Osteoporosis and low bone mass are a major public health threat for almost 54 million people in the U.S. Unfortunately, only a fraction of affected patients are receiving treatment for this potentially life-threatening condition. This is what you should know about osteoporosis.

What is osteoporosis?

Osteoporosis is disease process that affects the bone structures in your body. Over time, your bone matter decreases and becomes more porous as you age.

In general, people reach what is known as peak bone mass in our early 20s. As we get older, we begin to lose bone in a process called resorption. At the same time, bone cells continually make new bone throughout our lives. When resorption occurs faster than bone formation, though, bone loss occurs. Bone becomes more porous and fragile.

When the bones weaken, the risk of fracture increases.

While any fracture can be a serious occurrence, hip fractures are among the greatest public health concerns because the consequences are often devastating. Older adults who experience hip fractures have an increased risk of death during the first 12 months after the fracture. Among those who survive, many experience loss of mobility and may have to enter long-term care facilities.

What causes osteoporosis?

There are two classifications of osteoporosis causes: primary and secondary.

  1. Primary osteoporosis: Seen most often in postmenopausal females and elderly patients, this is the most common form of osteoporosis
  2. Secondary osteoporosis: Secondary osteoporosis occurs as a result of an underlying disease or health condition

Secondary osteoporosis has a variety of causes, including:

  • Kidney failure
  • Cushing’s disease
  • Anorexia or bulimia
  • Rheumatoid arthritis
  • Multiple sclerosis

Regardless of the cause, a proper diagnosis and treatment are crucial to protect bones from more loss.

6 osteoporosis treatment approaches

There are a variety of treatment options to slow the progress of osteoporosis. They include the following.

1. Weight-bearing exercise

One of the first treatments is regular weight-bearing exercise. Bones benefit more from weight-bearing exercise than any other type, with improved quality of life and better treatment outcomes.

Walking is a good place to start, but body-weight exercises are also a great way to build bone density and improve muscular support for your bones.

2. Eating for healthy muscles and bones

While younger people may have too much protein in their diet, older adults may find themselves struggling to get enough.

It is natural for the appetite to decrease as you age, and it’s important to focus your diet on healthy foods that promote bone density and retain muscle. Think lean, calcium-rich proteins (e.g, wild salmon and chicken or beans and lentils for vegetarians), leafy greens, and grains that have tons of calcium (i.e., amaranth).

Because it can be challenging to get enough calcium from food, find a great calcium supplement and take as directed.

3. Use bisphosphonates

Bisphosphonates are the most commonly-used medication for treating osteoporosis. They work by:

  • Inhibiting bone breakdown
  • Preserving bone mass
  • Increasing bone density

4. Consider estrogen therapy

In the past, estrogen was typically started in women following menopause as a way to help maintain bone density. However, for some women the risks of estrogen therapy outweigh the benefits. Risk factors include blood clots, endometrial/ breast cancer, and cardiovascular disease.

Because of concerns about its safety and because other treatments are available, estrogen hormone therapy is generally not a first-choice treatment.

5. Talk to your doctor about raloxifene

This selective estrogen receptor modulator mimics estrogen’s beneficial effects on bone density in postmenopausal women without some of the risks associated with estrogen.

6. Consider hormone replacement options

Calcitonin and teriparatide are hormones produced by your thyroid and parathyroid glands, respectively. Calcitonin may reduce bone resorption and slow bone loss. Unfortunately, this type of medication has not been shown to be as effective as other osteoporosis treatments.

Teriparatide is an analog of parathyroid hormone, reserved for patients who are at high risk for fractures. It works by stimulating new bone growth, while other medications prevent further bone loss.