Osteoporosis – Symptoms and Causes
Understanding Bone Health
Osteoporosis is a condition that weakens bones, making them fragile and more likely to break. Even minor activities like coughing or bending can cause fractures when bones are severely affected.
The most common break sites are the hip, wrist, and spine. Bones are in a constant state of transformation, marked by a continuous process of breakdown and renewal.
When new bone creation falls behind the removal of old bone, osteoporosis develops. This imbalance leads to decreased bone density and strength.
This condition affects people of all genders and ethnicities, though postmenopausal White and Asian women face a higher risk.
Prevention and management strategies include:
- Medication
- Calcium-rich diet
- Regular weight-bearing exercise
- Vitamin D supplementation
These approaches can help slow bone loss and strengthen existing bone tissue, reducing fracture risk and maintaining mobility.
Signs of Bone Loss
People with early bone loss often feel fine. As bones weaken due to osteoporosis, these problems may appear:
- Back pain from broken spinal bones
- Height loss over time
- Stooped posture
- Easily broken bones from minor falls or bumps
When to Talk with a Healthcare Provider
Consider discussing bone health with your doctor if you:
- Experienced early menopause
- Took steroid medications for several months
- Have parents who broke their hips
Don’t wait for a fracture to happen before seeking medical advice. Early detection can help prevent serious bone problems.
Causes
Bones continuously renew themselves through a balance of new bone formation and old bone breakdown. During youth, bone creation happens faster than breakdown, leading to increased bone mass.
This process slows after the early 20s, with most people reaching their peak bone mass around age 30. After this point, bone loss typically outpaces new bone formation.
Your risk of developing osteoporosis is partly determined by how much bone mass you built during your younger years. This peak bone mass is influenced by:
- Genetics: Bone density is partially inherited.
- Ethnic background: Different ethnic groups have varying bone density patterns.
Think of peak bone mass as a “bone bank.” Building bone density in youth increases reserves for later years, lowering the risk of osteoporosis as you age.
Bone Health Risk Factors
Several risk factors for bone thinning are beyond your control:
- Gender: Women face a much higher risk than men.
- Getting older: Your risk increases as you age.
- Ethnic background: White and Asian people have higher risk levels.
- Genes: Having relatives with bone problems, especially parents with hip fractures, raises your risk.
- Body size: People with smaller frames typically have less bone mass to lose as they age.
Hormone Imbalances
Problems with certain hormones can weaken your bones:
- Sex hormone drops: Lower estrogen in women during menopause significantly weakens bones. Men who receive testosterone-reducing treatments for prostate cancer and women on estrogen-reducing treatments for breast cancer often experience faster bone loss.
- Thyroid issues: Too much thyroid hormone can damage bones, whether from an overactive thyroid or taking too much thyroid medication.
- Other hormone problems: Overactive parathyroid and adrenal glands have been linked to weakened bones.
Food and Nutrition
Your eating habits affect bone health:
| Risk Factor | Why It Matters |
|---|---|
| Low calcium | Not getting enough calcium throughout life leads to lower bone density and a higher fracture risk |
| Eating disorders | Being underweight and severely limiting food intake weakens bones in everyone |
| Digestive surgeries | Weight loss surgeries and intestinal operations reduce nutrient absorption, including calcium |
Medications
Long-term use of certain medicines can harm bones:
- Corticosteroids (like prednisone and cortisone) interfere with new bone formation
- Medications for treating:
- Seizures
- Stomach acid problems
- Cancer
- Organ transplant rejection
Health Conditions
Several medical problems increase your risk:
- Celiac disease
- Inflammatory bowel disorders
- Kidney or liver disease
- Various cancers
- Multiple myeloma
- Rheumatoid arthritis
Daily Habits
Your everyday choices can affect bone strength:
Lack of activity: People who sit most of the time have weaker bones than active people. Weight-bearing exercise helps bones stay strong, especially walking, running, jumping, dancing, and lifting weights.
Too much alcohol: Regularly drinking more than two alcoholic beverages per day weakens bones.
Smoking: While the exact connection isn’t fully understood, tobacco use is known to contribute to bone weakness.
Making lifestyle changes can help protect your bones, even if you have other risk factors that can’t be changed.
Complications
Osteoporosis can lead to several serious health problems. The most dangerous complications are bone fractures, especially in the spine and hip.
Hip fractures typically happen after falls and can cause major problems. People who break their hips may become disabled. They also face a higher chance of dying within the first year after breaking a hip.
Spinal fractures can occur even without falling. The vertebrae (spine bones) may become so weak that they collapse under normal pressure. This leads to:
- Significant back pain
- Loss of height
- Hunched posture
Keeping Your Bones Strong
Bone health is essential for everyone, especially as we age. Many adults will lose some bone density over time, but there are effective methods to keep bones strong and lower the risk of fractures.
Getting Enough Calcium
Calcium serves as a fundamental building block for bone health. Without sufficient calcium, bones become weak and prone to breaking.
Daily calcium needs:
- Adults aged 50 and under: 1,000 mg daily
- Adults over 50: 1,200 mg daily
Most people only consume about half the recommended amount of calcium through diet alone. This gap can significantly affect bone strength over time.
Best food sources of calcium:
| Food | Serving Size | Calcium (approx.) |
|---|---|---|
| Plain yogurt | 1 cup | 300–400 mg |
| Milk | 1 cup | 300 mg |
| Fortified plant milks | 1 cup | 300–400 mg |
| Cheese | 1.5 oz | 300–400 mg |
| Leafy greens (kale, spinach) | 1 cup cooked | 100–250 mg |
| Fortified orange juice | 1 cup | 300 mg |
Tips for increasing dietary calcium:
- Aim for three servings of calcium-rich foods daily
- Choose calcium-fortified versions of foods when available
- Add leafy greens to smoothies, soups, and sandwiches
If you struggle to get enough calcium through diet alone, supplements can help bridge the gap. Calcium supplements are generally inexpensive and well-absorbed.
For best results, take calcium supplements with food and spread doses throughout the day rather than taking all at once.
Your body can absorb only 500–600 mg of calcium at once, so it’s best to space your intake throughout the day for better absorption.
Vitamin D Benefits
Vitamin D plays a critical role in bone health by helping your body absorb calcium efficiently. Without adequate vitamin D, even a calcium-rich diet won’t fully benefit your bones.
How vitamin D works:
- Helps intestines absorb calcium from food
- Maintains proper calcium levels in the blood
- Supports bone remodeling (the natural process of bone renewal)
Your body can make vitamin D when your skin is exposed to sunlight. However, many factors limit this natural production:
- Living in northern climates
- Using sunscreen (which blocks vitamin D production)
- Having darker skin (which reduces vitamin D synthesis)
- Limited outdoor time
- Aging (skin becomes less efficient at making vitamin D)
Recommended vitamin D intake:
- Adults under 70: 600–800 IU daily
- Adults over 70: 800–1,000 IU daily
Many people need higher amounts, especially those with vitamin D deficiency. Your healthcare provider can test your vitamin D levels and recommend appropriate supplementation if needed.
Food sources of vitamin D:
- Fatty fish (salmon, mackerel)
- Egg yolks
- Fortified milk and plant milks
- Fortified cereals
- Mushrooms exposed to UV light
Most people need a combination of dietary sources and supplements to reach optimal vitamin D levels. When taking calcium supplements, look for formulations that include vitamin D for better absorption.
Studies indicate that adequate calcium and vitamin D intake greatly lowers fracture risk and enhances bone density, particularly in older adults.
Exercise for Strong Bones
Physical activity is one of the most effective ways to maintain bone density and prevent fractures. Exercise exerts controlled stress on bones, stimulating their strength and resilience.
Best exercises for bone health:
Weight-bearing exercises (activities where your feet and legs support your
weight).- Walking is one of the simplest and most effective options.
- Jogging or running
- Stair climbing
- Dancing
- Tennis or other racquet sports
Resistance Training
- Weightlifting with machines or free weights
- Resistance bands
- Body weight exercises like push-ups and squats
Balance Activities
- Tai Chi is particularly effective for fall prevention
- Choose appropriate yoga levels based on your ability
- Simple standing balance exercises
Sample weekly bone-building exercise plan:
| Day | Activity | Duration |
|---|---|---|
| Monday | Walking | 30 minutes |
| Tuesday | Lightweight training | 20–30 minutes |
| Wednesday | Rest or gentle movement | – |
| Thursday | Walking | 30 minutes |
| Friday | Balance exercises | 15–20 minutes |
| Saturday | Dancing or tennis | 30–45 minutes |
| Sunday | Rest or gentle movement | – |
For maximum benefit, aim for:
- 30–60 minutes of combined exercise daily
- A mix of different exercise types
- Consistent activity rather than occasional intense workouts
Important safety considerations:
- Start slowly and gradually increase intensity
- Focus on proper form to prevent injuries
- Avoid high-impact activities if you already have osteoporosis
- Consult your healthcare provider before beginning a new exercise program
Exercise offers advantages that extend well beyond improving bone health. It also includes improved muscle strength, better balance, and enhanced coordination. These factors all help prevent falls and related fractures.
Even people who already have some bone loss can benefit from appropriate exercise. Studies show that regular physical activity can slow bone loss by up to 1–3% per year in adults over 50.
Remember that consistency matters more than intensity. Regular, moderate exercise several times per week provides more bone benefits than occasional, vigorous workouts. Find activities you enjoy to make exercise a sustainable habit for long-term bone health.
