As long as you live long enough, everyone will have this "problem", click to learn more →

Author: Song Chunli, Chief Physician, Peking University Third Hospital

Vice Chairman of the Sports and Health Branch of the Chinese Association of Preventive Medicine

Reviewer: Li Jun, deputy chief physician, Peking University First Hospital

If you live long enough, you will definitely get osteoporosis. This statement makes a lot of sense.

Because osteoporosis is a disease associated with aging. After the age of 25-30, bone mass will gradually decrease with age, especially after menopause, when bone mass decreases rapidly. Bone brittleness increases, and brittle fractures will occur.

1. Are there any symptoms of osteoporosis in the early stages?

Osteoporosis is a silent health killer. Its early symptoms are hidden and not easy to be detected.

In the middle and late stages of osteoporosis, symptoms such as back pain may occur. If vertebral compression fractures occur, hunchback and height loss may also occur.

In addition, calcium can regulate the excitability of neuromuscular system. Calcium deficiency will increase the excitability of neuromuscular system and cause symptoms such as leg cramps.

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Of course, symptoms of backache, back pain, and leg cramps may also be caused by poor sitting, standing, and sleeping postures. Whether you have osteoporosis or not requires relevant examinations to confirm the diagnosis.

2. What are the commonly used examination methods for diagnosing osteoporosis?

Bone density measurement is commonly used.

Of course, there are many ways to measure bone density, including single photon absorption, dual photon absorption, quantitative ultrasound detection, and dual-energy X-ray absorptiometry, or DXA.

In addition, there are some blood indicators, which are tested through blood tests to see the status of bone metabolism.

The commonly used method now is dual-energy X-ray absorptiometry (DXA) as a detection tool for diagnosing osteoporosis.

Clinically, a large population database is created based on epidemiology, and the normal peak bone mass is set as the reference. If the T value is higher than -1SD (standard deviation), it is normal bone mass.

If it is between -1 and 2.5 SD, it is called low bone mass. If it is lower than -2.5 standard deviations, it is osteoporosis. If it is lower than -2.5 SD and accompanied by one or more osteoporotic fractures, it is severe osteoporosis.

Of course, in actual clinical diagnosis and treatment, we cannot be dogmatic and "only focus on bone density". DXA examinations will often show false negatives. If a serious brittle fracture has occurred, osteoporosis should be diagnosed even if the dual-energy X-ray examination shows that the bone density is not low.

3. What are the treatments for osteoporosis?

The actual situation of each osteoporosis patient is different, and the selected treatment drugs are also different, so the treatment of osteoporosis needs to be carried out under the guidance of a professional doctor.

Generally speaking, the basic treatment for osteoporosis is calcium and vitamin D supplementation.

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Calcium is an important element in the composition of bones, and vitamin D can promote the intestinal absorption of calcium, promote calcium deposition and utilization, etc. It is a drug that regulates calcium metabolism. Therefore, the supplementation of these two nutrients is the basis of all drug treatments.

There is also vitamin K2, which can also promote calcium deposition into the bones, so vitamin K2 is also a very important element.

After taking calcium supplements, adding vitamin D and vitamin K2 can ensure that after calcium supplementation, the side effects of ectopic calcification such as stones and vascular calcification will not occur.

In addition, there are many other drugs, such as selective estrogen receptor modulators, bisphosphonates, parathyroid hormone, RANKL monoclonal antibodies, etc.

Of course, any drug can only slow down the pace of osteoporosis and reduce the harm of osteoporosis. Therefore, the key to osteoporosis is prevention.

4. How to prevent osteoporosis?

The prevention of osteoporosis is inseparable from calcium supplementation.

For most people, calcium can be supplemented with milk, such as drinking 500ml of milk every day. Friends who are lactose intolerant can choose yogurt, cheese, etc. In addition, the calcium content in foods such as dried shrimps and seaweed is also relatively high.

If food intake is insufficient, calcium tablets or other medications can be taken to supplement it.

Also, pay attention to getting more sun exposure. The ultraviolet rays in the sun can help synthesize vitamin D in the body and promote calcium absorption. However, it should be noted that sun exposure through glass is useless, and applying sunscreen will also reduce the effect of sun exposure.

It is generally recommended that you should get 30 minutes of direct sunlight every day. In addition, since the ultraviolet rays are weaker in the morning and evening, the sun exposure is best when the shadow cast by the sun does not exceed your height.

Finally, I would like to remind everyone to develop a healthy lifestyle, avoid sitting for long periods of time, and increase exercise, because exercise can make bones stronger, muscles more developed, and balance better, which can reduce the occurrence of osteoporotic fractures.