Professor Nicola Portinaro explains symptoms, causes, diagnosis, treatment and prevention of Osteoporosis.


Osteoporosis Overview

Osteoporosis is a disease that weakens bones. This health condition cause bones to become fragile and more likely to break.
In such a condition, a fall or mild stress can cause a fracture with the most common bones to break are hip, wrist, and spine.

We must keep in mind that bone is a living and growing tissue, mostly made of collagen and mineral as calcium and phosphate. This tissue is always renewing, so it regularly breaks down and reconstitute itself. When the formation of new bone tissue doesn’t keep pace with the loss of old bones Osteoporosis develops.

This condition affects millions of people of all genders and races, but it can be prevented and treated.


Causes and Risk Factor of Osteoporosis

Different risk factors can increase the chances of developing Osteoporosis.

The ones that you can not change are

  • Age (as people age the process of making new bone slows and you lose bone mass faster than it’s regenerated)
  • Sex (women are more likely to develop osteoporosis than men, in particular, if the menopause begins before the age of 45)
  • Race ( White and Asian women are at higher risk)
  • Family history/ medical history
  • Body size. Women with a small body and thin bones are at higher risk.

The risk of Osteoporosis is higher also in people who have/had certain medical conditions such as:

  • Inflammatory conditions
  • Hormone-related conditions and thyroid problems
  • Celiac disease or in general chronical bowel inflammation
  • Kidney or liver disease
  • Cancer
  • Lupus
  • Gastrointestinal surgery
  • Rheumatoid arthritis 

But there is also a risk factor that you can change, such as bad lifestyle habits that can increase the risk of Osteoporosis, such as:

  • Eating disorder such as anorexia or bulimia
  • Sedentary lifestyle
  • Excessive alcohol consumption
  • Smoking
  • Diet low in calcium and vitamin D


Preventing Osteoporosis

Since some risk factors for Osteoporosis are under our control, some measures can help us prevent this disease and reduce the risk of falling.

  • Exercising regularly helps to keep bones as strong as possible
  • Following a healthy diet, rich in protein, calcium, and vitamin D
  • Avoid smoking and excessive alcohol consumption
  • Getting your body weight under control (if you are underweight or overweight, you have more chance of bone loss and fractures).

Instead of taking calcium supplement, we can suggest you good natural sources of calcium, such as:

  • Low-fat dairy products
  • Fish such as salmon or sardines
  • Soy
  • Vegetables with dark green leaves (such as Spinach, Collard Greens, Turnip Greens, Broccoli Raab)


Symptoms and Diagnosis

Osteoporosis is considered a silent disease because it’s a nonsymptomatic condition.

Often people with osteoporosis realize they have this condition because sudden stress or strain leads to bone fracture.

If you or your doctor suspects you have Osteoporosis, you can measure your bone density to detect if you have osteoporotic bone. With a test called bone mineral densitometry (BMD) with a machine that uses low levels of X-rays to determine the proportion of minerals in your bones.
With this test, you can confirm a diagnosis of Osteoporosis and figure out the risk for fractures.
You can also repeat it every year or more to monitor the effects of treatment.
It is very important to also evaluate bone metabolism with specific markes for bone loss and start an adequate specific therapy.


Osteoporosis Treatment

Treatment depends on the diagnosis and BMD test result, and it is based on the risk of breaking a bone.

If the risk isn’t too high, your doctor may just suggest you change your lifestyle (if needed) to decrease risk factors.

Treatment aims to prevent falls and fractures.
You can achieve that on several levels:

  • Nutrition
  • Exercise
  • Medication to increase bone density and stop bone loss

As we have already said, nutrition is important to take the vitamins and proteins necessary for bone health.

Exercise is the most important factor both for treatment and prevention. It increases balance, coordination, muscle and bone strength

There are different medications that a doctor may suggest.

The choice of medication depends on age, on the level of Osteoporosis detected by the tests and on the side effects of the drugs you should take. Your doctor should consider whether there are other risk factors for your health-related to the use of estrogen, such as blood clots, endometrial cancer, breast cancer, and possibly heart disease.

The most common medications are:

  • Bisphosphonate (this is the most widely prescribed osteoporosis medications)
  • Calcitonin
  • Estrogen (hormone therapy) can help maintain bone density in postmenopausal women
  • Bone-building medications

Anyway, lifestyle and prevention are perhaps the most critical aspects of treatment.

As we said before you should avoid bad habits such as

  • Smoking
  • Drinking too much alcohol (this also increase your risk of falling)

To prevent falls, you should also wear low-heeled shoes, use a cane or walker, keep your rooms tiny, install grab bars on bathroom walls, and use a rubber bath mat.


Prof Nicola Portinaro experience

Although Prof Portinaro is mainly a Pediatric Orthopedic Surgeon, he has gained a great deal of experience over the years in treating ageing diseases such as Osteoporosis.

You can refer to professor Portinaro to screen for Osteoporosis and ask for a bone density testing.
If you are 65 years old or older, you can plan a visit and tell the doctor about your symptoms, habits, lifestyle. You should also inform the doctor about significant stress or fracture you had in the past, medications you are taking, your family, and medical history.

Expect the doctor to ask you about broken bones, diet, exercise, any surgery you had in the past, medications you are taking.


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