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Who Gets Osteoporosis?

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

Fractured Bones

Fractured Bones

Osteoporosis Facts

Osteoporosis affects 200 million women around the world, and 44 million women and men over the age of 50 have low bone density, which represents 55% of Americans. By the time a woman reaches age 80, two-fifths of women have osteoporosis. This is considered a silent disease as most people do not know they have osteoporosis until they get a bone fracture. Only about 25% of people get the required calcium intake for healthy bones.

Primary osteoporosis is typically caused by age-related bone loss or loss that occurs due to medications. Idiopathic osteoporosis is the term used when the cause of bone loss is unknown. This term is often used for men under the are of 70 that have serious bone loss.

Men can also exhibit bone loss, as 4-6% of men older than 50 have osteoporosis. Additionally, 33 to 47% of men have osteopenia, which is the stage of bone loss just before osteoporosis.

As a comparison, at age 65 men 4-5 men per thousand have hip fractures, where as 8-10 women at age 65 have hip fractures. Men have a higher peak bone mass, which is one reason the onset of bone loss is at a more advanced age.

Factors that Cause Osteoporosis

Osteoporosis happens when your body absorbs more bone than your body can produce. When low bone density occurs you become prone to bone fractures. Hip fractures tend to be particularly serious for the elderly, as women often die from complications.

There are other causes of osteoporosis that contribute to this condition. Diet has a specific impact on the health of your bones. Unfortunately, if children do not eat a balanced diet due to poverty or poor eating habits they may not develop strong, healthy bones. Lack of exercise, certain diseases and specific medications also have an impact on bone health.

Some risk factors that take work to overcome include:

  • Family history
  • Ethentricity
  • Age
  • Gender

Other common causes include:

  • Medications, especially glucocorticoid
  • Hypogonadism (low levels of testosteron
  • Gastrointestinal disease
  • Alcohol abuse
  • Hypercalciuria
  • Smoking
  • Immobilization

Osteoporosis Exercises

The Estrogen Impact

Having low estrogen levels puts you at risk for osteoporosis, as estrogen protects bones. A quick decrease in estrogen levels occur after menopause. After menopause a 4-8% annual bone loss occurs.

If your ovaries have been removed the risk for osteoporosis increases as they produce a great deal of estrogen. A supplemental estrogen therapy is often prescribed. Young women with irregular periods may have low estrogen levels, so bone health should be a priority. However, irregular periods may also be caused “under-eating” or “over-exercising”, which also causes bone loss.

While men have some estrogen, testosterone protects the bones. Low body weight in women with petite frames and under 130 pounds tend to have less bone mass, which puts them at a greater risk.

Medical Conditions Causing Osteoporosis

Thyroid conditions (hypothyroid or hyperthyroid) both cause bone loss. If hyperthyroidism (Graves Disease) is undiagnosed the cycle of bone remodeling is cut in half. Hypothyroidism, which is much more common (particularly in women). It causes the bone-resorbing osteoclast and therefore, the bone-forming osteoblast process to decrease, and it may cause osteoporosis.

Lactose intolerance is a common problem, and people with this condition often do not get enough calcium in their diet. “The Institute of Medicine" recommends a daily calcium intake of 1,000 mg (milligrams) for men and women up to age 50, increasing to 1,200 mg for women over age 50 and men over age 70.” Calcium along with vitamin D and a healthy diet may adequately support bone health.

Celiac disease (gluten intolerance) has become more common. This is often an inherited disease, but if not treated you may not absorb enough calcium, as the small intestine absorbs our important nutrients, such as calcium.

Osteogenesis imperfecta (OI) a genetic disorder that causes bones to break more easily. This disease may present as mild or severe, and bone malformations are common.

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Autoimmune diseases, such as systemic lupus and rheumatoid arthritis tend to run in families, but have not been classified as an inherited disease. The glucocorticoids that are often proscribed, plus the pain, fatigue and loss of joint function can all result in osteoporosis. As 90% of patients that have this disease are women, there is concern as women are already at high risk for osteoporosis.

Inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis also experience bone loss primarily due to glucocorticoids treatment.

Anorexia nervosa is an eating disorder where the patient is obsessed with their weight, and they severely limit their food intake, which causes a number of problems.

Diabetes, particularly Type 1 causes bone loss, and there is really no explanation for this. People with Type 2 diabetes tend to have a better bone density, but they still have bone loss as they age, possibly due to inactivity.


Diagnosis of Osteoporosis

Undiagnosed people with osteoporosis may have no symptoms. Back pain due to a fractured or collapsed vertebra is a sign. Many people are not diagnosed until they actually have a bone fracture. Loss of height is another symptom.

The primary test used to diagnose osteoporosis and low bone mass is a bone mineral density (BMD) test. The Dexa-Scan “uses a low energy X-ray to evaluate bone density in the hip and/or spine”. This is an accurate measurement of your BMD.

Preventative Treatments for Osteoporosis

There are several minerals and vitamins responsible for healthy bones including:

  1. Calcium, magnesium, boron, copper, silicon, nichol, selenium, strontium, phosphorus, potassium, vanadium and zinc
  2. Vitamins C, D, K2, B6, B12

Obviously, a healthy diet is imperative and one that includes the minerals and vitamins listed above, although a few of the minerals are not commonly discussed. If you smoke, quit! Smoking actually results in bone loss for a variety of reasons. Excessive alcohol also causes bone loss. Limit your caffeine as well. Too much protein can also cause the loss of calcium.

A good routine for exercising will strengthen your bones. Mixing aerobic exercise with strengthening exercises is ideal.

Medications that may cause osteoporosis include: corticosteroids (Prednisone), thyroid hormones, some anticonvulsants or anti-seizure (such as, Dilantin) and antacids with aluminum. If you take any of these medications you may be prescribed a medication to help protect your bones.

New Drugs Improve Osteoporosis Treatment

Treatment for Osteoporosis

The most commonly prescribed bisphosphonate medications for osteoporosis treatment include:

  • Alendronate (Fosamax)
  • Risedronate (Actonel)
  • Ibandronate (Boniva)
  • Zoledronic acid (Reclast)

These medications are not well absorbed in the stomach, so taking them with a large glass of water is recommended. They may cause heartburn or an upset stomach.

Two of them are given by an infusion. While they do not cause an upset stomach, they can give you flu-like symptoms, so taking a Tylenol is recommended.

  • Ibandronate (Boniva), infused once every three months
  • Zoledronic acid (Reclast), infused once a year

These biophosphids can safely be taken for ten years, but at that time physicians recommend stopping for 5 years if there have been no fractured bones, as the biophsphids stay in your bones.

Estrogen may be prescribed for prevention or treatment at a low dose due to potential side effects.

Raloxifene (Evista) is a hormonelike treatment prescribed for treatment or prevention. It is a newer medication

Denosumab (Prolia, Xgeva) has been shown to prevent the risk of bone fractures in men and women for osteoporosis treatment. This usually requires an injection every six months.

People with diagnosed very low bone density and/or bone fractures may take Teriparatide (Forteo) or Abaloparatide (Tymlos). These medications require a daily injection, but they have been shown to rebuild bones. These medications for low bone density or osteoporosis slow the breakdown of bones and also rebuilds them. Your physician will prescribe the appropriate medication for your particular condition, sometimes based on cost. For example, Forteo costs $1000 a month if you have good insurance (my personal experience).

In Summary

Osteoporosis is usually preventable. Eating the right diet and getting some exercise is so important. If you are one of those people with a disease that requires Prednisone or another medication that causes bone loss, discuss treatment for bone loss with your doctor.

I have lupus and have severe osteoporosis due to the medications I received. I am taking Forteo and have not had a bone fracture for over a year, so I guess it is helping. I had 11 bone fractures in 2017, plus I have had 2 failed back surgeries. I wish I had understood the physical and mental cost of the medications I received, as there are a few things I would have done differently. However, there was no treatment for lupus until a very few years ago.

Experience of Bone Loss

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Pamela Oglesby


Pamela Oglesby (author) from Sunny Florida on October 26, 2019:

Thank you for explaining what you are doing to be healthier. I don't eat a lot of meat, but I probably should eat a vegetarian diet to reduce my pain.

Lora Hollings on October 26, 2019:

It wasn’t as a direct result, Pamela, of drinking the soy or almond milk that my knee joints feel better. But as an indirect result of cutting down on animal protein by cutting out dairy products which have been shown to aggravate joint swelling and worsen the condition of RA pain. Red meat also has been shown to aggravate joint pain and inflammation which I totally abstain from.

Pamela Oglesby (author) from Sunny Florida on October 26, 2019:

Hi Lora, I'm glad to hear you are doing so many positive things to protect your body from osteoporosis.

I never heard that joint pain would decrease with drinking soy or almond milk. I don't tolerate milk from the cows and I am allergic to almonds, so I have used coconut milk for a long time. I always like to hear what others are doing. Your comments are much appreciated.

Lora Hollings on October 26, 2019:

An excellent article, Pamela, on osteoporosis and who is at risk for developing this serious disease. I drink plant based milk such as soy and almond milk and find that since I've been using it on my cereal and drinking a glass at night before retiring, that I'm having much less pain in my knee joints. Also losing twenty pounds sure helped and going for my daily long walk is also a way to prevent osteoporosis as we age. Doing exercises to strengthen bones as you point out in your article is very important. Eating a healthy diet and reducing meat is also a good way to prevent this disease. Learned much from reading your article. Thanks!

Pamela Oglesby (author) from Sunny Florida on October 26, 2019:

Thanks Linda, I know you are active, which is important also.

Heredity is an imporant factor. I would like to hear how it goes.

Linda Lum from Washington State, USA on October 26, 2019:

I've been taking calcium and D3 but apparently not enough. I'm certain that heredity also plays into the problem--my mom and all 3 sisters had it too. Meds start on Monday. I'll let you know how it goes. Thanks.

Pamela Oglesby (author) from Sunny Florida on October 26, 2019:

Hi Linda, it is a shame that doctors often do not clearly spell out the uptions clearly. I hope you get the type of treatment that will reverse the problem. Taking good quality calcium and vitamins will also help. I always appreciate your comments.

Linda Lum from Washington State, USA on October 26, 2019:

I've just been diagnosed and knew that if I came to your page I would probably find some good information here. Thank you for talking in a language that even I can understand.

Ann Carr from SW England on March 17, 2019:

No Pamela, I'm not keen on the back surgery route. I'll hang on with minimal pain killers and maybe try other help whilst I'm still in the 'mild' stages. Thanks for the advice and a happy Sunday to you too!


Pamela Oglesby (author) from Sunny Florida on March 17, 2019:

Hi Ann, I probably got my information from several sources to learn as much as possible. At least you are being treated for osteoporosis. Hindsight does not help much at this point, so we must move forward.

I appreciate your comments and wish you the best. Do not get back surgery if you can avoid it as with osteoporosis it is a more difficult operation. Happy Sunday Ann!

Ann Carr from SW England on March 17, 2019:

So sorry to hear about the lupus. You mention that you might have done things differently had you known about the effects. I had both ovaries removed on the advice of a doctor; he did not tell me of the possibility of osteoporosis, which I was diagnosed with two years ago. I might have made a different choice!

I am on Risedronate weekly and a calcium/vit.D tablet daily. The calcium helped immediately and I presume the weekly tablet is helping too. Lately, the back ache is worse but I've no idea if that is directly caused by the osteoporosis; I must have a discussion with my GP. So far, it doesn't affect my daily life so I'm lucky.

Thank you for explaining all in a nutshell. It's very helpful to see it all clearly before me. I do belong to the National Osteoporosis Society but you've mentioned things I haven't found within their pages.

All the best, Pamela.


Pamela Oglesby (author) from Sunny Florida on February 07, 2019:

Rajan Singh, Thank you for your commentd and good wishes.

Rajan Singh Jolly from From Mumbai, presently in Jalandhar, INDIA. on February 06, 2019:

Thanks for this information on osteoporosis causes and treatment. Good to know you are doing better with Foteo. Thank you for sharing.

Pamela Oglesby (author) from Sunny Florida on January 29, 2019:

Hi Maria, I think my situation has improved as no broken bones over past year. I hope you can avoid osteoporosis and not follow the path of your mother.

Thank you so much for your comments Maria. Hugs.

Maria Jordan from Jeffersonville PA on January 29, 2019:

Informative and relatable, dear Pam. My mother had osteoporosis and her mother before her.

As always your posts detail those factors we do / do not have control over. I appreciate how you share your personal experience, as well as your nursing knowledge with us.

Hoping 2019 is healthy for you. Have a lovely day. Hugs, Maria

Pamela Oglesby (author) from Sunny Florida on January 16, 2019:

Rachel, I am sorry to hear you have already had a knee and hip replacement. The milk should have helped as it is a good surce of calcium and vitamin D.

I do think the exercise is helpful, along with a calcium supplement, vitamin D3 and vitamin K2. Those are the 3 thing that buld bones. Also, your physician may give you a supplement to help keep your bones from getting any worse.

Blessings to you also Rachael.

Rachel L Alba from Every Day Cooking and Baking on January 16, 2019:

Hi Pamela, I have osteopenia. I had a left knee replacement and a right hip replacement. It runs in my father's side of the family. I drank a lot of milk growing up, my mother insisted on it but it didn't seem to help. Does that even matter when you grow up? Thanks for all of the information. I did join Planet Fitness to exercise my legs. Hope that helps.

Blessings to you.

Pamela Oglesby (author) from Sunny Florida on January 15, 2019:

Hi Dora, I am so glad you found answers to questions about osteoporosis. Thank you so much for your comments.

Dora Weithers from The Caribbean on January 15, 2019:

Pam, you answered questions I didn't even know I should ask. I learned so much from your article on a topic that concerns me. Thanks!

Pamela Oglesby (author) from Sunny Florida on January 15, 2019:

Bronwen, I am sorry to hear you have RA as I know it is a difficult, painful disease. I hope the diet helps. The Prednisalone helps with the pain, but it is also a medication that causes osteoarthritis.Maybe you won't have to take this mediation too long term.

I appreiate your comments and hope this article does help you.

Bronwen Scott-Branagan from Victoria, Australia on January 14, 2019:

Thank you for such an interesting article. I have Rheumatoid Arthritis (RA, but nothing to cheer about!), am recovering from Polymyalgea Rheumatica, and for another problem am on the FODMAP diet, which includes Lactose Free. I've found that the Prednisalone medication can cause unpleasant side effects, but I've just had the second 6 monthly injection and life is beginning to be less painful. Your hub is very encouraging, so, again, Thank You!

Pamela Oglesby (author) from Sunny Florida on January 14, 2019:

Mary, You bring up a good point about medicine. I think medications prescribed benefit us, but it seems there is often a price to be paid due to the side effects.

I am sorry to hear about your mother, and I hope you do not get osteoporosis. I appreciate your comments.

Mary Wickison from USA on January 14, 2019:

I am sorry to hear about the problems surrounding your health.

My mother had osteoporosis and it affected the quality of her life. She didn't have the best diet or lead a healthy lifestyle. It took its toll on her.

It is something I worry about developing. I will use this article as a reference.

Recently I bought some medication for my husband and after reading the potential side effects, decided that the long term risk wasn't worth the short term relief.

Pamela Oglesby (author) from Sunny Florida on January 14, 2019:

Liz, Bone density tests at least keeps track of your bone health. I didn't hear much about this topic years ago either. Thanks so muh for sharing what your friends are experiencing and for your comments.

Pamela Oglesby (author) from Sunny Florida on January 14, 2019:

Hi Alyssa, I am glad you are thinking long term. Honestly, I wish I would have understood this when I was in my 30s. I appreciate your comments.

Liz Westwood from UK on January 14, 2019:

Years ago we heard little about osteoporosis. Now in the UK we are much more aware of it. I have had friends going through cancer treatment who have had regular bone density checks.

Alyssa from Ohio on January 14, 2019:

Wow! This was incredibly informative. Now that I'm in my 30's, I'm taking my health more seriously and thinking long-term. I appreciate your tips for preventative care and the information on how this disease is treated.

Pamela Oglesby (author) from Sunny Florida on January 14, 2019:

Jackie, That is so true. I just try and live a day at a time. I don't worry too much about the future. It's good to hear from you.

Pamela Oglesby (author) from Sunny Florida on January 14, 2019:

Flourish, I'm glad to hear you learned a few new facts. I appreciate your comments.

Jackie Lynnley from the beautiful south on January 13, 2019:

Thank you, Pamela, we just have to never give up.

FlourishAnyway from USA on January 13, 2019:

I’m sorry to hear you have lupus. I appreciate your sharing this excellent information. I learned a number of things. I thought I knew a fair amount about this condition already but I learned a lot here!

Pamela Oglesby (author) from Sunny Florida on January 13, 2019:

Jackie, I am sorry to hear you have had 2 spinal surgeries and hope you got a good result. I do not blame your mother for the Do not Resuscitate order.

I had Prolia injections before the Forteo and I think they were helping, but the Forteo has seemed to improve my condition. This is a medication you only take once in a lifetime for 18-24 months. I started in May, 2018, so I am hoping my bone density test shows good improvement this year.

Thanks for sharing your experience, and I wish you well.

Pamela Oglesby (author) from Sunny Florida on January 13, 2019:

Peg, I am so sorry to hear about your mother. I am glad you had the bone density test so maybe you can avoid being as ill as your mother. I debated whether to write about my personal situation, but since I experienced this problem and have taken many of the medications I deided it was relevant.

I am doing much better. i wish you good health in the future.

Pamela Oglesby (author) from Sunny Florida on January 13, 2019:

Peggy, Osteoporosis is certainl a problem for manyy women as they age. I am doing much better. Thank you so much for your comments. i wish you well also.

Jackie Lynnley from the beautiful south on January 13, 2019:

Great article. I have osteoporosis and though I cannot see that it is a problem for me now I recall all the problems it was to my mother. She had a do not resuscitate order because of the problems it caused her.

I am trying natural things like bone broth very often and calcium added to my diet and I have had no fractures as of yet. I have had two spine surgeries, cervical and lumbar.

We do have to get serious about these things and take steps to help ourselves before it is too late or past a no return.

I will look into the Forteo, thank you.

Peg Cole from North Dallas, Texas on January 13, 2019:

Thanks for sharing this important information about osteoporosis. This disease runs in my family. My mother had severe osteoporosis that resulted in compression fractures in her spine and caused shortness of breath and pain as well as physical deformities. I finally went in for a bone density test and wasn't surprised at the results. Sorry about your illness and hope you have it well controlled now. Take care.

Peggy Woods from Houston, Texas on January 13, 2019:

The statistics are certainly not skewed in favor of women plus people with the medical issues you featured in this article with regard to developing osteoporosis. It is good to know that we do have some control over this issue by following good diets, exercising, avoiding tobacco, and not drinking alcohol in excess. So sorry to hear about your many fractures in 2017. It sounds like you are doing better since that time. Hope it continues.

Pamela Oglesby (author) from Sunny Florida on January 13, 2019:

Billy, That is my goal. Men are better off statistically, but maybe they have a wife with this problem. I sure appreciate your comments.

Bill Holland from Olympia, WA on January 13, 2019:

I read this and I think about how lucky I health issues, no broken bones, no illnesses, no diseases...but I am aware, and I am empathetic....and I'm happy you bring awareness of these things through your articles.

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