Osteoporosis

Osteoporosis

Osteoporosis (bone fragility) is a condition with reduced bone mass and altered structure of the bone tissue. This means that calcium levels and strength in the bones are reduced, which increases the risk of bone fractures. Women are affected more often than men, and the incidence increases with age.

What is osteoporosis?

Bone mass increases until we are approximately 25 years old. Bone mass then gradually decreases, which is a natural part of the aging process. Osteoporosis is a condition where the bone mass is reduced to a level below a certain threshold value. This means that the bone is weak, porous and breaks more easily than normal.

1 in 2 women and 1 in 5 men over the age of 50 experience a bone fracture due to osteoporosis. The incidence of osteoporosis is higher in the Scandinavian countries than in most other countries.

Causes of osteoporosis

Age and gender: Age and gender are the strongest risk factors for developing osteoporosis. Women are more susceptible than men due to a sharp reduction in estrogen production in connection with the menopause, at the same time that women have a less strong bone structure than men in the first place.

Medicines: Long-term use of cortisone tablets (steroids), which are used, among other things, in the treatment of rheumatic ailments, increases the risk of osteoporosis.

Diseases: Certain intestinal diseases, such as celiac disease and Crohn's disease, increase the risk of osteoporosis due to reduced absorption of nutrients (calcium and vitamin D).

Lifestyle: Smoking, excessive consumption of alcohol, little physical activity and poor nutrition can contribute to developing osteoporosis.

Low bone mass: Slim people with small bones and people who are taller than average have a generally lower bone mass and are therefore more at risk than others.

Heredity: Osteoporosis is hereditary. If you have close family members with osteoporosis, the risk increases.

Signs of osteoporosis

Low bone mass and loss of bone tissue do not in themselves cause any symptoms. Bone fractures in the wrist, spine or hip (femoral neck fracture) are often the first sign of osteoporosis. Increased curvature of the back occurs when the vertebrae lose a lot of calcium. This can cause pain and reduced body height.

Preventive advice against osteoporosis

• Make sure you get enough calcium and vitamin D. Calcium is the most important building block in our skeleton and vitamin D increases the absorption of calcium from the gut. Already from childhood, it is important to establish a healthy and varied diet that is rich in calcium and vitamin D. Fatty fish, cod liver oil and sunlight are important sources of vitamin D, and good sources of calcium are milk and cheese

• Ensure regular physical activity. Physical activity stimulates bone formation and prevents loss of bone mass

• Avoid smoking and high alcohol consumption

• Avoid too little weight. Thin people, people with weight loss, weight fluctuations and eating disorders have an increased risk of fracture

• There are hip protectors at the pharmacy that reduce the risk of hip fracture in the event of a fall

Measurement of bone density

The purpose of bone density measurement is to find out whether you can benefit from medication or other preventive measures against bone fractures. The following people are recommended to have their bone mineral density measured by a doctor:

• People who have used cortisone tablets for a long time (longer than 3 months)

• People who have had fractures that may be partly due to osteoporosis

• People who have two or more risk factors for osteoporosis (early menopause, low weight, smoking, tendency to fall, etc.)

Treatment of osteoporosis

Calcium and vitamin D

It is important for all people at high risk of developing osteoporosis or who already have osteoporosis to get enough calcium and vitamin D. If this cannot be achieved through diet, it is recommended to take supplements of calcium and vitamin D.

Bisphosphonates

Bisphosphonates are usually the recommended treatment in addition to calcium and vitamin D supplements. Bisphosphonates inhibit the breakdown of bone tissue and increase bone density, which reduces the risk of fractures. There are tablets to be taken once a day, once a week or once a month. There are also injections given by a doctor or nurse, one or more times a year.

Tablets with bisphosphonates are taken in the morning at least half an hour before breakfast and other medicines.

Lifestyle

Regular exercise is important if you have osteoporosis. Strength training of the large muscle groups in particular, balance and coordination training have been shown to have a good effect. Alcohol and smoking must be avoided.

Sources: Norwegian Institute of Public Health, Norwegian Health Informatics