory bowel disease, kidney or liver disease, rheumatoid arthritis, lupus, cancer, multiple myeloma
  • Excessive alcohol consumption is a risk factor
  • Excess tobacco use is a risk factor
  • Sedentary lifestyle increases the risk for osteoporosis

Prevention

Although bone loss is a natural part of aging, there are several measures you can take to maintain bone health. Proper nutrition and regular physical activity are crucial for bone health throughout your life.

Calcium

Adults aged 18 to 50 require 1,000 milligrams of calcium daily. This increases to 1,200 milligrams for women over 50 and men over 70.

Excellent sources of calcium include:

  • Low-fat dairy products
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Soy products like tofu
  • Calcium-fortified cereals and orange juice

If dietary calcium is insufficient, consider supplements. However, excessive calcium can lead to kidney stones and may increase the risk of heart disease. The Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine advises that total calcium intake, including supplements and diet, should not exceed 2,000 milligrams daily for those over 50.

Vitamin D

Vitamin D enhances calcium absorption and contributes to bone health. Sunlight is a natural source, but factors like high latitudes, being housebound, regular sunscreen use, or avoiding sun exposure due to skin cancer risks can limit this source.

Dietary sources of vitamin D include cod liver oil, trout, and salmon. Many milk and cereal products are fortified with vitamin D.

The general recommendation is at least 600 international units (IU) of vitamin D daily, increasing to 800 IU after age 70. Those with limited sun exposure might need supplements. Most multivitamins provide 600 to 800 IU of vitamin D. Up to 4,000 IU daily is safe for most people.

Exercise

Exercise helps build and maintain strong bones and slows bone loss. Starting exercise at a young age and continuing throughout life offers the greatest benefits.

Incorporate strength training with weight-bearing and balance exercises. Strength training strengthens muscles and bones in the arms and upper spine. Weight-bearing activities such as walking, jogging, running, stair climbing, skipping rope, skiing, and high-impact sports primarily benefit the bones in your legs, hips, and lower spine. Balance exercises like tai chi can reduce the risk of falls, especially as you age.

If you have symptoms of osteoporosis, your primary care provider will order a diagnostic test. If you do have osteoporosis, your provider will prescribe the right medication or treatment and discuss lifestyle habits to protect your bones now and in the future.   Call Primary Care at Catawba Valley Healthcare today at (828) 695-5900.