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May is National Osteoporosis Awareness and Prevention Month

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National Osteoporosis Awareness and Prevention MonthNational Osteoporosis Awareness and Prevention Month, observed each year in May, is dedicated to educating the public and raising awareness of the importance of osteoporosis prevention, screening, and treatment. The Bone Health and Osteoporosis Foundation (BHOF) will be hosting a number of webinars and in-person seminars to raise awareness of how medical professionals and the general public can benefit from and contribute to the awareness and prevention of osteoporosis. 

National Osteoporosis Awareness and Prevention Month differs from most health-centered calendar events. In addition to identifying the need to raise awareness of the condition, it also aims to reduce the incidence of osteoporosis by making the general public aware of how osteoporosis can be prevented.

Strong bones are a vital part of good health, but osteoporosis is often referred to as a “silent disease” because it goes undetected until an unexpected fall leads to bone fractures that can be life-changing. Especially in older people, it can seriously impact a person’s quality of life, robbing them of their independence and leading to other serious health outcomes. 

Osteoporosis is when bones become weak and more likely to fracture at even the slightest stress or impact. It already affects more than 10 million adults in the US, and the number is growing. Much of the growth in the prevalence can be attributed to the steady aging of the general population since there is a clear link between the risk of developing osteoporosis and a person’s age. 

According to the Bone Health and Osteoporosis Foundation, osteoporosis is a disease that is more likely to affect women, although men can develop it, too. About 50% of all women aged 50 and older will, at some point in their lives, suffer a fractured bone that can be attributed to the development of osteoporosis. In the case of men over the age of 50, the numbers are about one-half of that, with 25% of men aged 50 and older suffering fractures.  

These numbers are probably underestimating the true incidence of fractures that are attributable to osteoporosis simply because the great majority of older adults who are treated when fractures occur  (some estimates put this as high as 80%) are not screened for osteoporosis.

What exactly is osteoporosis?

Osteoporosis, also known as “porous bone,” typically develops gradually as individuals age or due to changes in body metabolism. It often remains undetected until a minor fall or sudden impact leads to a bone fracture or when individuals experience symptoms like lower back pain resulting from a broken bone or collapsed vertebrae.

Osteoporosis occurs when the body can no longer form enough new bone to compensate for the loss of old bone, and bone mass is depleted, causing it to weaken. The body either loses too much bone, makes too little bone, or does both. The bones become porous and fragile and, therefore, weaken. Bone density and mass both decrease due to osteoporosis.

How do our bodies maintain healthy bones?

Understanding the process of bone formation and breakdown is crucial in comprehending osteoporosis. Bones are dynamic structures that continuously change. They mostly grow during childhood and adolescence as the body grows. Once a person’s body has reached full size, there is an ongoing process to keep the bone strong. The cells in the mature bones are engaged in an ongoing cycle of resorption of older cells and the formation of new bone tissue. When a bone cell dies (osteonecrosis), specialized cells (osteoclasts) break it down and release some of the remains, mainly minerals like calcium, back into the bloodstream. This is essential in maintaining the strength of the bones. Other specialized cells then replace the old cells, keeping the structure strong.

If there is an imbalance between the breakdown of existing bone cells and their replacement with new bone, it can cause bones to become porous and weaker, increasing the likelihood of fractures. 

What factors contribute to the development of osteoporosis?

Various elements play a role in the onset of osteoporosis, including aging, hormone changes, specific illnesses, and medications. While people of all genders, ages, and ethnicities can develop osteoporosis, certain factors have been observed to increase the risk of developing osteoporosis, such as:

  • Gender: Women have almost twice the risk of developing osteoporosis as men due to a naturally lower bone density and changes that occur in menopause.
  • Aging: Bones become thinner and weaker with age, making this the greatest risk factor.
  • Diet: Inadequate intake of calcium and vitamin D throughout a person’s life contributes to the development of osteoporosis.
  • Lifestyle factors: Lack of exercise, smoking, excessive alcohol consumption, and extended bed rest can weaken bones.
  • Genetics: If there is a family history of osteoporosis, the risk in subsequent generations is higher, although there is no indication that it’s attributable to a single gene.
  • Ethnicity: Caucasian and Asian women have a slightly higher risk than African American and Hispanic women, but for all groups, the risk is higher than for men in all four ethnic groups.
  • Body size: Thin-boned, smaller women carry the greatest risk.
  • Medication: Long-term use of certain medications such as blood thinners, cyclosporine, chemotherapy drugs, cortisone, birth control, and thyroid hormone can result in the loss of bone density.

Is prevention of osteoporosis possible?

Osteoporosis should not be seen as unavoidable. Numerous practical lifestyle adjustments can help maintain strong bones. A healthy diet includes foods high in calcium and Vitamin D, is low in salt, saturated fats, trans fats, “bad” cholesterol, and sugars, and contains lots of fiber, fruits, vegetables, and whole grains. Combining this with regular physical activity can stimulate new bone growth. 

What treatments are available to prevent osteoporosis?

Talk to your doctor about the possibilities of treating and preventing osteoporosis. The two processes in maintaining bone health are bone cell death (osteonecrosis) and new bone-cell formation (osteogenesis). The main medications to prevent osteoporosis and maintain good bone health are intended to slow down osteonecrosis or boost osteogenesis.

Medications that slow down bone breakdown

Bone-stabilizing drugs like bisphosphonates work by reducing bone resorption. These include Fosamax, which is used mainly to treat or prevent postmenopausal and steroid-induced osteoporosis, and Actonel, which can be taken daily or weekly.

Medications that promote bone formation

Forteo is administered through self-injections. Forteo is mostly recommended for patients who develop osteoporosis resulting from corticosteroid treatment.

Prolia and Xgeva are administered by trained personnel. Xgeva is prescribed to prevent bone loss due to a malignant disease, such as multiple myeloma. Prolia is related to hormonal problems.

Evenity is given as a single treatment course administered by a doctor in two injections spread over six months. It is mainly used to treat osteoporosis in menopausal women at high risk of bone fracture or who cannot use other osteoporosis medicines.

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