Dr. Ravi Bhatt Clinic

Osteoporosis- Causes and symptoms

Osteoporosis is the commonest among bone diseases. Osteoporosis is characterized by a reduction in bone mineral density (BMD) and deterioration of microarchitecture of bone tissue, this reduction in bone mineral density (BMD) and deterioration of bone architecture makes osteoporosis the main cause of the nontraumatic fracture.

As age increases, the prevalence of osteoporosis and fractures related to osteoporosis also increases because there is an age-related decline in bone mass occurs. Osteoporosis is prevalent among postmenopausal women. The main clinical manifestation of osteoporosis is fractures of hip and vertebrae, but no skeletal site is spared.

In women, the loss of ovarian function at menopause (around 50 years of age) precipitates rapid bone loss and thus causes osteoporosis.

Manner of development of Osteoporosis:

  1. Postmenopausal osteoporosis:

It is due to because of low peak bone mass and accelerated bone loss post menopause and with aging.

In normal person bone mass increases during skeletal growth to reach its zenith between 20 to 40 years of age, but then it tends to fall after this age reached. After menopause, there are sharp increases in bone loss in women after menopause because of estrogen hormone deficiency which leads to uncoupling of bone resorption and bone formation, such that the amount of bone removed during the bone remodeling cycle slightly exceeds that which is replaced.

Exercise and intake of calcium during the early age of life play an important role in maximizing peak bone mass and helps in regulating rates of postmenopausal bone loss and thus help to combat osteoporosis.

Smoking had a negative effect on BMD and it will lead to an increase in fracture risk, alcoholism is an important cause of secondary osteoporosis.

2. Osteoporosis in males:

Osteoporosis is less common in men than women, in half of the cases, the patients of hypogonadism or those who are on corticosteroid use or consuming alcohol are on more risk.

3. Secondary osteoporosis:

When it results from any medicine and due to some disease, it comes under the term secondary osteoporosis.

Causes of osteoporosis:

  1. Inflammatory diseases: Ankylosing spondylitis, Rheumatoid arthritis, Inflammatory bowel disease.
  2. Endocrine disease: Cushing’s syndrome, Hyperparathyroidism, Hyperthyroidism, Hypogonadism.
  3. Gastrointestinal disease: Chronic liver disease, Malabsorption.
  4. Drugs: Heparin, corticosteroids, thyroxine over replacement, anticonvulsants, sedatives, Gonadotrophin-releasing hormone (GnRH) agonists.
  5. Other: Poor diet, immobilization (Prolonged bed rest or paralysis), myeloma, anorexia nervosa, athletes, Systemic mastocytosis, homocystinuria.
  6. Unusual causes: Juvenile osteoporosis, which is a rare condition associated with reduced bone mineral density and fracture of the bone in children,pregnancy-associated osteoporosis is also a rare condition.
  7. Severe vitamin D deficiency.
  8. Estrogen deficiency in the female.

Symptoms of osteoporosis:

The patient may be asymptomatic in starting, but in the later stage following symptoms occur.

  1. Pain in back.
  2. Height loss.
  3. Fragility fractures.
  4. Forward rounding of back (kyphosis).

Investigations for osteoporosis:

  1. X-ray examination which was done for trauma and other conditions may reveal radiological osteopenia in asymptomatic patients.
  2. Bone mineral density test (BMD), the preferred technology is dual-energy Xray absorptiometry (DXA) and in this lumbar spine and hip are the preferred measurement site. Osteoporosis is diagnosed when the T score level falls to -2.5 or below, whereas the T score lies between -1.0 and 2.5 are in the osteopenic range and above -1.0 is normal.
  3. Serum calcium and phosphate, immunoglobulin, thyroid function tests, Erythrocyte sedimentation rate.
  4. Investigations of serum 25(OH)D and PTH measurement may be required to exclude vitamin D deficiency or primary hyperparathyroidism.
  5. Males with osteoporosis and females who become amenorrhoeic prior to 50 years must be investigated for sex hormones and gonadotropins.

If the diagnosis of osteoporosis is confirmed by BMD, history must be taken to identify causes like alcohol intake, smoking, corticosteroid based treatment early menopause.

Food for healthy bones or Natural Treatment or Home Remedies :

  1. Olive oil.
  2. Red clover.
  3. Isoflavones rich foods like soybeans, chickpeas, natto, peanuts, fava beans, pistachios, cooked tempeh, textured soy flour, meatless bacon bits helps to slow down osteoporosis.
  4. Black cohosh.
  5. Green leafy vegetables except for spinach as it contains oxalates also so it reduces calcium absorption also.
  6. Horsetail a plant can be taken as a tea and herbal compresses.
  7. Soybeans, tofu,
  8. Blueberries.
  9. Foods rich in omega-3s, for example, fish oil and flaxseed oil.
  10. Fish like sardines and pilchards.
  11. Beans or legumes (only after soaking them for long hours in water and then cooking it as it contains phytates and phytates hinder the absorption of calcium in the body).
  12. Dairy products.
  13. Foods rich in vitamin D: Eggs, fatty fishes like salmon, sardines, mackerel.

Alcohol, caffeine, soft drinks decrease calcium absorption and lead to bone loss.

Vegetarian diet rich in calcium:

  1. Soy food like soybean and made from soybeans like tofu, natto.
  2. Nuts like almond, brazil nuts, walnuts.
  3. Chia and flax seeds.
  4. Butter made from sesame seeds like tahini.
  5. Teff and amaranth.
  6. Kidney beans, goa beans, navy beans, chickpeas, black beans, white beans.
  7. Seaweeds like wakame, kelp.
  8. Bok choy, turnip, mustard green, collard green (avoiding spinach), okra, kale, cabbage.
  9. Figs, orange, blackberries, raspberries.
  10. Edamame, sweet potato, sesame seeds.
  11. Fermented foods like kefir, kimchi, yogurt

Vegitarian diet rich in Vitamin D:

  1. Mushrooms like maitake mushrooms, portobello mushrooms.
  2. Almondmilk, rice milk, and soy milk fortified with vitamin D.
  3. Sweet cheese.
  4. Fortified cereals, fruit juices.

Non vegitarian diet for Vitamin D:

  1. Eggs (yolk).
  2. Pork chops.
  3. Fishes like sardines, salmon, herring.
  4. Canned tuna.
  5. Cod liver oils.
  6. Beef liver.