Osteoporosis affects men and women. Side effects of the disease can destroy quality of life and result in significant health care spending. Osteoporosis affects approximately 10 million Americans, according to the National Institutes of Health. The condition occurs from loss of bone mass associated with aging, medication use, kidney dysfunction, lack of calcium, vitamin D, vitamin A, vitamin K and magnesium, rheumatoid arthritis, alcoholism and diseases of the thyroid or adrenal gland.
Considerations
Osteoporosis is a "silent" disease that can progress with little or no symptoms until bone density loss is severe.The effects of the disease can remain hidden until a fracture occurs from a minor injury or fall. Awareness of the silent nature of the disease is important for early diagnosis and treatment.
Types
There are two types of osteoporosis: primary and secondary. Primary forms of the disease occur with aging and after menopause for women. Estrogen decline in menopausal women and decreased bone density occurs with aging. During youth, bones naturally break down and new growth occurs, making bones dense and long. After age 30, the process slows down and more bone is broken down than is formed. The process of bone breakdown and regrowth is known as remodeling. Secondary osteoporosis is caused by some medications such as corticosteroids, anti-seizure medication and barbiturates, chronic endocrine diseases, excessive alcohol intake and kidney disease.
Identification
Bone thinning from osteoporosis can cause a curved spine known as a dowager's hump. When the bones in the spine compress or fracture, the spine becomes curved. The result can lead to significant loss of height. A curved spine from osteoporosis is also known as kyphosis and is an identifiable feature of the disease. A non-invasive bone density test identifies loss of bone mass before fractures occur and can be used to monitor the effects of treatment.
Potential
Collapse from fractures of the vertebrae from osteoporosis can potentially compress the heart, lungs and intestines. Lung compression can make it difficult to breathe, causing fatigue. Gastrointestinal problems that can occur from organ compression include hiatal hernia and gastroesophageal reflux disease or GERD.
Significance
Osteoporosis has a negative impact on quality of life. Fear of falling, limited mobility and adaptive lifestyle changes can lead to decreased socialization and isolation. Depression related to loss of body image, impaired mobility and loss of independence is a psychological side effect linked to osteoporosis. Because osteoporosis is a silent and progressive disease, anxiety and depression are common following a fracture and initial diagnosis.
Expert Insight
According to recommendations found in the Merck Manuals Online Medical Library, testing for osteoporosis is important for all women older than age 65 and women between age 50 and 65 who have risk factors for bone density loss. Women who experience a fracture at a young age from a minor injury should also be tested. Adult men and women should undergo bone density testing for complaints of unexplained back pain that may be a symptom of vertebral fracture.
Prevention/Solution
Restoring bone density is difficult, making prevention of osteoporosis the only way to avoid the need for medications that are used to promote bone growth, known as bisphospohonates. Consuming adequate amounts of vitamin D and calcium and weight bearing exercises can keep bones healthy and strong. Vitamin D is difficult to obtain from foods naturally, but can be found in fortified cereals, milk, yogurt, fish, soy milk and fortified orange juice. Your doctor may recommend vitamin D or cod liver oil supplements to to help with osteoporosis prevention.
