In osteoporosis, bones become weak , brittle and fragile, so even mild falling or  slight impact, it can leads to fracture. It increases  risk of hip, wrist, and  spine fracture. 70 % Of people, over 65 with osteoporosis ,have never screened and don’t know they have osteoporosis.

Osteopenia  vs  osteoporosis: it is not a disease, it is a condition in which patient have low bone density level, but at not significant as in osteoporosis, so it warns u to take care of your bone and takes essential treatments to avoid developing osteoporosis.

Why it occurs?

When we are young , our body makes new bone faster than it breaks down old bone and your bone mass increase. In aging, bone mass reduces than its formation, so it depends  how much bone mass u have gained in youth… so when formation of new bone mass can not replace  with loss of old bone ,it leads to osteoporosis.

Symptoms:

• No symptoms can be seen in early phase, except,  reduced grip strength
• In most cases, patients are not aware of it , until they get fracture of bone
• Patient may have forward bending posture
• Back pain , which is caused by fracture of vertebrae.

Risk factors:

• Age :  The elderly  group are at more high risk
• Weight : Underweight or moderate obesity
• Mostly in women in post-menopause
• Race: more common in Asian race
• Habits: Smoking,  less of physical activity , job like sitting for long time,  excessive alcohol consumption
• Poor nutrition
• Family history: it may be inheritent, if your parents have fracture of hip, then u may have high chance.
• Small body size: as small  body size tends to have more risk as they might have less bone mass.
• Hormone level: In  hyperthyroidism it can cause bone loss or if u are taking thyroid medication for long time to treat hypothyroidism
• Sex hormone: during menopause , there is a reduction of estrogen level , and these age group are at more risk.
• Treatment of brest cancer that reduces the hormone are more prone to bone loss…in men testosterone level decrease  as they age
• Taking long term oral cortico-steroids medication, such as prednisolone or cortisone for some disease, like for transplant rejection
• Dietary factors
• Low calcium diet
• Gastrointestinal surgery; surgery which involves removal of intestine or part of stomach can cause it.
• Medical condition
• Kidney or liver disease
• Inflammatory bowel disease
• Cancer, Rheumatoid arthritis

Diagnosis :

• Your doctor will examine u and do necessary tests to be required. If u are at risk , then we may suggest a bone density test
• It is called as bone densiometry or dual-energy X-ray absorptiometry ( DEXA ) .It takes 10 tom 20 minutes

Treatment

• It can  minimises the breakdown of the bone, and make your bone strengthen
• Bisphosphonates: ibandronate, alendronate, risedronate, zolendronic acid, these medicines are used to prevent the loss of bone mass
• Hormone theraphy:  estrogen theraphy after menopause can stop bone density loss, but it may be associated with increased risk of blood clots, and heart disease
• Raloxifen:  it is found to be more effective than estrogen
• Denosumab: it is in injection form and have a good results
• Teriparatide:  it stimulates bone growth
• Calcitonin spray:  it is taken as nasal spray and reduces bone re-absorption
• Romosozumab: it is just approved by FDA in aprl – 2019, to be given in post-menopause women

Prevention: 

• Good nutrition and regular exercise are necessary to prevent it
• Calcium
• We need calcium of 1200 miligrams between age of 18 and 50 year. This may increase, when women turns 50 year. For absorption of calcium, vitamin D is must required.
• Good sources of calcium diet:
• 1 glass of milk daily, ragi,  low-fat dairy products, green leafy vegetables, soy products like tofu,  and cereals
• Vitamin d supplement
• We all require 1 lakh IU of vitamin D3, per month
• Vit- D ( National academy of science- 25 OH D 20 ng/ml)
• 600 IU daily in women < 50
• 800 IU daily in women > 50
• Exercise: u can get benefit of exercise , when u maintain it throughout your life. Combine strength training with weight  balancing exercise have a great rol