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Dr. Pham Hoang Trung

Osteoporosis is the disease of bones gradually losing calcium. Over time, osteoporosis causes our bones to become fragile, full of tiny holes and thus very easy to break. Osteoporosis has affected more than 10 million Americans. The bone mass decreases gradually (by 2% each year) starting from the age of 40, for both males and females. However, women have a higher risk of having osteoporosis because the density of their bone mass is naturally low before they reach 40. In general, osteoporosis affects 1/8 of all males and 1/4 of all females (or one out of four women will have osteoporosis, twice as many as men).

Bones occupy approximately 15-17% of the total weight of our body. Bones are formed with two main elements: organic substances and minerals. The organic substances make up 30% of the bones, forming a frame of protein to which the minerals adhere. The other 70% of the bones are the minerals, of which the most important ones are calcium, phosphorus, and magnesium. The construction of bones is regulated by two main types of cell: bone-forming cells (osteoblast) and bone-destroying cells (osteoclast). This is why there always are processes that destroy old bones and form new ones. At young age (under 25), with the body still growing, the bone-forming cells are more active than the bone-destroying cells. The quantity of minerals increases alongside the body’s growth to its maximum. Between the ages of 25-40, the activity of the bone-forming cells and that of the bone-destroying cells are balanced, which maintains the stability of the bone mass. This is the stage when the bones reach their optimal peak mineral density. From the age of 40 on, the activity of the bone-destroying cells goes over that of the bone-forming cells, causing a gradual decrease of minerals (at a rate of 2% each year). For women in their post-menopause period, the rate of bone loss is much faster than their male counterparts. During the first 10-15 years of menopause, the rate of bone loss is 2-4% each year.

Osteoporosis is a disease caused by the following factors over a long period of time:

  1. In the woman’s post-menopause period, the activity of the ovaries has stopped. The consequent lack of estrogen—which has the effect of restraining the activity of the bone-destroying cells—activates these cells. The bone mass of most women at 65 decreases by 30%-50%. Some only have less than 30% of the bone mass. These women usually have serious complications of osteoporosis such as compression fracture, hip fracture, wrist fracture, etc. Recent research has shown that osteoporosis can happen even before menopause.
  2. Taking medications for epilepsy, diabetes, blood clotting, and especially those of the corticosteroid group. Corticosteroid, on the one hand, oppresses the bone-forming process, and on the other hand, reduces the absorption of calcium in the intestines, thus augmenting the elimination of calcium from the kidneys and accelerating the bone-destroying process.
  3. Endocrinal diseases: Hyperthyroidism, hyper-adrenal glands, diabetes..., and especially the decreased functionality of the reproductive glands (women’s ovaries and men’s testicles).
  4. Chronic kidney failure or long-time dialysis can cause calcium loss.
  5. Hereditary: Those who have grand-parents or parents with osteoporosis.
  6. Caucasians and Asians are more prone to osteoporosis than other races.
  7. Those with thin and small bones.
  8. Excessive use of coffee, alcohol or cigarettes can cause imbalance in calcium (more loss than gain).
  9. Diets with too much meat, salt or sugar cause calcium to be discharged through urine.
  10. Frequent use of soft drinks like Coca Cola or Pepsi, which contain a lot of phosphate. This element can cause loss of calcium in blood. As a result, the body will automatically extract calcium from the bones for its own use. Kids who often drink soft drinks have more risks of bone fracture.
  11. Inactive lifestyle or lack of physical exercise can help the bone-destroying cells become more active.
  12. Diets without enoughcalcium, minerals and Vitamin D necessary for bone density.

The initial symptoms of osteoporosis are tolerable to the patient because of their ambiguous nature such as inconsistent pain or tiredness felt in the spine, limb bones, joints, etc. Later on, when the quantity of minerals has been lost increasingly, those pain symptoms become more defined. The pain is concentrated in the areas where the bones endure the body weight such as hip joints, knee joints, and the spine at the waist area. Osteoporosis usually accompanies the degeneration of joints, another disease found in older people. Osteoporosis worsens the joint degeneration process. Reversely, the pain caused by the degenerated joints makes the patient idle, which aggravates osteoporosis. A diet without calcium not only is the reason for osteoporosis but also accounts for other symptoms such as cramp, anxiety, high cholesterol level, insomnia, and foot numbness. People with these symptoms should have their blood tested to see if there is a lack of calcium so they can adjust their diet for the prevention of osteoporosis. People under the age of 50 need 1,000 mg of calcium daily, while those over 50 need 1,200 mg of this natural substance.


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