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Everything you need to know about Osteoporosis

 

For most people, the need to remain healthy is largely associated with avoiding medical conditions such as cancer and cardiovascular disease. Keeping our bones strong and virile in order to reduce the risk of osteoporosis is an issue to which we do not pay the necessary attention.

 

Osteoporosis as one of the most serious chronic diseases

Osteoporosis is one of the most serious chronic diseases, that leads to the loss of bone mass and the deterioration of their quality. The bones become gradually porous and brittle, with the result that patients are at increased risk of fractures.

Osteoporosis is characterized as a “silent” disease, because the bones are gradually weakened, skeletal strength is reduced, their architecture is disturbed, there is an increasing decrease in bone mass, without any symptoms until the first appearance – automatic many times- fracture.

 

The mechanisms that cause Osteoporosis

Bones have their own life cycle and metabolism. They have a specific pace at which they grow, live and die. In women, this cycle is determined by sex hormones, that is, by estrogen and progesterone. Therefore, as soon as the levels of these hormones decrease, the woman’s bones also age. This link between hormones and osteoporosis has been known since 1941.

 

The role of estrogen and progesterone in the development of osteoporosis

More specifically, estrogens control the action of osteoclasts. These are bone cells that break down the old bone. On the other hand, progesterone controls the action of osteoblasts. Osteoblasts are also bone cells that “build” new bone.

Therefore, progesterone contributes to the development of new bone, while estrogens break down old, aging bone tissue, until a fresh bone is formed again the following month during a woman’s menstrual cycle. If these two hormones are not at normal levels, then bone health is impaired.

The drop in estrogens and progesterone, which occurs after the permanent cessation of menstruation in women, is the primary causative factor of osteoporosis. Regardless of the age at which the woman will enter the menopausal phase, after the final cessation of menstruation, she will also develop Osteoporosis.

 

The “silent” symptoms of Osteoporosis

Osteoporosis is an “insidious” disease because it usually does not manifest through specific symptoms until the first fracture occurs. In particular, fractures in people over the age of 50 may be the primary sign of bone weakness due to osteoporosis or reduced bone mass.

There are some cases where patients learn that they have low bone density, when their height decreases due to fractures (subsidence) of one or more vertebrae. These fractures can occur without pain, which is why they escape our attention as muscle pain.

The most common osteoporotic fractures occur in the spine, wrist, especially in the extremity (Colles fracture), hips, neck and head of the femur and in some cases, can lead to disability or even death. In fact, acute pain may occur after a minor blow or injury. This pain worsens when the person moves or exercises and subsides as soon as the patient is lying down.

 

Risk factors for osteoporosis

The primary cause of osteoporosis, as it was previously mentioned, is related to disorders, deficiencies and imbalances of the hormonal system. However, there are also multiple risk factors associated with the onset of osteoporosis.

Increased alcohol consumption

First of all, excessive alcohol consumption disturbs the balance of calcium and increases the levels of parathyroid hormone (PTH), which further limits the calcium reserves in our body. Furthermore, it does not contribute to the production of vitamin D, a key factor in good bone health.

Anorexia nervosa

People with anorexia nervosa may have hormonal disorders, which affect bone density. Insufficient amounts of calcium in the body of women with anorexia nervosa and malnutrition lead to bone loss.

Rheumatoid arthritis

Studies suggest that people with rheumatoid arthritis are also at a higher risk of developing osteoporosis, as certain medications, which are used to treat the disease, can promote osteoporosis.

Anti-inflammatory drugs and breast cancer

Anti-inflammatory drugs, which are prescribed to people with asthma, make it more difficult for them to absorb calcium from food, increase the loss of calcium from the kidneys and reduce bone formation. Breast cancer can also stimulate the production of osteoclasts (cells that break down bones).

Inflammatory Bowel Diseases, Systemic Lupus Erythematosus and Incomplete Osteogenesis

Patients with Inflammatory Bowel Disease and Systemic Lupus Erythematosus are at increased risk of developing osteoporosis due to glucocorticoid intake. Incomplete osteogenesis is a genetic disorder that impairs the body’s ability to produce collagen and makes bones more fragile.

Age, smoking, decreased physical activity, delayed menstruation and hypogonadism

Other risk factors for osteoporosis include advanced age, smoking, lack of physical activity, delayed menstruation in women and hypogonadism in men.

 

Diagnosis of Osteoporosis

There are several methods of measuring bone density, but the method which uses the “dual energy x-ray absorsiometry” (DEXA) is the most reliable way. This is a short diagnostic method in which the measurements are performed on the spine and / or the hips using X-rays, while the person being examined absorbs minimal radiation. Then, the value of the examinee is compared with that of a healthy young adult and is expressed numerically in percentage points.

Based on the results of the measurements, Osteoporosis occurs in those who have values below -2.5, while when the values are lower than -3.5, then we talk about severe or advanced osteoporosis. However, this diagnostic method is not sufficient. Further tests need to be performed, because, as it was mentioned, there is a number of diseases related to osteoporosis and laboratory testing is necessary in which hematological, biochemical and hormonal tests need to be included.

 

The mechanisms of bone regeneration

The prevailing view is that there is no definitive cure for osteoporosis. Osteoporosis is a process that can be predicted or reversed with appropriate targeted therapies and above all in a natural way. The key to the mechanisms of bone regeneration lies in the elimination of the causes that cause osteoporosis and in the detailed detection and personalized treatment.

The solution, then, lies in the modern therapeutic approach, which includes obtaining a complete medical history and applying individualized biochemical, hormonal, imaging and metabolic tests.

Based on the diagnostic findings, the appropriate treatment is prepared by the Health Specialist, which is adapted to the individual biochemical needs of each patient. These treatments address the deficiencies that are found at the cellular level and gradually restore the body’s hormonal and cellular balance.

There are multiple therapies that may, depending on the case, include Hormone Rehabilitation therapies with Natural “Biomimetic” hormones, Micro- and Macronutrient therapies and appropriate Molecular Nutrition.

By this therapeutic approach, the mechanisms of bone regeneration are favored and the existing osteopenia and osteoporosis are gradually reversed. In fact, the sooner the restoration of bone health begins, in the shorter period of time, the health of the patients returns to the best possible (optimal) levels, overall.

Prevention of Osteoporosis

About 85-90% of an adult’s bone mass is formed by the age of 20 in boys and by the age of 18 in girls. Therefore, “building” strong bones during childhood and adolescence is the basis of preventing osteoporosis in older ages.

With proper nutrition and exercise, bone health can be maintained. All this contributes to the consolidation of a proper lifestyle that will protect.

Intake of Vitamin D and calcium

It is recommended to increase the intake of vitamin D and calcium through the diet. It is necessary to take 1000 mg of calcium daily for adults up to 50 years old and 1200 mg for older people. Adults under the age of 50 also need to take in 800 to 10000 IU of Vitamin D daily depending on their laboratory and other findings, while older people are advised to take in 1000 IU daily or more.

Smoking cessation and limit coffee and alcohol consumption

Smoking cessation is also recommended, as it increases the rate of bone thinning, especially when it coexists with other risk factors for the disease, such as excessive consumption of coffee and alcohol.

Regulation of hormone levels

Regulating hormone levels in premature menopause or amenorrhea for a long time is the most important method of preventing osteoporosis.

 

Dr. Nikoleta Koini, M.D.

Doctor of Functional, Preventive, Anti-ageing and Restorative Medicine.
Diplomate and Board Certified in Anti-aging, Preventive, Functional and Regenerative Medicine from A4M (American Academy in Antiaging Medicine).
 

References:
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  7. Laskou F, Dennison E (April 2019). “Interaction of Nutrition and Exercise on Bone and Muscle”. European Endocrinology. 15 (1): 11–12. doi:10.17925/ee.2019.15.1.11. PMC 6587895. PMID 31244903.
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