Health Tips

A healthy and strong bone has a structure that looks like a honeycomb: with little to no holes and spaces, very compact and has high density. However, when you develop osteoporosis, your bone becomes “porous” — large holes and spaces in the bone structure. This leads to low bone density and abnormal tissue structure, which makes the bones weaker and prone to fracture. 

Image credit: BruceBlaus, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

Osteoporosis is particularly dangerous because you can’t really “feel” that your bone is weaker, but it can sneak up on you when you have bone fractures after accidentally slipping and falling. Doctors run a test called bone mass density (BMD) measurement to determine your bone mass, establish diagnosis for osteoporosis and evaluate how well you respond to treatment of osteoporosis.

In conjunction with World Osteoporosis Day 2021, let’s look at the things that can increase your risk of developing osteoporosis.

Risk factors that you can’t change

Unfortunately, if you are a woman, your risk of developing osteoporosis is naturally higher than the male counterparts. The same applies to age: the older one's age is, the higher the risk of osteoporosis. Studies also found that Caucasian and Asians are also more likely to develop osteoporosis. 

Medical conditions can also increase your risk of developing osteoporosis:

• Autoimmune diseases (e.g. rheumatoid arthritis, lupus, multiple sclerosis) 

• Digestive diseases (e.g. celiac diseases and inflammatory bowel disease) 

• Endocrine and hormonal diseases (e.g. diabetes, Cushing’s syndrome)

• Chronic kidney disease

• Drastic weight loss

Risk factors that you CAN change

Nonetheless, there are many lifestyle factors that can increase one’s risk of osteoporosis. A healthy lifestyle can be important for keeping bones strong. Factors that contribute to bone loss include:

• Low levels of physical activity and prolonged periods of inactivity can contribute to an increased rate of bone loss. They also leave you in poor physical condition, which can increase your risk of falling and breaking a bone.

• Chronic heavy drinking of alcohol

• Smoking

• Low intake of calcium and vitamin D - Check out the calcium content of common foods here so that you can incorporate more calcium into your diet.

Medications that may cause bone loss

Some medications can lead to bone loss, even if you need to take them for another medical condition. Bone loss is usually greater if you take the medication in high doses or for a long time. It’s important to talk with your healthcare provider about the risks and benefits of any medications you take and about how they may affect your bones, but do not stop any treatment or change the dose of your medicines unless your healthcare provider says it’s safe to do so. If you need to take a medicine that causes bone loss, work with your healthcare provider to determine the lowest possible dose you can take to control your symptoms, or explore other alternatives that may be less harmful to bone.

Here’s an non-exhaustive list of medications that may lead to bone loss:

• Systemic glucocorticoids (e.g. prednisolone, dexamethasone)

• Antiepileptics

• Antiretroviral therapy

• Proton pump inhibitors, a medication for gastric diseases (e.g. pantoprazole, omeprazole)

Note: Both proton pump inhibitors and systemic glucocoticoids are commonly prescribed together to manage one of the many side effects of glucocorticoids, which is stomach upset.

Read more!

You can read more about treatment of osteoporosis in our previous article here. On how to reduce fall risk in elderly, read here.

Take care of your bones! 

A word from DOC2US

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References

1. National Osteoporosis Foundation - What is Osteoporosis and What Causes It?

2. NIH - Osteoporosis Overview

3. CPG Management of Osteoporosis 2015 (2nd edition)

Specific references have been linked in its relevant part of the article. 

Cover image credit: Photo by Owen Beard on Unsplash

Written by

Ms Joyce Toh