Osteoporosis is a progressive disease that causes the bones to deteriorate and eventually lead to fractures. Osteoporosis causes the bones to gradually loose bone mass resulting in porous, brittle bones. The different causes of osteoporosis usually interrupt the bone remodeling process causing the bones to become brittle and thin. Osteoporosis affects 44 million Americans, 68% of whom are women.
In the United States today, 10 million people already have osteoporosis and 34 million more have low bone mass (weak or thin bones); these people are at increased risk for fractures and osteoporosis. Half of women and a quarter of men older than 50 years will have an osteoporosis-related bone fracture in their lifetime.
The actual breaking down and rebuilding of bone tissue is performed by two groups of cells called osteoclasts and osteoblasts. Bone remodeling occurs when small amounts of bone are broken down by cells known as osteoclasts. After the bone has been broken down and reabsorbed in the body, cells known as osteoblasts move in to the area and start building new bone. Osteoporosis occurs when there is an imbalance between new bone formation and old bone resorption. The body may fail to form enough new bone, or too much old bone may be reabsorbed, or both. Bone loss in women occurs fastest in the first few years after menopause, but bone loss continues into old age.
Until recently osteoporosis was thought of as a natural part of aging. Osteoporosis is not a natural part of aging. Due to a loss of bone mass and tissue, bones that were once strong may be unable to endure the stress of normal activities. Each year osteoporosis is responsible for more than 1.5 million fractures. These fractures usually occur in the spine, hip or wrist, but they may occur in other bones as well. Osteoporosis fractures can be debilitating, painful and sometimes can result in death. For example, only one-third of the people who break a hip ever return to being as active as they were before the fracture!
There are (2) accepted modes of treatment and one way that we prefer to approach the patients presented with osteoporosis. First, we test their hormone levels through either saliva, urine, or serum panel. These tests determine if there is a feedback mechanism that may be inhibiting the osteoblasts from building new bone or whether too much bone is being absorbed. It is important to try and isolate the (2) effects of osteoporosis since various treatment options are available depending upon the results. These tests will also confirm whether hormone replacement is contraindicated and other types of prescription drugs would be used. There are a number of factors that need to be explored for treatment especially when many of the prescribed drugs for osteoporosis have serious side effects or may be less efficacious in treating osteoporosis.
The best treatment (though may not be indicated for everyone) is hormone replacement therapy (HRT) and estrogen replacement therapy as they are now approved for both prevention and treatment of postmenopausal osteoporosis. This is because declining estrogen and progesterone levels do not just affect a woman’s reproductive capabilities; they also cause bone density to decrease and the risk of fractures to increase. Estrogen (a reproductive hormone) is important for bone growth and strength because it works with the cells responsible for forming bone (called osteoblasts). Estrogen works with these cells to stimulate the substances in the body that encourage bone growth. The taking of Estrogen either as ERT or as HRT, bone loss is slowed and bone density can even be regained. Prescription drugs such as Bisphosphonates, Calcitonins, Parathyroid Hormone Derivatives, and other Investigation Drugs come with serious side effects and may not be as effective.
There are also lifestyle and natural approaches to osteoporosis when combined with treatment protocols also prove very effective. Exercise, Calcium & Vitamin D, foods enriched in calcium or Vitamin D, as well as lifestyle changes (limiting alcohol and quit smoking) all enhance the treatment for osteoporosis. There are also other natural supplements that stimulate bone health.