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What You Need to Know About Osteoporosis Awareness and Prevention

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middle-aged couple and their grandchild playing and smilingEach year the American Society for Bone and Mineral Research (ASBMR) promotes osteoporosis knowledge in the broader community to boost public awareness of a widely prevalent condition for which there are, in fact, some preventative measures that will reduce danger, pain, and suffering for millions.

The ASBMR is international in scope and draws membership from around the globe, constituting a scientific and medical body dedicated to promoting bone and musculoskeletal research. The purpose of the society is to advance the understanding of the anatomy, physiology, pathology, genetics, and epidemiology of bone metabolism among scientists and physicians worldwide. The ASBMR is also committed to promoting public health by sponsoring the transition of scientific discoveries into clinical applications to improve the prevention and treatment of bone disorders.

Over the past four decades, the ASBMR has become a highly influential organization with thousands of members from more than 60 countries.

Who can benefit from Osteoporosis Awareness and Prevention Month?

Osteoporosis affects more than 10 million Americans, and is particularly prevalent in older women once they pass into menopause, and in men who have undergone radical prostate surgery.

In the case of postmenopausal women, statistics show that up to 50% of all women over the age of fifty will, at some point, suffer a bone fracture that can be attributed to their bones being brittle as a result of osteoporosis. About a quarter of men over fifty will do the same.

What is osteoporosis?

Osteoporosis is also known as “porous bone.” It develops slowly as people age or when there is some change in the body’s metabolism. It often will only be diagnosed when a minor fall or sudden impact causes a bone fracture or when people complain of symptoms like lower back pain caused by fractures or collapsed vertebrae.

How are healthy bones built?

To understand osteoporosis, knowing how bones are built and decay is essential. Bones are living structures that constantly change throughout life. Bone formation happens especially during childhood and adolescence when the body grows and continues throughout life to replace damaged bone. Each bone is built from millions of cells known as osteocytes, which are mature bone cells that give the bone its strength and shape. 

Mature bones undergo a lifelong process of bone resorption (mainly through the action of osteoclasts) and new bone formation (mainly through the action of osteoblasts). Osteocytes live relatively long, and they don’t divide. So when an osteocyte cell dies (osteonecrosis), its remnants are scavenged by osteoclast cells which reabsorb the cell walls and contents, releasing minerals such as calcium back into the bloodstream. This process is crucial for maintaining the mineral balance in the body and allowing the skeleton to adapt to physical stress, which happens when we move, lift or stretch.

In a healthy body, these processes work synchronously, ensuring bone cells are replaced. In diseased bodies, there can be an imbalance of bone formation and bone resorption. There’s either too much bone being removed, too little being made, or both. As a result, bones become porous and lose strength, leading to a higher risk of fractures.

What can cause osteoporosis?

Many factors can contribute to developing osteoporosis, including aging, hormonal changes, certain diseases, and medications. It’s more common in postmenopausal women due to the fall-off in the levels of estrogen, a hormone necessary to protect against bone loss. Dietary factors such as lack of calcium and vitamin D also contribute to the onset of osteoporosis.

Can osteoporosis be prevented?

Although osteoporosis cannot be cured once it has already affected bone structure, its progress can be slowed. Osteoporosis doesn’t have to be considered an inevitable part of aging. Many reasonably simple lifestyle changes can be taken to keep bones healthy and slow down the process. A balanced diet rich in calcium and vitamin D and regular, weight bearing exercise will promote new bone formation. Steps can also be taken to slow down bone cell resorption, such as avoiding smoking and cutting down on alcohol.

Can osteoporosis be treated?

There are several options available in consultation with a trained healthcare provider. Some are:

  • Medications that work by reducing the rate of osteonecrosis (breakdown): 
    • Bone-stabilizing medications, such as bisphosphonates, slow bone resorption by reducing osteoclast function. Fosamax (alendronate) is administered weekly, or Actonel (risedronate) is available as a daily or weekly oral dose. 
  • Medications that work by speeding up the bone-building process:
    • Forteo (teriparatide) or Prolia / Xgeva (denosumab), which are bone-building meds delivered by daily self-administered injections for two years
    • Evenity (romosozumab) is also a bone builder, delivered in a single course of treatment where the standard dosage is 12 doses administered monthly by a doctor in two injections for six months 
    • These drugs are typically reserved for people who have very low bone density, who have had fractures or whose osteoporosis is caused by steroid medication 
    • Read more here about how these newer drugs improve life for people in danger of osteoporosis.
    • After the injection courses have stopped, bone-stabilizing medication may be required to protect the bone that’s been built up.
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