You can more easily get bone fractures if you have osteoporosis and a weaker skeleton. The most common are leg fractures in the wrists, hips, vertebrae or upper arms. Osteoporosis is because the balance between the breakdown and build-up of bones in the body is disrupted so that more bones are broken down than what is being rebuilt. You can reduce the risk of osteoporosis by being physically active and not smoking.

Osteoporosis is most common in menopause. It is due to the decreased amount of the sex hormone estrogen. Osteoporosis is also commonly called osteoporosis.

Osteoporosis in children and adolescents is usually congenital and is called osteogenesis imperfecta.

You can get treatment of osteoporosis with drugs that strengthen the skeleton and reduce the risk of bone fractures if you have osteoporosis.

Symptoms of Osteoporosis

Osteoporosis is often detected when you get a bone fracture or a crack in a bone. It can also occur in everyday situations because the skeleton is fragile. 

Most leg fractures hurt in some way, but there are exceptions. Spinal vertebrae that are compressed due to osteoporosis sometimes give only moderate back pain, which you may not even seek care for. If several vertebrae in the back are compressed due to osteoporosis, the spine can change shape, which can eventually make you cut and shorter.

You may need to be examined for osteoporosis if you have reduced a lot in length.

When and where should I seek care?

If you think you have osteoporosis, contact a health care provider. You can contact many receptions by logging in.

You can seek care at any healthcare center you want throughout the country. You also have the opportunity to have a regular doctor’s contact at the health center.

How can I prevent osteoporosis?

Exercise is a way to prevent osteoporosis. It improves the skeleton, muscle strength, coordination, and balance. It also reduces the risk of falls and thus bone fractures. You can choose what you like best, but it is important with a form of exercise that loads the skeleton, preferably a couple of times a week. You may want to combine with daily walks or jogging. Keep in mind that stressful chores such as gardening and cleaning are also included.

Physiotherapists have special training programs for you who have suffered from various types of bone fractures. They also have special movements to strengthen and support the back during osteoporosis.

It is also important not to smoke to prevent osteoporosis. There are substances in tobacco smoke that have a negative effect on the build-up of bones in the body.

Good food reduces the risk

It is enough that you eat a varied general diet containing calcium and vitamin D to get you the nutrients needed for the skeleton. It is important that you get these nutrients differently if you have a different diet, such as vegan. You may also need to adjust your diet if you have undergone obesity surgery or if you weigh too little. You can seek help from a dietician if you need to.

Children and adolescents can affect their bone mass by eating foods that contain enough calcium. Examples of calcium-rich foods are dairy products, broccoli, peas, beans, and spinach. It is important for young people to move around and be outdoors every day. You keep the skeleton as strong as possible if you keep moving even as an adult.

Vitamin D is needed, among other things, to enable you to absorb calcium into the skeleton. You can increase blood vitamin D levels if you are out in the sun during the summer months.

Investigations

To find out if you have an increased risk of breaking bones, the doctor usually starts by asking questions about, for example, hereditary risks, lifestyle and if you use drugs. The doctor also asks if you have had bone fractures before or about diseases that can cause osteoporosis. The answers to the questions can be entered by a doctor in a form called FRAX, which gives you the opportunity to calculate how much risk you have to encounter, for example, a broken hip bone in the next ten years. This calculation can only be done if you have not previously been treated with osteoporosis drugs.

The doctor also does a general body examination and a special assessment of what the back looks like and what the mobility is.

You may undergo an X-ray examination of the spine if you have unclear back pain. The examination is done for the doctor to see if there are any vertebrae that have been compressed, and to exclude other skeletal diseases.

Bone density measurement is needed in some cases

You may undergo a bone density examination if your doctor suspects you have osteoporosis. You may make a new measurement a couple of years after you have begun drug treatment to check that the treatment is working.

The examination is done by means of a weak X-ray passing through the body while lying on a breeze in a so-called DXA machine.

You should get bone density measured after a bone fracture where the doctor suspects that osteoporosis may have played a role.

Other investigations

Osteoporosis can also be a sign of another disease or a consequence of drug treatment. To safely rule it out, the doctor does a body examination and takes some blood tests. A blood test is performed if, for example, it appears that you are taking up nutrition from the gut. Sometimes the investigation can proceed with samples from the intestinal wall, which are taken with a special instrument at another time. This can happen, for example, if the doctor suspects hypersensitivity to gluten.

You have the right to understand

In order for you to be able to participate in your care and make decisions, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. You can also ask for information printed so that you can read it peacefully.

Treatment of Osteoporosis

You can get treatment with drugs that strengthen the skeleton and reduce the risk of bone fractures if you have osteoporosis.

You can help maintain your bone density by moving around, staying outdoors and eating a balanced diet that provides enough calcium and vitamin D.

When you are getting medicines for osteoporosis, you often need to take extra vitamin D or calcium in tablet form. There is seldom reason to take extra calcium and vitamin D otherwise, it is only if you have a found deficiency or belong to a risk group to develop a deficiency. You should first consult your doctor about medicines.

If you need treatment of osteoporosis with cortisone tablets for 3 months or more, you may also need drug treatment that reduces the effect of cortisone on your skeleton. Take up the matter with the doctor who starts your cortisone treatment.

If osteoporosis has been caused by another disease, you should first be treated for it. If medication with any drug is a cause of osteoporosis, you can discuss with your doctor how important it is to continue with the same drug, and at the same time receive a treatment of osteoporosis that protects the skeleton.

How to avoid bone fractures during osteoporosis

Here are some tips for arranging your home environment to reduce the risk of falling over and breaking bones in your body:

  • Make sure that the floor is free of loose objects, cords and other things that could pose a risk of tripping. The floor should be level but not slippery.
  • Use real shoes indoors instead of socks or soft slippers.
  • Remove small carpets and place slip protection under the larger ones.
  • Make sure stairs have good lighting and handrails preferably on both sides. Make sure there is good lighting if you need to get up at night.
  • Make sure there are handles at the toilet, shower and bathtub, and preferably a slipmat.
  • Bring a cordless phone with you so you don’t have to rush to the phone when it rings.
  • Ask for help when changing bulbs and cleaning at high altitude. Avoid getting up on tables and chairs.


You can also use a cane, walker or have someone accompany you when you go out if you have poor balance. There are slip stitches, also retractable, to mount on walking shoes and boots. Avoid going out when it is very slippery.

Supplements of mineral and vitamin

It is essential that you get enough calcium and vitamin D to build a strong skeleton.

First and foremost, you should try to get enough calcium through the food and vitamin D by staying outdoors during the summer. Calcium is found in dairy products such as milk, film milk, yogurt, and cheese, but also in leafy vegetables such as broccoli and spinach.

It can be difficult to get enough vitamin D through the food and if you spend too little time in the sunlight, there is a risk that vitamin D levels will below. A blood test shows if you are deficient and it may then be necessary to take extra vitamin D in tablet form.

If you have received drug treatment for osteoporosis, you usually also need extra calcium and vitamin D supplementation. Read more about such combination tablets and other medicines for osteoporosis.

Vitamin D increases the body’s ability to absorb calcium from the food in the gut. It is important that you get the level of calcium in your blood and kidney function checked before you start taking extra calcium and vitamin D. If you have had kidney stones, the risk of new kidney stone attacks may increase if you get too much calcium. Therefore, you should always consult a physician before you start taking calcium and vitamin D supplements.

What happens in the body?

Inside many of the body’s bones, there is bone marrow where red blood cells and other cells are formed.

The bone is a living tissue that breaks down and is replaced in a constant adaptation to the demands of the skeleton. This rebuild lasts throughout life and is controlled by hormones such as parathyroid hormone and sex hormone, but also by the amount of vitamin D and calcium in the body. You replace your entire skeleton over the course of 10 to 20 years.

Usually, there is a balance between the breakdown and the build-up of bones, but when you have osteoporosis, the balance is upset and more bones are broken down than what is being rebuilt.

Common with osteoporosis after menopause

The skeleton of women is mainly built up during the first 20 years of life. In men, the build-up continues for a few more years and they usually get a higher bone mass than women. Most then retain their bone mass up to 50 years of age.

In conjunction with menopause, the amount of female sex hormone, called estrogen, decreases. This hormone has many effects on the body. The skeleton is affected by estrogen in such a way that the bone mass is maintained. When estrogen production then decreases in association with menopause, bone breakdown increases. The bone mass decreases most during the first years after the period of menstruation has ceased.

Women with a little more body fat after menopause seem to have some protection against osteoporosis. This is because, even after menopause, women can produce an estrogenic hormone by the male hormone androstenedione. This occurs in the body’s fat tissue.

For most people, it is good to exercise to prevent osteoporosis. But young women who are hard-working in competition class may be at risk of getting worse bone mass. This is mainly due to the fact that the hard workout affects the hormone balance in the body, which is also evident by the menstruation slipping out and can disappear completely. The same can happen to women with anorexia.

Lack of calcium

After the age of 70, bone loss occurs at an even and slower rate and is no longer as dependent on decreasing levels of the sex hormone estrogen. This is partly due to the fact that the elderly are more easily diagnosed with vitamin D deficiency, which is needed to absorb calcium from the intestine. Then the amount of calcium in the blood decreases and the body compensates it by taking calcium from the skeleton. If you have too low levels of vitamin D, the skeleton can eventually be calcified because of this.

Women are at higher risk than men

The risk of getting osteoporosis and various bone fractures can increase for many different reasons. For example, women have a two to three times higher risk than men, since they have lower bone mass from the beginning and are also exposed to the extra bone loss that occurs after menopause.

For example, a long-term low level of estrogen in women’s blood may be due to menstruation starting late and menopause starting early. Men who have low levels of testosterone in their blood have an increased risk of osteoporosis.

If you have a previous bone fracture, it can be due to osteoporosis and increase the risk of having a new bone fracture. If you have reduced in length, more than three centimeters before or five centimeters after the age of 70, it may be due to a compression of the vertebrae in the spine, which in turn may be due to osteoporosis.

More reasons for the risk increase

There may be other reasons why the risk increases. Here are some examples:

  • Smoking.
  • That you have been drinking a lot of alcohol for a long time.
  • Medicines such as cortisone, certain anti-epilepsy drugs, long-term treatment with the blood clot preventive agent heparin and anti-hormonal drugs in the treatment of breast and prostate cancer.
  • That you move too little.
  • Diseases such as arthritis, anorexia, gluten hypersensitivity, thyroid and parathyroid disease.
  • Lack of vitamin D.

Heredity does matter

Hereditary factors are a strong risk factor for osteoporosis and bone fractures. Among other things, heredity affects the amount of calcium and other minerals in the skeleton. It can also affect balance. The risk of having a bone fracture is greater if you have close relatives, such as parents and siblings, who have experienced osteoporosis and bone fractures. 

How common is osteoporosis?

Osteoporosis is becoming more common, partly because people live longer today. At the age of 70, just over every third woman and sixth were osteoporosis.

Ehtisham Nadeem

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