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Osteoporosis causes, risk factors, symptoms, diagnosis and treatment

Osteoporosis is becoming more and more common as the years pass by. Learn more about the disease and how to prevent it.

Written by Editorial Team |Updated : October 23, 2015 2:36 PM IST

Osteoporosis20% of female adults and 11% of the male population above the age of 50 have osteoporosis. It is also ranked as the second most common health-related risk in the world after coronary heart disease. Around 93 percent of women are aware of it, but of them, only 8 to 10 percent know they have it. The bone and joint disease leads to weak bones that put a person at a high risk of having a fracture. In this megaguide, we'll tell you everything you need to know about the disease.

How is osteoporosis caused?

The normal bone is made up of protein, collagen, and calcium. When the bones begin to lose their density, and become more-than-normal porous, they are more easily compressed making them more likely to crack (e.g. hip fracture) or collapse (spinal fracture). The loss of BMD occurs on a scale such that the first-level of BMD loss is known as osteopenia which, if undetected and untreated, proceeds to osteoporosis. Other common areas at high risk for fractures are ribs and wrists.

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Why is it more common for women? And even more common for post-menopausal women?

The bone mass density (BMD) varies such that men have a higher BMD than women and African Americans have a higher BMD than Caucasian or Asians. Plus, BMD naturally decreases after the age of 30-35 years at the rate of 0.3%-0.5% every year. Estrogen is important for BMD maintenance in women and decrease in its levels (post-menopause) leads to accelerated BMD loss (2%-4% per year).

Risk factors

  • Gender and Race (women, Asian descent > risk)
  • Age and Genetics (50+, family history of osteoporosis > risk)
  • Physical inactivity
  • Calcium deficiency
  • Vitamin D deficiency
  • Smoking (5%-10% extra BMD loss)
  • Excess alcohol
  • Low weight
  • Rheumatoid arthritis
  • Medications (e.g. heparin, prednisone)

Symptoms and diagnosis

Unfortunately osteoporosis is a silent disease and a person with osteoporosis could look perfectly healthy until he/she sustains a fracture. But some things that one can look out for is pain the joints, swelling around a joint, inability to perform certain daily functions like sitting, walking or bending and change in one's posture like gradual formation of a stoop all these indicate that there is something wrong in the person's bone and joints and it should be investigated immediately. A glaring indicator is suffering a fracture after a seemingly innocuous fall (a fall that shouldn't have led to a fracture normally). This type of fracture is also known as a fragility fracture.

A DEXA scan is the gold standard to diagnose osteoporosis and if it shows the presence of osteoporosis one should immediately visit a doctor.



The patient is treated for the fracture and given appropriate medical care for the underlying reason. People who suffer from a fracture due to osteoporosis usually have a long road to recovery. Even after the fracture has healed it takes a long while to rehabilitate that area and make the bones strong enough to support their weight and the stress of everyday activities.

Available medications aim to stop bone loss and increase bone strength or bone formation. The use of hormone (estrogen) replacement therapy (HRT) after menopause was popular until recent times when its benefits have been questioned. There are 2 surgical options that can reduce pain caused by spinal compression vertebroplasty and kyphoplasty. These surgeries use "bone cement" that is injected into the damaged spinal bones (vertebrae) to make them denser and stronger.


Here are a few guidelines on how to naturally prevent osteoporosis.

1. Get enough exercise

Several research studies have found that regular weight-bearing exercise has a preventive action on osteoporosis. Walking, jogging, climbing up steps and lifting weights are all forms of exercise that help to improve your bone strength; besides, they also improve your flexibility and strengthen the groups of muscles that help the body move. Take up such exercise for at least half an hour per day for a minimum of three days a week and you are sure to reduce your chances of suffering from osteoporosis.

2. Stock up on natural sources of calcium: It is a well-known fact that minerals such as calcium and magnesium and vitamin D are very important for strong bones. So ensure you get enough of these into your body through the diet. Milk, curd, cheese, green leafy vegetables, salmon and sardines are rich sources of calcium. Greens and nuts are a rich source of magnesium.

3. Soak up the sun for Vitamin D: While the bones are made of calcium, you need to get sufficient vitamin D in order to ensure your body is able to assimilate the calcium. Include oily fish that are rich in vitamin D in your diet. Get enough exposure to early morning sunlight; this allows your skin to produce vitamin D in the body.

4. Keep up your Vitamin K: This vitamin helps to activate a protein called osteocalcin which helps to bind calcium molecules more firmly in the bones. Brussels sprouts are a very good source of vitamin K and can therefore help to prevent osteoporosis.

5. Beat obesity

Being obese or overweight can be a death knell for your bones and joints. Not only does it exert an inordinate amount of weight and pressure on your bones, it also leads to faster leeching of calcium. Research has shown that fat (or adipose tissue) in the body negatively influences the skeletal system through hormonal signals that disrupt remodeling of bone cells.

6. Go for plant estrogens: Bone density in women is closely related to the levels of the hormone oestrogen; as women near menopause, the fluctuating hormone levels can cause a lot of damage to bones. Include soybean, lentils, beans and chickpeas that are a rich source of phyto-oestrogens or plant oestrogens in your diet and you can compensate for the lack of oestrogen in your system.

8. Watch out for those calcium smugglers: Certain substances such as caffeine or high concentrations of protein can cause the body to excrete a greater amount of calcium from the body, adversely affecting your bones. Watch your consumption of these to prevent your risks of osteoporosis.

9. Quit smoking and alcohol: Alcohol has been found to have a significant adverse impact on the body's ability to absorb calcium from the diet. Smoking ups the risk of losing vital minerals resulting in lower bone densities. Besides, fractures don't heal as well or as fast in people in smoke indicating a clear negative connection between nicotine and healthy bones.

10. Beat stress for your bones' sake: People under constant stress have higher levels of cortisol a hormone that tends to cause minerals to leach out of bones. (Read: 10 reasons why women should quit smoking)

11. Try oil massages: According to Ayurveda, osteoporosis is a result of an increase in thevata element over a period of time and therefore, it is good to avoid its accumulation. The external application of oils to the entire body (oil massage) followed by a hot water bath (abhyanga snana) is said to have a beneficial effect on the health of the bones.

12. Include sesame in your diet: Ayurveda also considers sesame seeds to be useful against osteoporosis and these can be roasted, powdered and added to milk and consumed. (Read: 10 ways til or sesame seeds add more to your life than just flavour!)

Whether you develop osteoporosis or not or when you begin to suffer from brittle bones depends on your bone density that in turn is greatly dependent on genetic factors. But if you take the precautionary steps outlined here from a young age itself, it is quite possible to slow down this thinning process and keep your bones healthy and strong well into old age.

13. Regular health check-ups could be your savior

Most of us tend to ignore it, but regular health check-ups are a must, especially as women reach the premenopausal stage. Osteoporosis generally appears without any symptoms, so the only time you know something is wrong is when the condition has progressed to a point beyond repair. Regular health check-ups help to identify the onset of this condition early, helping you to take remedial measures before the condition worsens.

In order to help you determine the foods you should eat, here is a table that'll tell you more about the nutrients required for good bone health.

The nutrition guidelines for good bone health are:


Daily Requirement



1,200-1,500 mg

Milk products, tofu, green leafy vegetables, fish

Vitamin D

800-1,000 international units

Fortified cereals and milk products, fish, sunlight


1250 mg (9-18 years old),

700 mg (for adults > 19 years)

Milk products, whole grains, peas, beans, lentils, nuts, meat


300-750 mg

Green leafy vegetables, whole grains, seeds, nuts, fermented soy products, meat, fish

Warning - do not use calcium supplements to prevent osteoporosis! It can lead to a heart attack.

Often people, in particular women, take calcium and vitamin D supplements to reduce the risk of osteoporosis and fractures but this course of preventive action is now discouraged. For one, the prevention of osteoporosis and fractures with calcium supplementation is not well-established. On the other hand, excess calcium raises the risk for kidney stones and heart attack. A German study found that people, aged 35-64, taking regular calcium supplements were at 86% higher risk for heart attack. While, people whose entire daily calcium requirements was dependent on supplements had a 139% higher risk for heart attack.


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