What is Osteoporosis?

Bone is a living tissue that is constantly being broken down and rebuilt. When the balance between breakdown and rebuilding is disturbed – for example, by hormonal changes or dietary changes – the bone may lose some of the minerals that contribute to its density and strength. A condition of diminished bone density is called osteopenia.

When a significant loss in bone density occurs, such that the bone is markedly weakened and susceptible to fracture, the condition is termed osteoporosis (porous bone).

Osteoporosis increases the risk of bone fractures, especially in the hips, spine, and wrists. Although it can affect anyone, the risk of developing osteoporosis increases with age, affects women significantly more often than men, and is most prevalent in Caucasian and Asian women.

According to the National Osteoporosis Foundation (NOF),  Risk is also higher in individuals with petite body frames who likely have a lower than average bone mass supply. Most of the people at risk for osteoporosis are not aware of it. It is called a "silent disease" because there are usually no symptoms until a person has a bone fracture.

This breakage, frequently in the hip, the vertebrae of the spine, or in the wrist, can occur with very little pressure and can cause the person significant pain and protracted or permanent disability. If the fracture causes severe debility and affects the person's general health, it may be a contributing factor in the person's death.

Bones are primarily a combination of type-I collagen protein and calcium phosphate. The protein forms a spongy network that is "mineralized" by the addition of the calcium compound to make the bones both strong and flexible. Bone is living tissue that is slowly but continuously replaced. During a process called bone resorption, cells called osteoclasts dissolve bone on a microscopic scale and enzymes break down the collagen network. This is followed by the formation of new bone by cells called osteoblasts.

This on-going process is called bone turnover or bone remodeling and continues throughout a person's life. An individual's entire skeleton is replaced about every 10 years.

During childhood, bone formation proceeds at a faster rate than bone resorption and bone mass increases to peak usually by the early 20's. After this peak, bone formation slows and resorption begins to outpace it, resulting in a decline in bone mass with age.

Calcium and vitamin D deficiencies during childhood, the use of medications that contain high-dose glucocorticosteroids (although not the usual doses taken as inhalers to control asthma or nasal allergies), eating disorders (e.g., anorexia), gastrointestinal surgery, inactivity, smoking, and excess alcohol consumption can all increase the risk of a person developing osteoporosis later in life. Some diseases, such as thyroid disease, Cushing disease, rheumatoid arthritis, kidney disease, and hyperparathyroidism, can also have an effect on bone health. Those with a strong family history of osteoporosis may also be at an increased risk of developing it.

Menopausal and postmenopausal women may experience an increased rate of bone mass loss with a decrease in the hormone estrogen. Going through menopause early can exacerbate the loss. According to the NOF (National Osteoporosis Foundation), some women can lose up to 20% of their bone mass in the first 5 to 7 years following menopause. Men with decreased testosterone levels are also at risk for increased bone loss Osteoporosis

 Exams and Tests

A diagnosis of osteoporosis is based on your medical history, a physical exam, and a test to measure your bone thickness (density). Medical history and physical exam Your doctor will:

• Take a medical history by asking questions about your family's health history and your own.

• Measure your height and compare the results with past measurements.

• Examine your body for signs of previous broken bones, such as changes in the shape of your long bones and spine.


You will have a bone density test. It helps your doctor estimate the strength of your bones.

Know Your Osteoporosis Blood Test Markers

Some of these measures include:

• Bone-specific alkaline phosphatase (Bone ALP or BALP). This is an estimate of the rate of bone formation over your entire skeleton. Bone formation may sound like a good thing, but depending on the circumstances, too much can be bad. People with osteoporosis generally have BALP levels that are up to three times normal.

• Osteocalcin. This is another marker of bone formation.

• CTX. This is a marker of bone resorption, or loss of bone.

• Vitamin D levels. This measure assesses whether you have a deficiency of vitamin D, which is essential for your body's absorption of calcium. You can be taking plenty of calcium, but if you don't have enough vitamin D, it won't be efficiently absorbed by your body.

There are several ways to measure bone health. Learn about these osteoporosis tests

1. What Is Bone Mineral Density? A bone mineral density test, sometimes just called a bone density test, examines segments of your bone through X-rays to detect osteoporosis.

2. Measuring Bone Health: DEXA Scans One of the most common osteoporosis tests is dual X-ray absorptiometry. It measures people’s spine, hip, or total-body bone density to help gauge their risk of fractures.