Osteoporosis : Symptom, Risk Factor, Diagnosis, Treatment, And Prevention

Osteoporosis is a disease where decreased bone strength increases the risk of a broken bone.It may be due to lower than normal peak bone mass and greater than normal bone loss.Bones usually breaks the back bones, the forearm bones, and the hip.The osteoporotic fractures are most common in the wrist, spine, shoulder, and hip.Osteoporosis is diagnosed if the bone mineral density is less than or equal to 2.5 standard deviations below that of a young (30-40 years old), healty adult women reference population.

The Symptoms of Osteoporosis

• Sudden Back pain caused by fractured vertebra
• Radicular pain that shoots pain due to nerve root compression
• Spinal cord compression
• Loss of height over time
• A stooped posture
• A bone fracture
• Chronic pain with resultant reduction in mobility

The Risk Factors of Osteoporosis

• Family history of osteoporosis
• Female sex
• Race
• A small stature
• Consumption of alcohol excessively
• The defiency of vitamin D
• Tobacco smoking
• Malnutrition
• High dietary protein from animal sources
• Underweight
• Endurance training
• Heavy metals.A strong association between cadmium and lead
• Soft drinks that contain phosphoric acid
• Immobilization or Sedentary lifestyle
• Low level of sex hormone, mainly estrogen in women
• Certain medications, including glucocorticoid (corticosteroids) medications ; prednisone (brand names : Deltasone, Orasone)
• Diseases, including Endocrine disease, inflammatory arthritis
• Eating disorders, such as Anorexia
• Gastrointestinal surgery

Diagnosis of Osteoporosis

Some procedures and tests are done to diagnose osteoporosis by measuring the bone mineral density (BMD)

• Conventional Radiography is to detect the complication of osteoponia (preosteoporosis), such as fractures.
• Dual Energy X-Ray Absorptiometry (DXA) is considered the gold standart for the diagnosis of osteoporosis.It is a means of measuring bone mineral density (BMD).
• Blood test is a laboratory analysis performed on a blood sample.
• Biomarkers are a useful tool in detecting bone degradation.
• Quantitative Computed Tomography (QCT) gives separate estimates of BMD for trabecular and cortical bone and reports precise volumetric mineral density in mg /cm3.It can analyze a region of any size or shape, excludes irrelevant tissue, such as fat, muscle, and air.
• Quantitative Ultrasound (QUS) provides some structural information, which may be important in determining the risk of fracture.It is a relatively recent and noninvasive method of estimating bone mineral status at peripheral skeleton.

Treatment of Osteoporosis

Medications

1. Biphosphonates are drugs to prevent and treat osteoporosis.

• Alendronate (brand name : Fosamax) is used once-daily or once-weekly pills.It prevents and treats osteoporosis in postmenopausal women and osteoporosis in men.
• Risedronate (brand name : Actonel) is used once-daily, once-weekly or once-monthly pills.It prevents and treats osteoporosis in postmenopausal women and osteoporosis in men.
• Ibandronate (brand name : Boniva) is used once-monthly pills or every  three months by intravenous infusion given through a vein.It prevents and treats osteoporosis in postmenopausal women.
• Zoledronic Acid (brand name : Reclast) is used once a year by IV.It prevents and treats osteoporosis in postmenopausal women and osteoporosis in men.

2. Calcitonin (Calcimar, Miacalcin) can prevent vertebral (spine) fractures and control pain after an osteoporotic vertebral fracture.

3. Strontium Ranelate (brand names include Protelos, Protos, Osseor, Ossum, Protaxos, and Bivalos) is to lower the fracture risk in postmenopausal women.

4. Denosumab (Prolia) is a fully human monoclonal antibody.It is used for women and men at high risk of bone loss.Patients receive this medicine as an injection under the skin every six months.

5. Teriparatide (Forteo) is a form of parathyroid hormone that helps in stimulating the formation of bone.It is used for postmenopausal women and men at high risk of osteoporotic fracture. It is used for the treatment of glucocorticoids-induced osteoporosis.It is given as a daily injection under the skin for up to two years.

6. Estrogen or Hormone Replacement Therapy is to decrease the osteoporosis risk and the osteoporotic fratures in women.It may raise the stroke risk.

7. Selective Estrogen Receptor Modulators (SERMs) are used only for postmenopausal women.The SERM Raloxifene (Evista) is to decrease the risk of spine fractures in women.

Prevention of Osteoporosis

• Stop smoking
• Avoid alcohol intake excessively
• Do Physical Activity or weight-bearing exercise
• Get enough vitamin D about 400 - 800 IU for adults younger than 50 years old and 800 - 1.000 International Units (IU) for adults 50 years old and over.
• Get enough calcium about 1.000 milligrams per day for most adults and 1.200 milligrams per day for women over 50 years old and 1.200 milligrams per day for men over 70 years old.