When people age-particularly women-there often comes a loss of height and weight, and the development of stooped posture. A bone-thinning disease called osteoporosis often causes these body changes. This disease is characterized by loss of bone mass and structural deterioration of bone tissue. This leads to bone fragility and increased susceptibility to fractures of the spine, hip, and wrist. Spinal fractures are the most common type of osteoporotic fractures. Forty percent of all women will have at least one by the time they are 80 years old. These vertebral fractures can permanently alter the shape and strength of the spine.
Most women are likely to feel some effects of osteoporosis in their lifetime, but the good news is that much can be done to reduce and even prevent loss of bone mass and fractures. New treatments for this disease are being discovered each year. You can actively work to decrease your chances of suffering the effects of osteoporosis. The key is prevention and intervention.
Learn more about osteoporosis including
- what causes the condition
- what factors contribute to developing osteoporosis
- what symptoms are present
- how the condition is diagnosed
- what treatment options are available
Loss of bone mass begins at around age 30. Although men can be affected by osteoporosis, the typical sufferers are older women, particularly those who are past menopause. Bone loss becomes worse in women after menopause because of the body's lack of estrogen. When bones lose mass they tend to weaken and become fragile. This increases the risk of fracture under stress or because of a fall-particularly in the spine and hip. Falls in elderly women are often the result-rather than the cause-of hip fractures. In other words, a fragile hip bone may simply fracture, causing the person to fall. In severe cases of osteoporosis, the bones can fracture with any kind of slight movement, leaving some patients bedridden.
Doctors use two types to classify osteoporosis, primary and secondary. Primary osteoporosis is further divided into "primary type I" and "primary type II" osteoporosis.
Primary (Type I) Osteoporosis
Most people think of this type when talking about osteoporosis. It's the form that mainly affects women after menopause. Primary type I osteoporosis is six times more common in women than men, occurring in women 15 to 20 years after menopause. The loss of bone is linked to an estrogen deficiency in women and a testosterone deficiency in men. These hormones tend to become deficient with age.
Primary type I osteoporosis is sometimes called high-turnover osteoporosis because it causes a rapid loss of the spongy inner part of the bones (called trabecular bone). Normally there is a large amount of trabecular bone in the vertebral bodies of the spine and in the end of the long bones, like the wrist. People who lose trabecular bone have a higher risk of spine and wrist fractures.
Primary (Type II) Osteoporosis
Type II osteoporosis is only two times more common in women than men. It typically occurs once people reach their 70s and 80s. It is also thought to be the result of a deficiency in dietary calcium, age-related Vitamin D decline, or increased activity of the parathyroid glands (secondary hyperparathyroidism).
With primary type II osteoporosis there is a simultaneous loss of both the outer bone and the spongy tissue inside the bone. Because the rate of bone turnover is much lower, primary type II osteoporosis is also called low-turnover osteoporosis. Hip fractures are the most common result of this type of osteoporosis.
Secondary Osteoporosis
This form of osteoporosis develops when another problem in the body increases the rate of bone remodeling, leading to a loss of bone mass. Bone turnover is caused by two functions: (1) the production of new bone, and (2) the loss (resorption) of old bone. The amount of bone mass you have depends on the balance between these functions, which is your bone turnover rate. If bone production is less than the amount of bone being resorbed, the risk of developing osteoporosis increases.
Secondary osteoporosis can occur from an imbalance in hormones.
- Hyperparathyroidism is increased activity of the parathyroid glands.
- Hyperthyroidism is an excessive secretion of the thyroid glands.
- Diabetes is a disease where the body does not produce or use insulin correctly. This leads to hyperglycemia-an increase in blood sugar, increasing susceptibility to infection-and to glycosuria-glucose in the urine.
- Hypercortisolism is a result of systemic illness or long-term use of oral corticosteroid.
Secondary osteoporosis can also occur from disorders where the bone marrow cavity expands at the expense of the trabecular bone. The trabecular bones have a honeycomb appearance and large marrow spaces. If a trabecular bone is affected by increased bone marrow cavities, it loses some of its strength.
Other Causes of Secondary Osteoporosis
- Thalassemia is a hereditary form of anemia (a problem where there are too few red blood cells).
- Multiple myeloma is a condition where there are multiple tumors within the bone and bone marrow.
- Leukemia is a serious disease that is characterized by unrestrained growth of white blood cells in the tissues.
- Metastatic bone disease is a condition that occurs when malignant tumor cells spread from one part of the body to another. The disease travels through the blood and settles in the bones.
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