What Is Osteoporosis?

Basic Facts About Osteoporosis

Exercise helps prevent osteoporosis.
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Osteoporosis, which means "porous bone", is a disease characterized by progressive bone thinning. The deterioration of bone tissue can lead to bone fragility and fracture, especially of the hip, spine, and wrist.

Osteoporosis is considered a type of arthritis. Often, osteoporosis is confused with osteoarthritis (the most common type of arthritis), but they are two different diseases.

Osteoporosis Symptoms

Osteoporosis is regarded as a "silent disease" since bone density is lost over a period of years without evident signs or symptoms.

The disease typically remains undiagnosed until it becomes so advanced that the weakened bones are easily fractured. Osteoporosis is the cause of 1.5 million fractures each year.

Who Gets Osteoporosis?

Osteoporosis is a major public health concern with more than 25 million Americans affected, 80% of whom are women. It has been estimated that one out of every two women and one out of five men will experience an osteoporosis-related fracture at some point in their life. By age 75, one third of all men will be affected by osteoporosis. Though osteoporosis is thought of as an old person's disease, it actually can strike at any age.

Risk Factors for Osteoporosis

There are certain risk factors involved which make some people more likely to develop osteoporosis than others:

  • advanced age
  • being female
  • family history of osteoporosis
  • thin or small frame
  • early menopause, either naturally or surgically
  • men having low testosterone levels
  • amenorrhea
  • anorexia or bulimia
  • thyroid disease
  • rheumatoid arthritis 
  • maladies involving blocked intestinal absorption of calcium
  • use of corticosteroid medications (use lowest possible dose to reduce risk of osteoporosis and other side effects)
  • use of anticonvulsant drugs
  • diet low in calcium
  • lack of exercise
  • cigarette smoking
  • excessive use of alcohol of caffeine

Detection of Osteoporosis

Early detection of osteoporosis is very important. There are tests which can detect bone density problems:

Standard x-rays do not detect osteoporosis until one-quarter of bone mass is already lost. By then susceptibility to fracture already exists. DEXA is an early detection tool and can detect as little as one percent of bone loss.

DEXA uses a low level of radiation, focuses on the hip and spine which are common sites of fracture, and is considered safe and comfortable for the patient. However, DEXA which has been called the "gold standard" of bone density tests may not be covered by some insurance plans. In that case, people at risk for osteoporosis should get one of the less expensive screenings done first. If there is evidence of bone loss the insurance company will likely pay for a DEXA test since it is then indicated.

Treatment of Osteoporosis

There are now several categories of drugs used to treat osteoporosis:

  • estrogens
  • parathyroid hormones
  • bone formation agents
  • bisphosphonates
  • selective estrogen receptor modulators

Depending on what drug is used you can slow bone loss, promote bone growth, and reduce the risk of fractures. Drugs used for osteoporosis now include:

  • Actonel (Risedronate)
  • Boniva (Ibandronate)
  • Didronel (Etidronate)
  • Estrogens (Hormone Therapy)
  • Evista (Raloxifene)
  • Forteo (Teriparatide)
  • Fosamax (Alendronate)
  • Miacalcin (Calcitonin)

Prevention of Osteoporosis

Prevention of osteoporosis is primarily tied to 3 things:

  • Proper nutrition, with sufficient amounts of calcium and vitamin D through diet or supplementation
  • Weight-bearing exercise
  • Lowering your risk by paying attention to modifiable risk factors (e.g., smoking) 

Osteoporosis and Nutrition 

Nutrition is among the factors that affect bone density. Calcium is an essential nutrient for bone health. Actually, 99% of the body's total calcium is found in bone. Calcium is also needed for proper function of the heart, muscles, nerves, as well as normal blood clotting.

There are other nutrients which are essential because they affect calcium absorption and calcium excretion. Vitamin D increases calcium absorption in the gastrointestinal tract and therefore positively influences calcium absorption. Sources of vitamin D include exposure to sunlight, fatty fish, eggs, liver, and fortified foods (including milk and multivitamins). 

Protein is necessary in our diet because it plays a role in tissue growth, as well as tissue repair. Protein also is necessary for fracture repair and proper functioning of the immune system. Protein, though, increases calcium excretion which creates a need for more calcium to maintain the proper balance of nutrients in the body.

Sodium, along with chloride as the components of salt, also increase the excretion of calcium. People who typically have high salt intake require more calcium. 

Oxalate is found in certain foods, such as spinach, rhubarb, and sweet potatoes. Oxalate interferes with calcium absorption from the same food source.

Phosphorus is a necessary mineral in our diet. Most of the phosphorus in our bodies is stored in the bones, with lesser amounts found in teeth, DNA, and cell membranes. Excessive dietary intake of phosphorus (e.g., cola or processed foods) may interfere with calcium absorption. Generally, this is not considered a problem in people with normal kidney function.  

Beverages that contain caffeine can reduce calcium absorption, but not significantly. In fact, the reduction can be offset by including milk in your diet. Just be aware that caffeine does reduce calcium absorption and make it a point to offset that effect.

It's important to pay attention to nutrition. Adequate intake of nutrients helps to maintain bone health and lower your risk of developing osteoporosis.


Glucocorticoid-Induced Osteoporosis Guidelines Overview, American College of Rheumatology. Updated June 2015.

Fact Sheet on Osteoporosis. American College of Rheumatology. Update May 2015.

Osteoporosis Overview. NIH Osteoporosis and Related Bone Diseases. Accessed 10/12/2015.

Food and Your Bones. National Osteoporosis Foundation. Accessed 10/18/2015.

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