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Osteoporosis

Osteoporosis is a chronic medical condition characterized by low bone mass and abnormal microarchitecture. This will increase the risk for low trauma and nontraumatic fractures.
According to the National Osteoporosis Foundation (Bone Health and Osteoporosis Foundation) “one in two women and up to one in four men will break a bone in their lifetime due to osteoporosis. For women, the incidence is greater than that of heart attack, stroke and breast cancer combined.”
https://www.bonehealthandosteoporosis.org/wp-content/uploads/2015/12/Osteoporosis-Fast-Facts.pdf

Osteoporosis is diagnosed based on a clinical low trauma/nontraumatic fracture or based on an abnormal bone density test (in patients that didn’t sustain a fracture).
The quantity (bone mass) and quality (structure, biochemical and physical properties that confers strength) of the bone is accrued during the childhood and adolescence according to genetic instructions but is influenced by diet, exercise, medical conditions and medications used during growth period.

We achieve the peak bone mass (maximum quantity of bone) around age 25 and if health status is maintained (healthy diet and regular exercise, absence of chronic disorders and medications that can negatively affect the bone metabolism) we will maintain the accrued bone mass and microarchitecture until approximate age 50 (for females until few years before menopause – the time when menstrual periods stop). Females go through a period of rapid bone loss during the early menopause while men lose bone very slow. By age 65-70 and after both men and women lose bone at a similar rate but the quality of this bone deteriorates with every decade after age 50 (for more information on bone metabolism please see video [https://www.youtube.com/watch?v=78RBpWSOl08]

We can prevent and treat osteoporosis. Maintaining a diet rich in plants (plant based diet), with addition of fish or poultry and avoiding processed foods is important throughout our life. Dairy products as well as non-dairy milks/yogurts/cheeses should be part of our daily meals. Weight bearing and resistance exercises, core strengthening and balance exercises are absolutely necessary to maintain bone strength throughout our life.

There are many drug therapies available for prevention and treatment of osteoporosis for both females and males but it is very important to first exclude other disorders that can interfere with the bone metabolism before starting any treatment. The treatment sequence is also very important and that’s why you need to be guided by physicians experienced in osteoporosis treatment like Dr Stanciu.

Osteopenia

Osteopenia is both a clinical and a radiological term. It means that the bone mass or density has declined and it is no longer in the “normal” range. This “normal” range is the bone density of a healthy young female ~ age 25-30 and it is derived from normative databases. If you have a bone density test that shows osteopenia, it should alert you to look into it in order to prevent osteoporosis.

Osteomalacia

Osteomalacia is a condition found in adults in which bones become soft and deformed because they don’t have enough calcium, vitamin D and/or phosphorus. It is a mineralization problem that often occurs because of vitamin D, calcium and/or phosphorus deficiency. This condition may be genetic or acquired (due to dietary deficiency, intestinal disorders that impair absorption of minerals and vitamins as well as intestinal surgeries or other chronic medical conditions).

Abnormal Bone Density test (DXA)

A bone density test (also called DXA scan) is a measurement of how much mineral is in your bone or how dense is your bone. This test uses a special X-ray technique (with much less radiation than a usual X Ray and even less than you would get on a cross-country airplane flight) to measure bone mineral density. It is used to screen for osteoporosis (that means to find out if a person has osteoporosis before breaking a bone). It is also used to monitor the osteoporosis treatment. It is very important to have a quality test in order to obtain a correct result. It requires highly trained technicians and qualified physicians that can interpret it correctly. The international Society of Clinical Densitometry (ISCD) certifies both technologists and physicians so required standards are met.
Bone density test (DXA) measures your bone mineral density at certain sites and compares it with standard young bone mineral density as well as with the bone mineral density of individuals your age. There are many causes of abnormal bone density. Do you know if your bone density is normal? Make an appointment to find out why.

There are other ways to measure bone mineral density but they are less used.

Parathyroid Disorders

Parathyroid disorders (overactive = hyperparathyroidism and underactive = hypoparathyroidism) are disorders that affect many organs including bones and are characterized by abnormal levels of calcium in the blood.

Maintaining normal blood calcium level is of paramount importance as an abnormal (too low or too high) calcium can immediately impair the heart function and be life threatening.
The parathyroid cells have calcium-sensing receptors that measure continuously the blood calcium levels and send signals to the parathyroid cell to adjust the amount of parathyroid hormone produced.
The only calcium deposit in the body is the bone so, if you do not have enough calcium in your diet, the parathyroid hormone will take calcium out of the bones and put it into the blood in order to maintain normal heart function.

Overactive parathyroid glands can cause brittle bones, kidney stones, fatigue, weakness, fractures, and other problems.

Underactive parathyroid glands are unable to maintain the normal blood calcium and will cause irregular heart rhythms, muscle spasms and contactures as well as breathing abnormalities.

Osteogenesis Imperfecta

Osteogenesis Imperfecta is a genetic disorder that mostly presents in childhood but often is asymptomatic until adult age. The genetic defect is responsible for abnormal collagen production and results in multiple fractures that occur without apparent cause. If you have many fractures without trauma you may have a genetic mutation that makes your bone brittle. Find out if you are at risk.

Hypophosphatasia

Hypophosphatasia (HPP) is a rare (but not so rare) genetic disorder characterized by impaired mineralization (“calcification”) of bones and teeth. Many adults don’t know they have this condition, which will predispose to many fractures without trauma, but also many other symptoms like diffuse body pain, headaches, muscle weakness, fatigue, kidney stones, joint pain, teeth problems/losing teeth, frequent fractures (especially metatarsal fractures)

Even though the most severe cases are found in infants and children, the mild cases can be difficult to diagnose until adulthood and very frequently can be misdiagnosed as other disorders like fibromyalgia.

Life-saving treatment is available!

Fibrous Dysplasia (FD)

Fibrous dysplasia (FD) is a rare bone disorder that can affect one or more bones and sometimes can be associated with other hormonal disorders (like thyroid abnormalities). The normal bone is replaced with abnormal fibrous tissue that weakens the bone and makes it fragile and prone to fracture. Pain and deformities can also be present. Fibrous Dysplasia is usually diagnosed in children or young adults, but mild cases may go undiagnosed until adulthood.

X-linked hypophosphatemia (XLH)

X-linked hypophosphatemia (XLH) is an inherited genetic disorder characterized by low levels of phosphorus in the blood due to an abnormal process in the kidneys that involves a hormone called FGF-23.. This will cause loss of phosphorus in the urine leading to soft, weak bones (rickets). XLH is usually diagnosed in childhood but many adults are never diagnosed until they break a bone or they are found to have increasing fatigue and generalized weakness. This condition is now treatable so you can enjoy an active life.

Paget’s Disease

Paget’s disease is another rare but chronic metabolic bone disorder characterized by excessive breakdown and regrowth of the bone. This abnormal process makes the bones soft, easily breakable and painful. It can affect one or several bones but its cause is not yet known. It is more common in older people. Depending on the bones involved it can give other symptoms like headaches, hearing loss, pressure on the nerves, damage of the cartilage in the joints, increase in size of the affected bone. Treatment is available to control the disease and maintain normal functionality.