Bones break. It happens. If you have osteoporosis, your bones are less bendable, more fragile. Something as simple as a trip and fall or even a bad cough could cause a fracture in someone with osteoporosis. Let’s talk a bit about how healthy bones work and why unhealthy bones break.
How bones work
When you think of your skeleton you probably picture something like this:
And you might think of bones as rock-hard things like fossils that last millions of years without breaking like this dinosaur:
But bones are really more like wood than stone. They’re designed to be strong of course because they hold you up. Your muscles pull on them all the time so they have to be tough. But they also have to be flexible. If they don’t bend under pressure and they become too stiff or fragile, then they b
ecome more likely to break.
That’s what osteoporosis is. It’s when bones become weaker, more brittle. But despite what you’ve heard it doesn’t only happen to old people.
Like trees, bones are alive with a circulatory system. But what makes bone so interesting is that it is constantly being broken down and built back up again.
Think of a highway. Over time cracks and potholes make a highway more dangerous to get around on. So, workers come and strip away the fragile parts of the highway and repave it with healthier stuff. Bones do the same thing. Special cells called Osteoclasts are like the chompers. They come and eat away the bad bone. Then builders called Osteoblasts come and rebuild the bone in those places.
When someone develops osteoporosis it means that their chompers have either worked too hard or that their builders haven’t worked hard enough. What you end up with are bones that are more hollow in the middle than full. Bones like that are more likely to break.
So why does that happen? Why don’t bones keep fixing themselves forever? Simply
put, the chompers and builders rely on a stable healthy body to do their job.
- Reduction in sex hormones (loss of estrogen and/or testosterone)
- Hyperthyroidoism (too much thyroid hormone)
- Hyperparathyroidism (too much parathyroid hormone)
- Low calcium intake (not getting enough in your diet)
- Eating disorders (if you are underweight and not consuming enough nutrients, like calcium, you might not build strong bones to begin with)
- Gastrointestinal surgery (removing parts of the digestive system that absorbs calcium)
- Long-term steroid use (steroids like, prednisone and others, interfere with how calcium and vitamin D get used)
- Diseases of poor nutritional absorption (things like celiac disease, gastroparesis, inflammatory bowel disease – they prevent the body from absorbing calcium in the first place)
- High alcohol consumption (more than 2 drinks a day) or tobacco use
- Genetic factors (for instance, if you have a parent with osteoporosis you might be more prone to it yourself)
As you can see, these are conditions that happen to men and women, young and old.
So if anyone can get osteoporosis, what do you do to prevent it?
- Get enough calcium – the National Institute of Health’s Office of Dietary Supplements says if you are over 18 you should get between 1000 and 1200mg of calcium each day.
- Get enough vitamin D – most people don’t get enough sun exposure to make enough vitamin D, but it is added to some foods and is cheap and easy to get as a supplement.
- Eat protein – some diets that do not get enough protein cause bones to weaken. Vegetarians in particular are prone to this if they do not seek out protein rich foods.
- Maintain a healthy body weight – if you are too thin you may lose bone too quickly. If you are too heavy, you may be more prone to fractures in your arms.
- Fight gravity – when you lift, pull or carry heavy objects you are fighting against gravity. The more you fight gravity the stronger your bones get. Did you know astronauts who live in zero gravity lose a lot of bone mass?
What if you already have osteoporosis? What can you do to treat it?
The things that help you prevent osteoporosis can be an important part of treating osteoporosis. However, because of the increased risk of breaking bones you must create a plan with your doctor before making changes. Your doctor can also prescribe you drugs that can help treat your osteoporosis, such as:
- Bisphosphonates – Drugs like Fosomax, Boniva and Actonel act to slow down the breakdown of bone by osteoclasts
- Anti-RANKL – Drugs like Prolia work by slowing down the body’s production of osteoclasts
- Protein based – Drugs like Tymlos and Forteo work by building bone faster to catch up with bone break down
The treatment that is right for you is something you can determine with your doctor.
Bones are a bit mysterious because we can’t see them, and when we do, it’s usually not for any good reason. But knowing that your bones are alive and require certain nutrients and exercise to keep them healthy can help you make the most of them.
Jim Sliney Jr. is a Registered Medical Assistant and a Columbia University trained Writer/Editor who creates education and advocacy materials for patient support groups. He has worked closely with several rare disease communities. Jim also coordinates the patient content for PatientsRising and collaborates with other writers to hone their craft. He’s a native New Yorker where he lives with his wife and all their cats. Connections: Twitter Quora Email