Osteoporosis

Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones.

Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones.

Understanding Bone Health

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine).

The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

Osteoporosis literally means "porous bone" — bone that is weak and more likely to fracture.

Osteoporosis vs. Osteopenia

Normal Bone

Healthy bone density with normal strength and structure

Osteopenia

Slightly less dense than normal bone but not to the degree of osteoporosis

Osteoporosis

Significantly decreased bone density with high fracture risk

Risk Factors for Osteoporosis

Age — Bone density decreases with age, especially after menopause
Gender — Women are at higher risk, particularly post-menopausal women
Family History — Having a parent with osteoporosis or hip fracture
Body Size — Small, thin body frame increases risk
Hormonal Changes — Low estrogen (menopause), low testosterone
Dietary Factors — Low calcium and vitamin D intake
Lifestyle — Sedentary lifestyle, smoking, excessive alcohol consumption
Medical Conditions — Hyperthyroidism, hyperparathyroidism, eating disorders
Medications — Long-term use of corticosteroids, certain anti-seizure medications

Common Symptoms

Back pain caused by fractured or collapsed vertebra
Loss of height over time
Stooped posture (kyphosis)
Bones that break much more easily than expected
Fractures from minor falls or even sneezing/coughing

When Should You Get Screened?

Consider bone density screening if you:

Are a woman aged 65 or older
Are a man aged 70 or older
Have experienced a fracture after age 50
Have a family history of osteoporosis
Have a medical condition or take medication that affects bone health
Are post-menopausal and have risk factors
Have lost height or developed a stooped posture

Diagnosis & Treatment

Diagnosis of osteoporosis typically involves:

Medical History & Physical Examination — Including assessment of risk factors and symptoms
Bone Density Scan (DXA/DEXA) — The gold standard test that measures bone mineral density
Blood Tests — To check calcium, vitamin D, thyroid, and parathyroid hormone levels
X-rays — To detect fractures or vertebral compression

Treatment options include:

Lifestyle Modifications — Regular weight-bearing exercise, balanced nutrition, fall prevention
Calcium and Vitamin D Supplements — Essential for bone health
Bisphosphonates — Medications that slow bone loss
Hormone Replacement Therapy — Estrogen or testosterone therapy
Selective Estrogen Receptor Modulators (SERMs) — Help maintain bone density
parathyroid Hormone Therapy — Helps build new bone
RANKL Inhibitors — Newer medications that prevent bone breakdown

As a Consultant Endocrinologist, I specialize in identifying and treating metabolic bone disorders, helping patients maintain bone health and prevent fractures through comprehensive evaluation and personalized treatment plans.