Osteoporosis

It is the result of the loss of bone mass and the progressive change in the structure of the bone, which will involve a greater proportion of holes than the actual tissue. This will lead to increased fragility and susceptibility to fractures, often of the hip, spine, and wrist. It is one of the most common conditions worldwide, with a prevalence close to 18.3%.

Bones are in a constant state of renewal. During youth, the development of new bones is faster than their degradation, leading to an increase in bone mass. However, as one ages, bone mass is lost more quickly than it is created. Based on this, the development of osteoporosis will depend, among other factors, on the maximum bone mass achieved, which is partly determined by hereditary components and ethnic group. Additionally, there are several other categories of risk factors that can influence the likelihood of developing osteoporosis:

Non-modifiable factors:

• Advanced age. Although it can also appear at younger ages.
• Gender. Women are much more prone, particularly when estrogen levels decrease: with early menopause or hysterectomy, especially if the ovaries are also removed, particularly if this occurs before age 45, or due to the absence of menstruation for more than 6 months as a result of excessive exercise or an excessive diet.
• Levels of certain hormones. Sex hormones, specifically estrogen in women with menopause or hormonal treatment in estrogen-dependent breast cancer, or testosterone in men undergoing treatment for prostate cancer. Hyperthyroidism or excess thyroid hormone in the treatment of hypothyroidism. Hyperactivity of the parathyroid and adrenal glands.
• Asian or non-Hispanic Caucasian ethnic origin.
• Small bone structure due to lower bone mass availability.
• Previous fractures from minor injuries, especially after age 50, or family history, particularly if there are hip fractures.

Modifiable factors:

• Eating disorders such as anorexia nervosa and bulimia that restrict food intake, as well as gastrointestinal surgeries that limit the available surface area for nutrient absorption.
• Smoking and excessive alcohol consumption.
• Low levels of calcium and vitamin D, obtained from the diet since adolescence or inadequate absorption.
• Sedentary lifestyle or immobility, such as prolonged bed rest.

Other bone diseases:

• Endocrine diseases: hyperthyroidism, hyperparathyroidism, Cushing's disease, etc.
• Inflammatory arthritis, inflammatory bowel disease, celiac disease, kidney or liver diseases, neoplasms, etc.

Medication use:

Long-term glucocorticoids, heparin, anticonvulsants, immunosuppressants, antineoplastics.

Usually, in the early stages, there are no symptoms. Once the bones are weakened, the following signs and symptoms may appear:

• Back pain caused by a fractured or collapsed vertebra.
• Loss of height over time.
• A stooped posture.
• Painful joints or stiffness.
• A bone that breaks much more easily than expected, for example, after a minor injury.

Lifestyle changes related to diet and physical exercise are the most recommended measures for the prevention of osteoporosis:

• Ensure adequate calcium intake either through diet (dairy products, dark leafy vegetables, nuts, orange juice) or supplements if necessary. Between the ages of 18 and 50, 1000 milligrams per day. This amount increases to 1200 milligrams for women from age 50 and men from age 70. It is recommended not to exceed 2000 milligrams daily for those over 50.
• Ensure adequate Vitamin D intake necessary to enhance calcium absorption. It is obtained from exposure to sunlight, foods such as fatty fish, red meat, egg yolks, and liver. The recommended intake is at least 600 IU per day, and from age 70, 800 IU per day. If necessary, supplements can be used.
• Quit smoking and limit alcohol consumption.
• Engage in physical exercise regularly for at least 30 minutes a day, including strength training to strengthen bones and muscles and delay bone loss. Exercises that improve balance can help prevent falls.
• Try to plan strategies to avoid falls as much as possible.