osteoporosis Osteoporosis is a metabolic bone disease primarily characterized by bone loss and reduction, microstructural deterioration of bone tissue, and increased bone fragility, leading to a systemic metabolic bone disease in which patients are prone to fractures.

Osteoporosis is a metabolic bone disease characterized by a reduction in bone mass and density, microstructural deterioration of bone tissue, and an increase in bone fragility, leading to an increased risk of fractures in affected individuals.

Postmenopausal osteoporosis

Estrogen can influence bone metabolism. After menopause, the decreased levels of estrogen are unable to effectively inhibit osteoclasts, leading to increased osteoclast activity, rapid bone resorption, decreased bone mass, and increased bone porosity, resulting in osteoporosis.

Senile osteoporosis

Firstly, the decrease in sex hormones in the elderly stimulates osteoclasts while inhibiting osteoblasts, leading to a decrease in bone mass. Secondly, during the aging process, there may be a decrease in nutrient absorption capacity, organ function decline, resulting in vitamin D deficiency, chronic negative calcium balance, and other factors, which can also lead to a decrease in bone mass and quality.

Idiopathic osteoporosis

The cause of idiopathic osteoporosis is currently unclear, but it may be related to abnormal bone metabolism regulation, such as increased bone resorption, or sudden growth in adolescence, disrupting the balance between bone formation and resorption, or related to abnormal calcium metabolism in children.

Secondary osteoporosis

It is mainly caused by diseases or medications that affect bone metabolism. Common contributing factors include endocrine disorders (such as hyperthyroidism, hyperparathyroidism, type 1 diabetes, Cushing's syndrome), digestive system diseases (post-gastrectomy, liver and bile duct diseases, malabsorption syndrome), hematologic diseases (leukemia, lymphoma, plasma cell disorders), connective tissue diseases (rheumatoid arthritis, gout, systemic lupus erythematosus), and medication effects (glucocorticoids, heparin, methotrexate, cyclosporine), etc.

Easily fatigued, worsens with exertion, decreased load-bearing capacity, and may even lead to the inability to bear weight.

Bone pain

Most commonly observed in the lower back, but can also occur as generalized bone pain. The pain is usually diffuse, without a specific point of pain. The pain typically worsens with changes in posture, prolonged walking, at night, or during weight-bearing activities, and may even lead to limited mobility.

Spinal deformity

Such as kyphosis, severe osteoporosis-induced vertebral compression fractures can cause a decrease in height, hunchback, and even affect cardiopulmonary function. Severe compression fractures in the lumbar vertebrae can also affect abdominal organs, leading to constipation, abdominal distension, etc.

Fractures

Also known as fragility fractures, they occur easily with minor trauma or during daily activities, most commonly affecting the thoracic and lumbar vertebrae, followed by the hip, distal forearm, and other areas such as the ribs, tarsal bones, pelvis, etc. After a fracture, the risk of subsequent fractures significantly increases.

Idiopathic juvenile type

In addition to the more typical symptoms, during the onset of the disease, there may be sudden growth retardation, a propensity for multiple fractures, followed by natural remission of the disease.

Basic bone health supplements

Calcium supplements

Adequate calcium intake can help achieve the ideal peak bone mass, slow down bone loss, and maintain bone health. The recommended daily calcium intake for adults is 800mg, while for those aged 50 and above, it is 1000-1200mg per day. It is recommended to obtain calcium through diet as much as possible. When dietary calcium intake is insufficient, calcium supplements should be provided. Studies show that the daily dietary calcium intake in China is 400mg, and an additional 500-600mg of calcium can be supplemented daily.

Calcium carbonate has a high calcium content, high absorption rate, and is easily absorbed, but it can cause constipation. Calcium citrate has a low calcium content but good water solubility and is less likely to irritate the gastrointestinal tract. Calcium supplementation should be moderate, and those with hypercalcemia should avoid it, as excessive calcium supplementation can also lead to kidney stones and cardiovascular disease.

Vitamin D

It can increase intestinal calcium absorption, promote bone strength, and when used in conjunction with calcium, it can improve balance and reduce the risk of falls and osteoporotic fractures. Studies show that 61% of postmenopausal women have a deficiency in vitamin D, and individuals with inadequate sunlight exposure and the elderly are also at high risk of vitamin D deficiency. For high-risk individuals, it is recommended to test serum 25-hydroxyvitamin D levels to assess the vitamin D nutritional status and guide vitamin D supplementation.

Those with mobility issues should use assistive tools such as canes, exercise caution in daily activities to prevent falls and fractures.

Attention should be paid to changing the layout of household items, installing handrails in bathrooms, and reducing the risk of falls for patients.

For bedridden individuals, frequent repositioning and cleansing should be done to prevent bedsores.

Emphasize the intake of calcium and protein: Consume 300ml of milk daily, or an equivalent amount of low-fat dairy products; consume dark green leafy vegetables, salmon or sardines, and soy products.

Adequate sunlight exposure: Skin should be exposed to sunlight for 15-30 minutes daily, while avoiding direct exposure to intense sunlight to prevent burns.

Weight-bearing and resistance exercises: Consult a physician for a suitable exercise prescription to improve agility, strength, posture balance, etc. Exercise should be gradual, and its appropriateness should be assessed by a physician.

Osteoporosis is a chronic disease, and monitoring during treatment is crucial. It is important to monitor the adequacy of calcium and vitamin D intake.

Bone density should be measured annually after initial treatment or changes in treatment, and every 1-2 years once the effect stabilizes, to assess the treatment's effectiveness.

Medication treatment may have corresponding adverse reactions, and it is important to monitor the symptoms of adverse reactions and have a basic understanding of how to address them.

Self-screening and testing through questionnaires, but these are only used for preliminary screening and not for diagnosis (recommended questionnaires: "International Osteoporosis Foundation One-Minute Osteoporosis Risk Test" and "Asian Osteoporosis Self-Screening Tool").

Due to its mild initial symptoms, long course, and poor patient compliance, it is important to take medication on time, undergo regular check-ups, and not be complacent.

In China, bone density testing has been included in the routine physical examination for individuals aged 40 and above, so it is important to actively pay attention to bone density testing.

In daily life, prevent calcium deficiency and calcium loss through exercise, dietary calcium supplementation, and adequate sunlight exposure.

For perimenopausal women, active prevention and treatment of osteoporosis should be emphasized.