The bones that make up the skeletal system are structures that contain high levels of calcium. There is rapid bone formation in infancy and childhood. Towards the end of the 20s, when the adolescent period ends, bone formation reaches almost the same level with bone destruction. From this moment on, as the age progresses, in order to delay the destruction of bones, care should be taken to intake calcium and vitamin D to protect bone mass and health. Since bone destruction accelerates with the advancement of age, when this situation is combined with unbalanced nutrition, it begins to develop the picture of bone resorption, also known as osteoporosis. Although it does not cause major problems in the early period, since it may cause damage to the bones as the age progresses, the disease should be detected early with routine screenings and necessary treatment procedures should be applied.
What is osteoporosis (osteoporosis)?
In healthy and young bones, there is a structure consisting of minerals and mostly calcium salts linked to strong collagen fibers. With aging, it is normal for this structure to lose its strength, weaken and become unstable. However, osteoporosis means that bones turn into a much more fragile structure due to the extreme decrease in bone density. Osteoporosis, known as osteoporosis, literally means spongy (porous) bone. The density of the bones decreases by forming gaps in them. This causes them to become prone to breaking and cracking. It is usually detected as a result of imaging the bones after a fracture or crack has developed. The most common bone fractures due to osteoporosis are the bones in the wrists, spine and hip. The incidence of osteoporosis increases with age, and the likelihood of its incidence in women is higher than in men.
What are the symptoms of osteoporosis (osteoporosis)?
Bone loss does not cause any symptoms in the early period. It is also very difficult to detect the disease as long as there is no fracture or cracking in the bone despite the decrease in bone density, or unless bone density tests are performed. In case of progression of osteoporosis, patients may feel some symptoms. Some of these are as follows:
• Low back pain caused by a broken or collapsed vertebra in the spine
• Neck shortening due to the curvature of the bones over time
• Hunchback and crooked posture
• Breaking and cracking that can occur even with simple movements
The symptoms given above are symptoms that can only manifest themselves when osteoporosis reaches advanced levels and bone damage begins to occur. After the disease reaches this stage, it is not possible to reverse the damage in the bones. For this reason, elderly individuals should apply the necessary lifestyle changes, pay attention to their diet and exercise regularly in order to avoid this disease. Postmenopausal women should have screening tests for bone density at the intervals recommended by their physicians.
What are the causes of osteoporosis (bone loss)?
Bones are constantly in a state of renewal. While osteoblast cells are responsible for the production of new bone cells, osteoclast cells allow the old bone cells to be broken down. As the age progresses, bone formation becomes incapable of bone destruction, and the process of osteoporosis begins, and when this condition comes together with malnutrition, the picture called osteoporosis occurs. Risk factors for the occurrence of osteoporosis are:
• Insufficient intake of calcium, phosphorus and vitamin D
• Female gender and especially being in the post-menopausal period
• Advanced age
• Genetic predisposition
• Low levels of sex hormones
• Thyroid hormonal disorders
• Removal of the ovaries in the premenopausal period
• Adrenal gland diseases
• Use of steroid-containing drugs
• Smoking and alcohol use
• Sedentary lifestyle
How is osteoporosis diagnosed?
Osteoporosis also brings some complications. The most common of these are bone fractures. In the case of osteoporosis, it is not necessary to take a heavy blow or have an accident to cause fractures in the bones. In patients with severe bone resorption, fractures may occur due to a small sprain and sometimes even sudden movements such as coughing. An example of this is the detection of fractures in people who go to a doctor, especially due to hip pain. Bone density measurement should be done to accurately diagnose bone resorption. DEXA is the most commonly used and most reliable method for this. With the DEXA method, bone density can be measured easily and painlessly, while patients are not exposed to high amounts of radiation. Measurement can be done in any of the bones of the hip, wrist or spine, which are the areas most affected by osteoporosis. As mentioned above, osteoporosis does not cause any symptoms in the early period. Therefore, taking into account that bone resorption is a very common disease without waiting for symptoms to appear, women in the post-menopausal period and men over 50 years old should consult a physician and undergo regular DEXA measurements.
How is osteoporosis (osteoporosis) treatment done?
The nature of the treatment to be applied in bone resorption; The progress of your disease, the problems you have experienced in bone health in the last 10 years, the results of your bone density measurements are evaluated together and planned by the physician. It can be applied in the form of a healthy nutrition plan with vitamin and mineral supplements as a treatment for people with low probability of having broken bones. The most commonly used osteoporosis drugs in patients who are found to have a high risk of developing bone fractures are bisphosphonates. Common side effects of bisphosphonate-containing medications include abdominal pain, nausea, and heartburn. In patients with such problems, intravenous (intravenous) derivatives of the drug may be preferred.
The first of the other options used for treatment is monoclonal antibody drugs. These are drugs administered subcutaneously every 6 months, and since discontinuation of the drug may cause some complications, it is beneficial for patients who can use this drug for a long time. Hormone-related therapies are also among the applications that can be preferred for bone resorption treatment. Estrogen supplements, which are started to be used immediately after menopause, can have positive effects on the preservation of bone mass. However, due to the use of estrogen-containing drugs, the risk of breast and endometrial cancers, disorders related to blood clotting and heart diseases increases, so this treatment should be recommended only in patients with low bone density and genetic predisposition for osteoporosis even in the pre-menopausal period, taking into account the profit-loss relationship. The use of “raloxifene” containing drugs that mimic the positive effects of estrogen on bone formation and testosterone replacement therapies for men are also among the hormone-related bone resorption treatments. In addition to these, some drugs that support bone formation can be prescribed during the treatment process.