Osteoporosis can surprise a working-age person – you can recognize it by these signs

Osteoporosis is thought to be a problem for the elderly, but it still does not discriminate against younger people either. A small fracture can indicate weakening of the bones at any age. Often the first thing to break is the wrist, when catching a fall with the hand.

– It would be good for a wrist fracture to make the doctor think about whether it could be osteoporosis, says the specialist in internal medicine and geriatrics Tiina Huusko.

In addition to a bone fracture, osteoporosis is mostly discovered by chance, for example in an imaging study related to other ailments. Or collapsing means that the vertebrae have collapsed. The length could have been several centimeters and the pain could be severe.

– I have written several middle-aged women to retirement because they have had broken vertebrae, which have not been noticed, even though they have complained of back pain.

Bone is a living tissue that breaks down and rebuilds itself throughout a person’s life. The bone tissue is the most in 20-30 year olds and the situation remains pretty much the same until the age of 40. After that, more bone breaks down than new ones are born.

– Both constructive osteocytes and destructive osteoclasts develop from bone stem cells. In children and adolescents, the development of bone mineral density can also be influenced, and later mainly on the speed at which osteoclasts weaken the bone, Huusko says.

Osteoporosis is more common in women. Women lose more than half the spongy cancellous bone inside the bone during their lifetime than men. The reason is at least partly in menopause, as the decrease in the amount of estrogen accelerates the weakening of bone density.

DEXA or FRAX or both?

At the doctor, the possibility of osteoporosis is investigated by measuring the bone density with a DEXA device intended for that purpose. An ordinary X-ray is therefore not enough. Bone density is usually measured at the lumbar vertebrae or the top of the femur. In osteoporosis, bone density is at least 25 percent lower than in healthy 20-40 year olds. A smaller but still clear decrease in bone density is called osteopenia.

DEXA equipment is not everywhere. Especially if the bone density cannot be measured, the doctor must otherwise assess the risk of fractures and whether medical treatment is needed or not.

– The world’s most famous osteoporosis researcher, John A. Kanis, recommends that the FRAX fracture risk calculator be used when deciding whether to start treatment. It’s a questionnaire that tells you how big the fracture risk is, says Huusko.

Preventive medicine for risk groups

The risk of osteoporosis is increased by folk diseases, many medicines and all cancer treatments. Then the doctor can prescribe osteoporosis drugs even before the first fracture.

– The list of diseases that increase the risk of osteoporosis is long, about an A4 sheet full of small print. Roughly speaking, it includes all Finnish folk diseases, Tiina Huusko explains.

The list includes, for example, diabetes, rheumatism, cardiovascular diseases and intestinal problems from celiac disease to inflammatory bowel diseases. Treatments include, in addition to cancer treatments, corticosteroids used to treat asthma and rheumatism, as well as some blood thinners and epilepsy drugs, as well as many others that predispose to osteoporosis.

– The risk of osteoporosis is usually identified in specialized medical care, but diabetes, for example, is treated in basic medical care, and the same is not always the case.

Take care of your bones

1. Increases strength and balance. The health of your bones can be influenced by lifestyle, such as diet and exercise. Exercise not only strengthens the bones, but also helps to keep the muscles strong and the control of balance and movements of the limbs in good condition. When the body functions normally, the risk of falling is reduced, and that is the best protection for someone with osteoporosis.
2. Enough protein. Muscles need building materials, so you need to get enough protein from food. It is usually not a problem for working-age people if several meals are eaten every day. The plate model appropriately guides you to fill a quarter of the plate with a source of protein, such as fish, chicken, legumes or meat.
3. Calcium and vitamin D are important for bones. Calcium is an important building material for bones. Sufficient intake of it is usually not a problem for Finns, especially for those who regularly use fish and vitaminized dairy products or plant-based products that have been supplemented with calcium and vitamin D. Vitamin D helps calcium to be absorbed, regulates its access to the bones and supports the regeneration of bone cells. Low vitamin D levels in the blood can increase the risk of bone fractures.

Expert Tiina Huusko LT, specialist in internal medicine and geriatrics and president of the Bone Association.

This article has appeared in Hyvä tervey magazine. As a subscriber, you can read all issues free of charge from the digilehdet.fi service.