What is Osteoporosis?
Osteoporosis is brittle bones due to low bone density and impaired architecture.
What are the causes?
Post menopausal: Most common (Due to excessive resorption in old age aggravated by loss of hormonal support)
Secondary causes like various hormonal disorders (hyperparathyroidism,Cushingssyndrome, thyrotoxicosis), blood related (leukemia,lymphoma, myeloma) and joints related (Rheumatoid arthritis etc)
Long term steroid use.
Symptoms
In majority, Osteoprosis is asymptomatic. Some can have back pains and bodyache. They are prone for fractures (even with minor trauma/slip).
What are the tests to be done?
Blood tests:
Calcium, phosphorus, alkaline phosphatase, creatinine and albumin levels. Specialized blood tests can be done if we are suspecting any secondary cause.
BMD (Bone Mineral Density):
DEXA scan: Helps to find out how much is the bone density and how much it is prone for developing fracture
Bone x-rays :
Usually show severe porosity of bones; X ray of the spine is very helpful to find out osteoporosis (May show rarefaction, wedging and compression fractures)
What is the treatment?
Treatment involves oral vitamin D and calcium supplements.
Antiresorptive agents like Bisphosphonates (Zoledronate, Alendronate and Risedronate) and Denosumab are helpful in improving bone density.
Anabolic agents like Teriparatide improve the bone density significantly and reduce the risk of fractures.
What is the prognosis?
Improvement is seen with Teriparatide or Bisphosphonates. However, it is prevent falls
as much as possible in elderly.
How to prevent?
A diet rich in vitamin D and calcium throught the lifetime.
Regular physical exercise.
When to Contact an Endocrinologist?
If you have backache or develop fractures with minor or no trauma.
