Osteoporosis is a condition that affects bone mineral density and strength, resulting in weak bones and fractures. About 40 million Americans (80% women and 20% men) are either affected or at risk of developing osteoporosis.
Postmenopausal osteoporosis is the most common cause of osteoporosis resulting in 1.5 million fractures yearly, which is the reason for the recommendation by many organizations such as the American Medical Association, and National Osteoporosis Foundation to screen for osteoporosis.
The peak bone strength is typically achieved by the mid-30s; unfortunately, many young women do not have adequate calcium intake to maximize bone strength, which then declines further over their lifetime.
When women reach menopause, their estrogen levels decline and since estrogen protects bones by keeping the bone breaking cells called osteoclasts and bone building cells called osteoblasts in check, bone density decreases.
This is the reason that postmenopausal osteoporosis is the most common cause of the disease. Men can also be affected by this condition and there are multiple risk factors such as chronic steroid use and declining testosterone levels which can results in low bone mineral density. Other risk factors include family history, vitamin D deficiency, hyperparathyroidism, hyperthyroidism to name a few.
When evaluating for osteoporosis it is important to assess for secondary reasons which may need to be corrected before treatment is initiated. A bone density (different from a bone scan) helps with the diagnosis.
Treatment would typically include calcium and vitamin D supplements and either bone forming or anti-resorptive agents depending on the severity of the disease. Other considerations include risk factors concomitant medical conditions, and side effects of the different medications.
At NorCal Endocrinology & Internal Medicine we conduct a full evaluation for Osteoporosis and optimize therapy to each patient.