August 28, 2025 • 17 mins
Osteoporosis: What is it? What are the symptoms? How do we treat it? In this episode, we will discuss the history of osteoporosis, the risk factors for osteoporosis, and how we diagnose it. Tune in to learn more!
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Resources:
International Osteoporosis Foundation: https://www.osteoporosis.foundation/
Bone Health & Osteoporosis Foundation (US): https://www.bonehealthandosteoporosis.org/
Royal Osteoprosis Society (UK): https://theros.org.uk/
Healthy Bones Australia: https://healthybonesaustralia.org.au/
References:
https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
https://medlineplus.gov/ency/imagepages/17182.htm
https://bellarmine.lmu.edu/classics/archaeologycenter/archaeologymuseum/babedh-dhra/
https://academic.oup.com/jbmr/article-abstract/12/6/881/7516075?redirectedFrom=fulltext
https://onlinelibrary.wiley.com/doi/10.1002/ajpa.1330510411
https://onlinelibrary.wiley.com/doi/10.1002/ajpa.20365
https://www.londonosteoporosisclinic.com/celebrities-with-osteoporosis/
https://www.mayoclinic.org/diseases-conditions/osteoporosis/diagnosis-treatment/drc-20351974
https://pmc.ncbi.nlm.nih.gov/articles/PMC3111801/
https://www.webmd.com/osteoporosis/features/sally-field-osteoporosis-story
https://onlinelibrary.wiley.com/doi/10.1111/joim.12369
*This podcast is for entertainment purposes only. If you suspect you have a medical condition, please seek out an opinion of a medical professional.*
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
You get a phone call from your dad.
(00:01):
He tells you that your grandma Lucy had a fall.
She's in the hospital and they think she has broken her hip.
You are confused but concerned.
Your grandma has always been really healthy and active,
although she has been slowing down over the past few years.
She is 80 after all.
You head to the hospital to go see your grandmother.
As you head into the room, the doctor tells you that they need to run some tests.
(00:30):
Hello and Welcome to Anatomy Of Illness.
Today's episode is about osteoporosis.
Before we get into the condition, we are going to start with the history.
So why do we know osteoporosis exists?
A quick reminder that our Kickstarter pre-launch page for our second season is active now.
(00:54):
So be sure to sign up through the link in the episode description for updates,
as there will be plenty of exciting content coming.
Now onto the history.
We begin in the early Bronze Age over at the site of Bab-edh-dhra.
This site is located in Jordan.
This site is typically dated to around 3000 BC to 2500 BC.
So this is our first stop.
(01:16):
Anyway, what is more important than the dates is what has been found here.
They found skeletons with evidence of postmenopausal osteoporosis.
These skeletons are potentially the earliest evidence we have of this medical condition.
Moving on to the 12th dynasty in ancient Egypt, which is between the years 1990 and 1786 BC.
(01:40):
We are specifically going to be in Upper Egypt in Lisht.
Here we would have what looks like a case of osteoporosis.
In this case, they found a fracture of the femoral neck and compression fractures of
some of the vertebrae.
The femoral neck is part of the thigh bone just before it meets the socket that forms
the hip, and the vertebrae are the bones that make up the spine.
(02:01):
However, this is not what makes the case interesting.
With this case, the fracture in the femoral neck showed signs of healing.
This is interesting as with the signs of healing,
it shows that there was a supportive community for this person.
Essentially, this means that the person with the fracture would have had time to rest and heal,
whilst others assisted with daily tasks, jumping forward to between 3rd century and 4th century AD.
(02:25):
And over to England.
This is where we would find something interesting in the skeletons studied from this time period.
They found that when they compared the over 50-year-old women skeletons
to a reference population from the early 2000s, the 3rd and 4th century skeletons
had greater bone loss.
This over 50s population of women from the 3rd and 4th century also had a larger amount
of fractures that would be typically associated with osteoporosis.
(02:49):
However, this condition would not have been understood by this population at the time.
Moving on to 1822.
This is when we would have the British surgeon and anatomist, Sir Astley Paston Cooper,
making comments about bones with abnormal structures and associating these with fractures.
Interestingly enough, the name for osteoporosis would not exist until 11 years later in 1833.
(03:13):
This would actually come from an autopsy which would lead to a paper by Jean Martin Lobstein,
who was a French pathologist.
In this, he would describe a condition where there were holes associated with the bones being fragile.
He would use two terms as a way of describing it.
These being osteoporose and osteopathyrose.
(03:35):
In this paper, he would describe the autopsy of “a man of 60 years,
in which almost all the bones began to soften at the age of 18 years,
and then they degenerated into tumours.
Yet these same spongy bones resumed their original strength when all were united.
A review of the corpse suggested that the bone swelling was due to a bone expansion
(03:55):
of the reticular substance, therefore osteoporosis.”
What is interesting is it is entirely possible that this was actually never a case of osteoporosis,
but instead another condition called osteogenesis imperfecta, which we covered in episode 31.
But why do I say this?
Well, the man he autopsied was described to have blue-grey sclera,
(04:18):
so the whites of the eye are the sclera, which is a symptom of this condition,
specifically osteogenesis imperfecta type 1.
But anyway, the term osteoporosis would spread rapidly after Lobstein's use of the word.
We see it appearing in a German dictionary of medical terms in 1839.
This is where the recognition for osteoporosis would really take off.
(04:39):
We see this in several medical texts,
these recognizing the prevalence of fractures in elderly women with the condition.
Bauer would make comments on the work of Bruns in 1882.
This would be recognizing the relationship between
age and the female sex with the development of osteoporosis.
Moving on to 1941 with Fuller Albright, as he would make further observations with this.
(05:01):
He would make his own discoveries about how women with the loss of ovarian function
and vertebral fractures would have a stabilization of their condition with estrogen treatment,
as the calcium balance would be improved in these women.
And they would also stop losing height, or I guess you could say shrinking.
If you are enjoying this episode so far and think a friend may enjoy it,
you share it with them as it helps us grow.
(05:23):
So what actually is osteoporosis?
Osteoporosis is a condition that causes the bones to become weak and brittle.
With the weak and brittle bones, it increases the risk of broken bones.
So if you have a fall, you could break a hip.
Or even in some cases, you could break a rib just by coughing.
With normal bone, it is constantly being broken down and replaced,
as it is living and part of the life cycle of the skeleton.
(05:45):
However, in osteoporosis, the replacement of bone does not keep up with the breaking down.
After your early 20s, this process normally begins to slow down.
So as you age, the new bone growth is slower than the bone being broken down.
But what are the risk factors for developing osteoporosis?
When it comes to osteoporosis,
(06:06):
there are several different kinds of risk factors with this condition.
There are risk factors that are unchangeable.
So risk factors that are out of your control.
These include your sex.
Being a woman makes you more likely to develop osteoporosis.
However, men can still develop it.
It is in about one in every two women and one in every five men
who will go on to develop this condition with age.
(06:27):
Speaking of age, age. Getting older increases your risk of osteoporosis.
It is normally associated with aging,
but younger people can have it if they have really bad bone health.
Race.
Those who are of either white or Asian descent happen to be at a higher risk of osteoporosis.
Family history.
When it comes to osteoporosis, if you have a parent or a sibling with this condition,
(06:50):
you are at a higher risk for it.
This is especially true if either parent has fractured their hip.
Body frame size.
So this measurement is your height in relationship to the size of your wrist
as a rough estimate to your body frame size.
Those with a small body frame size have a higher risk of developing osteoporosis
due to potentially less bone mass being present as they age.
(07:12):
I have provided a link in the episode description if you're really curious about checking that out.
This is in inches though.
So if you are like me and the rest of the world, maybe a little interesting to measure.
Hormone levels are another risk factor that can increase the risk of developing osteoporosis.
As there are several different hormones that can affect bone health.
(07:32):
These include sex hormones.
When you have lower levels of sex hormones, this can weaken the bone.
This goes for both men and women.
With women, we see the decrease of estrogen during menopause as a strong risk factor
when it comes to osteoporosis.
We also see this increased risk when it comes to medications used to reduce estrogen.
These especially being part of breast cancer treatment as these accelerate bone loss.
(07:57):
We see a similar accelerated bone loss and increased risk of osteoporosis
when it comes to treatments, reducing men's testosterone levels.
These being used for prostate cancer thyroid problems.
When you have too much thyroid hormone in your body, you can begin to experience bone loss.
The extra thyroid hormone can be due to several reasons.
This being if you have a hyperactive thyroid, which is hyperthyroidism.
(08:20):
This is when your thyroid makes too much of the hormone,
or if you have taken too much of the medications used to treat an underactive thyroid,
which is hypothyroidism.
We covered this condition in episode 75.
There are also other glands that are associated with osteoporosis.
These include the adrenal glands and the parathyroid glands.
In both of these, when they are elevated amounts of the hormones they produce,
(08:43):
there is an increased risk of developing osteoporosis.
Dietary factors also influence our risk of developing osteoporosis.
Dietary factors we see being important when it comes to the risk of developing osteoporosis
include low calcium intake.
Having a lifelong low calcium intake will play a role in the development of osteoporosis.
When you have low calcium intake, you experience low bone density.
(09:05):
And when you have early bone loss, you experience an increased risk of fractures.
Eating Disorders
When you severely limit food intake and end up becoming underweight,
this increases the risk of osteoporosis.
This being due to the weakening of the bone.
Gastrointestinal Surgery
When you have surgery to reduce the size of your stomach or to remove part of your intestine,
you limit the amount of calcium your body is able to absorb along with other nutrients.
(09:29):
These surgeries may be done to assist in weight loss or to assist with other medical conditions,
like Crohn's or ulcerative colitis.
We covered these conditions in episode 21.
The use of various medications can also increase the risk of osteoporosis.
These include the long-term use of corticosteroids.
Whether these are taken orally or injected.
These increase the risk of osteoporosis.
(09:49):
This is due to the steroids interfering with the bone rebuilding process.
We also see various other medications associated with an increased risk of osteoporosis.
These being medications that are used to either prevent or combat the following conditions.
Cancer, gastric reflux, seizures, and transplant rejection.
Having certain medical conditions can increase your risk of developing osteoporosis.
These include
(10:10):
cancer, celiac disease, which we discussed in episode 10, inflammatory bowel disease,
which again is things like Crohn's and ulcerative colitis, kidney or liver disease,
multiple myeloma, or rheumatoid arthritis.
Various lifestyle choices can also increase your risk of developing osteoporosis.
These include living a sedentary lifestyle.
If you spend the majority of your time sitting, you are going to have a higher risk of developing
(10:33):
osteoporosis when compared with someone who has a more active lifestyle.
Participating in any sort of weight-bearing activity and activities that promote good
balance and good posture are good for your bones.
We see this especially with activities like walking, running, jumping, dancing, and weightlifting.
So these activities are good for your bones and preventing osteoporosis.
Excessive alcohol consumption.
(10:54):
Regularly drinking more than two alcoholic beverages a day
increases the risk of osteoporosis.
Tobacco use.
The use of tobacco has been shown to contribute to the weakening of bones.
Weakened bones leads to osteoporosis.
How do we diagnose osteoporosis?
When it comes to osteoporosis, if this condition is suspected,
you will be referred for a bone density test.
(11:15):
This test uses a machine that uses low levels of x-rays
to test the proportion of minerals in your bones.
In most cases, only certain bones like the hip and spine will be measured.
However, they can check other bones as well.
We will get right into the symptoms and presentation right after this little break.
(11:38):
This podcast is supported by listeners like you on Buy Me A Coffee.
What symptoms might you have if you had osteoporosis?
When it comes to osteoporosis, the early stages typically do not cause any symptoms.
However, as the condition progresses and the bones become weakened by osteoporosis,
(12:00):
it will start to cause symptoms.
So the symptoms you may have if you had osteoporosis include back pain.
This can be caused by broken or collapsed bones in the spine,
experiencing a loss of height over time,
having a stooped posture, so a bent forward posture,
and experiencing bone breaks,
especially fractures that occur more easily than they should have.
What complications should a doctor be aware of when it comes to osteoporosis?
(12:24):
When it comes to osteoporosis, there are several complications doctors should be aware of.
These include bone breaks and fractures.
Due to increased weakness in the bones, the bones are at a higher risk of breaking or fracturing.
When it comes to these fractures, the most concerning fractures are of the hip or of the
spine.
Hip fractures can be caused by a fall and can lead to disability,
(12:44):
and even an increased risk of death during the first year after the injury.
Fractures, however, are not always caused by a fall.
Broken bones can occur in the spine even if there has been no fall or potential injury
to cause this.
This is due to the bones in the spine, these being the vertebrae, weakening to the point
of collapsing.
This can cause pain, a decrease in height, and a hunched forward posture.
(13:05):
So when it comes to osteoporosis, fractures are a complication that doctors need to be
aware of, as there may not always be an obvious cause or injury to blame for these breaks
in the bone.
And having broken hips can increase the risk of death and disability in those with osteoporosis.
How do we treat osteoporosis?
Well, when it comes to the treatment methods, they will evaluate how likely they believe
(13:27):
you are to break a bone in the next 10 years.
This will then inform their approach to your condition.
This evaluation is based on several factors, including your bone density test.
If you are a low risk for fractures, so you have higher bone density among other factors,
they may recommend focusing on various things like modifying your risk factors for bone
loss and falls.
(13:48):
If you are considered to be a higher risk of bone break in the next 10 years, then doctors
will use medications to help manage your condition.
There are several medications that can be used to help with osteoporosis.
These include biphosphonates.
These are the most widely used medications when it comes to osteoporosis.
These medications slow down the breakdown of bones.
(14:09):
These can either be taken intravenously or orally.
Denosumab, Much like biphosphonates, this medication also slows down breakdown of bones.
It reduces the risk of all kinds of bone breaks whilst taking the medication.
Hormone related therapy. The use of estrogen soon after starting menopause
can reduce the likelihood of developing osteoporosis, as it helps to maintain bone density.
(14:33):
When it comes to testosterone therapy, there have not been many studies as to how it may
assist in the treatment of osteoporosis in men, especially those with low testosterone.
So the use of testosterone is not recommended as a standalone treatment.
Testosterone may be recommended as part of a treatment plan, along with other osteoporosis
medications.
Bone building medications These are used in severe cases of osteoporosis,
(14:57):
or if no other medication has worked.
These medications increase new bone formation.
These can only be used for a limited amount of time.
Are there any famous people who have or have had osteoporosis?
Yes, there are actually several famous people who have osteoporosis.
These include Sally Fields.
She is an award-winning actress who played roles in films like Places in the Heart.
(15:19):
Fields was diagnosed with osteoporosis just before her 60th birthday.
There is also Gwyneth Paltrow, who was diagnosed with osteopenia at the age of 37.
Now, osteopenia is not osteoporosis, but it is essentially the first stages of the condition.
It is a warning sign that you are on a fast track to developing the condition if things
don't change, especially if you do not change some of the risk factors that you are able
(15:42):
to change.
At the time of Paltrow's osteopenia diagnosis, she was found to have incredibly low vitamin
D levels.
Vitamin D is important for bone health and bone strength, so ensuring that if you have
low vitamin D levels, this is corrected, as this can cause issues in the future.
Osteopenia does not always develop into osteoporosis, however, if it is not treated and managed,
(16:04):
it is likely to.
If you would like to check out a foundation, there is the International Osteoporosis Foundation.
This foundation is dedicated to preventing osteoporosis, diagnosing, and treating osteoporosis
along with related musculoskeletal conditions.
Their goal is to make people more aware of bone health.
For those in the US, there is the Bone Health and Osteoporosis Foundation.
(16:25):
They raise awareness of osteoporosis, provide resources for those experiencing the condition,
along with resources for professionals treating osteoporosis.
For those in the UK, there is the Royal Osteoporosis Society.
They provide support for those with osteoporosis, fund research into the condition to improve
treatment and care.
They also work with the healthcare system and healthcare professionals to improve care
(16:47):
and diagnosis.
For those in Australia, there is Healthy Bones Australia.
They aim to support people experiencing poor bone health, including those with osteoporosis.
They encourage people to build healthier bones and increase awareness of the condition so
people can be diagnosed earlier.
If you want to check out the sources, social media links, or any other links, you can head
to anatomyofillness.com.
(17:08):
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If you want to join our community, you can join us on Discord or Instagram.
Otherwise, stick around for the next episode.
Did you know the femur, which is your thigh bone, is the longest and the strongest bone
You get a phone call from your dad.
(00:01):
He tells you that your grandma Lucy had a fall.
She's in the hospital and they think she has broken her hip.
You are confused but concerned.
Your grandma has always been really healthy and active,
although she has been slowing down over the past few years.
She is 80 after all.
You head to the hospital to go see your grandmother.
As you head into the room, the doctor tells you that they need to run some tests.
(00:30):
Hello and Welcome to Anatomy Of Illness.
Today's episode is about osteoporosis.
Before we get into the condition, we are going to start with the history.
So why do we know osteoporosis exists?
A quick reminder that our Kickstarter pre-launch page for our second season is active now.
(00:54):
So be sure to sign up through the link in the episode description for updates,
as there will be plenty of exciting content coming.
Now onto the history.
We begin in the early Bronze Age over at the site of Bab-edh-dhra.
This site is located in Jordan.
This site is typically dated to around 3000 BC to 2500 BC.
So this is our first stop.
(01:16):
Anyway, what is more important than the dates is what has been found here.
They found skeletons with evidence of postmenopausal osteoporosis.
These skeletons are potentially the earliest evidence we have of this medical condition.
Moving on to the 12th dynasty in ancient Egypt, which is between the years 1990 and 1786 BC.
(01:40):
We are specifically going to be in Upper Egypt in Lisht.
Here we would have what looks like a case of osteoporosis.
In this case, they found a fracture of the femoral neck and compression fractures of
some of the vertebrae.
The femoral neck is part of the thigh bone just before it meets the socket that forms
the hip, and the vertebrae are the bones that make up the spine.
(02:01):
However, this is not what makes the case interesting.
With this case, the fracture in the femoral neck showed signs of healing.
This is interesting as with the signs of healing,
it shows that there was a supportive community for this person.
Essentially, this means that the person with the fracture would have had time to rest and heal,
whilst others assisted with daily tasks, jumping forward to between 3rd century and 4th century AD.
(02:25):
And over to England.
This is where we would find something interesting in the skeletons studied from this time period.
They found that when they compared the over 50-year-old women skeletons
to a reference population from the early 2000s, the 3rd and 4th century skeletons
had greater bone loss.
This over 50s population of women from the 3rd and 4th century also had a larger amount
of fractures that would be typically associated with osteoporosis.
(02:49):
However, this condition would not have been understood by this population at the time.
Moving on to 1822.
This is when we would have the British surgeon and anatomist, Sir Astley Paston Cooper,
making comments about bones with abnormal structures and associating these with fractures.
Interestingly enough, the name for osteoporosis would not exist until 11 years later in 1833.
(03:13):
This would actually come from an autopsy which would lead to a paper by Jean Martin Lobstein,
who was a French pathologist.
In this, he would describe a condition where there were holes associated with the bones being fragile.
He would use two terms as a way of describing it.
These being osteoporose and osteopathyrose.
(03:35):
In this paper, he would describe the autopsy of “a man of 60 years,
in which almost all the bones began to soften at the age of 18 years,
and then they degenerated into tumours.
Yet these same spongy bones resumed their original strength when all were united.
A review of the corpse suggested that the bone swelling was due to a bone expansion
(03:55):
of the reticular substance, therefore osteoporosis.”
What is interesting is it is entirely possible that this was actually never a case of osteoporosis,
but instead another condition called osteogenesis imperfecta, which we covered in episode 31.
But why do I say this?
Well, the man he autopsied was described to have blue-grey sclera,
(04:18):
so the whites of the eye are the sclera, which is a symptom of this condition,
specifically osteogenesis imperfecta type 1.
But anyway, the term osteoporosis would spread rapidly after Lobstein's use of the word.
We see it appearing in a German dictionary of medical terms in 1839.
This is where the recognition for osteoporosis would really take off.
(04:39):
We see this in several medical texts,
these recognizing the prevalence of fractures in elderly women with the condition.
Bauer would make comments on the work of Bruns in 1882.
This would be recognizing the relationship between
age and the female sex with the development of osteoporosis.
Moving on to 1941 with Fuller Albright, as he would make further observations with this.
(05:01):
He would make his own discoveries about how women with the loss of ovarian function
and vertebral fractures would have a stabilization of their condition with estrogen treatment,
as the calcium balance would be improved in these women.
And they would also stop losing height, or I guess you could say shrinking.
If you are enjoying this episode so far and think a friend may enjoy it,
you share it with them as it helps us grow.
(05:23):
So what actually is osteoporosis?
Osteoporosis is a condition that causes the bones to become weak and brittle.
With the weak and brittle bones, it increases the risk of broken bones.
So if you have a fall, you could break a hip.
Or even in some cases, you could break a rib just by coughing.
With normal bone, it is constantly being broken down and replaced,
as it is living and part of the life cycle of the skeleton.
(05:45):
However, in osteoporosis, the replacement of bone does not keep up with the breaking down.
After your early 20s, this process normally begins to slow down.
So as you age, the new bone growth is slower than the bone being broken down.
But what are the risk factors for developing osteoporosis?
When it comes to osteoporosis,
(06:06):
there are several different kinds of risk factors with this condition.
There are risk factors that are unchangeable.
So risk factors that are out of your control.
These include your sex.
Being a woman makes you more likely to develop osteoporosis.
However, men can still develop it.
It is in about one in every two women and one in every five men
who will go on to develop this condition with age.
(06:27):
Speaking of age, age. Getting older increases your risk of osteoporosis.
It is normally associated with aging,
but younger people can have it if they have really bad bone health.
Race.
Those who are of either white or Asian descent happen to be at a higher risk of osteoporosis.
Family history.
When it comes to osteoporosis, if you have a parent or a sibling with this condition,
(06:50):
you are at a higher risk for it.
This is especially true if either parent has fractured their hip.
Body frame size.
So this measurement is your height in relationship to the size of your wrist
as a rough estimate to your body frame size.
Those with a small body frame size have a higher risk of developing osteoporosis
due to potentially less bone mass being present as they age.
(07:12):
I have provided a link in the episode description if you're really curious about checking that out.
This is in inches though.
So if you are like me and the rest of the world, maybe a little interesting to measure.
Hormone levels are another risk factor that can increase the risk of developing osteoporosis.
As there are several different hormones that can affect bone health.
(07:32):
These include sex hormones.
When you have lower levels of sex hormones, this can weaken the bone.
This goes for both men and women.
With women, we see the decrease of estrogen during menopause as a strong risk factor
when it comes to osteoporosis.
We also see this increased risk when it comes to medications used to reduce estrogen.
These especially being part of breast cancer treatment as these accelerate bone loss.
(07:57):
We see a similar accelerated bone loss and increased risk of osteoporosis
when it comes to treatments, reducing men's testosterone levels.
These being used for prostate cancer thyroid problems.
When you have too much thyroid hormone in your body, you can begin to experience bone loss.
The extra thyroid hormone can be due to several reasons.
This being if you have a hyperactive thyroid, which is hyperthyroidism.
(08:20):
This is when your thyroid makes too much of the hormone,
or if you have taken too much of the medications used to treat an underactive thyroid,
which is hypothyroidism.
We covered this condition in episode 75.
There are also other glands that are associated with osteoporosis.
These include the adrenal glands and the parathyroid glands.
In both of these, when they are elevated amounts of the hormones they produce,
(08:43):
there is an increased risk of developing osteoporosis.
Dietary factors also influence our risk of developing osteoporosis.
Dietary factors we see being important when it comes to the risk of developing osteoporosis
include low calcium intake.
Having a lifelong low calcium intake will play a role in the development of osteoporosis.
When you have low calcium intake, you experience low bone density.
(09:05):
And when you have early bone loss, you experience an increased risk of fractures.
Eating Disorders
When you severely limit food intake and end up becoming underweight,
this increases the risk of osteoporosis.
This being due to the weakening of the bone.
Gastrointestinal Surgery
When you have surgery to reduce the size of your stomach or to remove part of your intestine,
you limit the amount of calcium your body is able to absorb along with other nutrients.
(09:29):
These surgeries may be done to assist in weight loss or to assist with other medical conditions,
like Crohn's or ulcerative colitis.
We covered these conditions in episode 21.
The use of various medications can also increase the risk of osteoporosis.
These include the long-term use of corticosteroids.
Whether these are taken orally or injected.
These increase the risk of osteoporosis.
(09:49):
This is due to the steroids interfering with the bone rebuilding process.
We also see various other medications associated with an increased risk of osteoporosis.
These being medications that are used to either prevent or combat the following conditions.
Cancer, gastric reflux, seizures, and transplant rejection.
Having certain medical conditions can increase your risk of developing osteoporosis.
These include
(10:10):
cancer, celiac disease, which we discussed in episode 10, inflammatory bowel disease,
which again is things like Crohn's and ulcerative colitis, kidney or liver disease,
multiple myeloma, or rheumatoid arthritis.
Various lifestyle choices can also increase your risk of developing osteoporosis.
These include living a sedentary lifestyle.
If you spend the majority of your time sitting, you are going to have a higher risk of developing
(10:33):
osteoporosis when compared with someone who has a more active lifestyle.
Participating in any sort of weight-bearing activity and activities that promote good
balance and good posture are good for your bones.
We see this especially with activities like walking, running, jumping, dancing, and weightlifting.
So these activities are good for your bones and preventing osteoporosis.
Excessive alcohol consumption.
(10:54):
Regularly drinking more than two alcoholic beverages a day
increases the risk of osteoporosis.
Tobacco use.
The use of tobacco has been shown to contribute to the weakening of bones.
Weakened bones leads to osteoporosis.
How do we diagnose osteoporosis?
When it comes to osteoporosis, if this condition is suspected,
you will be referred for a bone density test.
(11:15):
This test uses a machine that uses low levels of x-rays
to test the proportion of minerals in your bones.
In most cases, only certain bones like the hip and spine will be measured.
However, they can check other bones as well.
We will get right into the symptoms and presentation right after this little break.
(11:38):
This podcast is supported by listeners like you on Buy Me A Coffee.
What symptoms might you have if you had osteoporosis?
When it comes to osteoporosis, the early stages typically do not cause any symptoms.
However, as the condition progresses and the bones become weakened by osteoporosis,
(12:00):
it will start to cause symptoms.
So the symptoms you may have if you had osteoporosis include back pain.
This can be caused by broken or collapsed bones in the spine,
experiencing a loss of height over time,
having a stooped posture, so a bent forward posture,
and experiencing bone breaks,
especially fractures that occur more easily than they should have.
What complications should a doctor be aware of when it comes to osteoporosis?
(12:24):
When it comes to osteoporosis, there are several complications doctors should be aware of.
These include bone breaks and fractures.
Due to increased weakness in the bones, the bones are at a higher risk of breaking or fracturing.
When it comes to these fractures, the most concerning fractures are of the hip or of the
spine.
Hip fractures can be caused by a fall and can lead to disability,
(12:44):
and even an increased risk of death during the first year after the injury.
Fractures, however, are not always caused by a fall.
Broken bones can occur in the spine even if there has been no fall or potential injury
to cause this.
This is due to the bones in the spine, these being the vertebrae, weakening to the point
of collapsing.
This can cause pain, a decrease in height, and a hunched forward posture.
(13:05):
So when it comes to osteoporosis, fractures are a complication that doctors need to be
aware of, as there may not always be an obvious cause or injury to blame for these breaks
in the bone.
And having broken hips can increase the risk of death and disability in those with osteoporosis.
How do we treat osteoporosis?
Well, when it comes to the treatment methods, they will evaluate how likely they believe
(13:27):
you are to break a bone in the next 10 years.
This will then inform their approach to your condition.
This evaluation is based on several factors, including your bone density test.
If you are a low risk for fractures, so you have higher bone density among other factors,
they may recommend focusing on various things like modifying your risk factors for bone
loss and falls.
(13:48):
If you are considered to be a higher risk of bone break in the next 10 years, then doctors
will use medications to help manage your condition.
There are several medications that can be used to help with osteoporosis.
These include biphosphonates.
These are the most widely used medications when it comes to osteoporosis.
These medications slow down the breakdown of bones.
(14:09):
These can either be taken intravenously or orally.
Denosumab, Much like biphosphonates, this medication also slows down breakdown of bones.
It reduces the risk of all kinds of bone breaks whilst taking the medication.
Hormone related therapy. The use of estrogen soon after starting menopause
can reduce the likelihood of developing osteoporosis, as it helps to maintain bone density.
(14:33):
When it comes to testosterone therapy, there have not been many studies as to how it may
assist in the treatment of osteoporosis in men, especially those with low testosterone.
So the use of testosterone is not recommended as a standalone treatment.
Testosterone may be recommended as part of a treatment plan, along with other osteoporosis
medications.
Bone building medications These are used in severe cases of osteoporosis,
(14:57):
or if no other medication has worked.
These medications increase new bone formation.
These can only be used for a limited amount of time.
Are there any famous people who have or have had osteoporosis?
Yes, there are actually several famous people who have osteoporosis.
These include Sally Fields.
She is an award-winning actress who played roles in films like Places in the Heart.
(15:19):
Fields was diagnosed with osteoporosis just before her 60th birthday.
There is also Gwyneth Paltrow, who was diagnosed with osteopenia at the age of 37.
Now, osteopenia is not osteoporosis, but it is essentially the first stages of the condition.
It is a warning sign that you are on a fast track to developing the condition if things
don't change, especially if you do not change some of the risk factors that you are able
(15:42):
to change.
At the time of Paltrow's osteopenia diagnosis, she was found to have incredibly low vitamin
D levels.
Vitamin D is important for bone health and bone strength, so ensuring that if you have
low vitamin D levels, this is corrected, as this can cause issues in the future.
Osteopenia does not always develop into osteoporosis, however, if it is not treated and managed,
(16:04):
it is likely to.
If you would like to check out a foundation, there is the International Osteoporosis Foundation.
This foundation is dedicated to preventing osteoporosis, diagnosing, and treating osteoporosis
along with related musculoskeletal conditions.
Their goal is to make people more aware of bone health.
For those in the US, there is the Bone Health and Osteoporosis Foundation.
(16:25):
They raise awareness of osteoporosis, provide resources for those experiencing the condition,
along with resources for professionals treating osteoporosis.
For those in the UK, there is the Royal Osteoporosis Society.
They provide support for those with osteoporosis, fund research into the condition to improve
treatment and care.
They also work with the healthcare system and healthcare professionals to improve care
(16:47):
and diagnosis.
For those in Australia, there is Healthy Bones Australia.
They aim to support people experiencing poor bone health, including those with osteoporosis.
They encourage people to build healthier bones and increase awareness of the condition so
people can be diagnosed earlier.
If you want to check out the sources, social media links, or any other links, you can head
to anatomyofillness.com.
(17:08):
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Did you know the femur, which is your thigh bone, is the longest and the strongest bone
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