Osteoporosis

Osteoporosis is a condition of thin, brittle, weakened bones that are easily fractured and slow to heal. 

Normal, healthy bones are strong, flexible and in a constant state of repair and regeneration. Once this process slows (for a number of reasons), the cellular turnover that makes bones healthy stops and bones become weak and thin.

Not all bones ‘age’ at the same rate. Osteoporosis typically affects the bones in the hip, spine and wrists. However, any bone can be affected.   
And, both women and men are affected by osteoporosis. 

Risk Factors

Osteoporosis drastically increases one’s risk for bone fractures. Because osteoporosis increases with age, older people who suffer from fractures are at great risk of suffering from chronic pain and disability, decreased quality of life, loss of independence and increased mortality (risk of dying).

1 out of 2 postmenopausal women and 1 in 5 older men are at risk for osteoporosis-related fractures. Osteoporosis is more common in white people than other ethnicities.

Screening

At age 65, all women should be screened for osteoporosis (using a DEXA scan) and men at age 70. However, if a person of either sex has additional risk factors (history of smoking, low body weight, previous fractures or family history of osteoporosis) screening should start at menopause or age 50 for men.

Signs and Symptoms

Typically the first sign of osteoporosis is a fracture. Unfortunately thinning bones don’t really cause a lot of symptoms until osteoporosis is well under way. Some general signs can include:

     1. Fragility-related fractures - breaking bones very easily from mild impacts.

     2. Receding gums can be an early sign - as the jaw loses bone, it shrinks and cause gums to recede.

     3. Losing height can be attributed to thinning and shrinking of bones.

     4. Low back pain as the spine becomes weaker it’s less able to handle day to day stresses.

     5. Curving of the upper back happens as the vertebrae weaken and become wedge-shaped.

Prevention & Treatment

Prevention and treatment of osteoporosis are similar in that all steps can be taken at any time, to strengthen bone and prevent its loss. Ideally, prevention begins early in life, as bone reaches its strongest point in a person’s mid-20’s.

After that, bone density decreases very slowly over the coming years. Here are the best steps & things to avoid for keeping bone healthy and strong through the years.

1. Regular strength training and weight-bearing exercise (running, walking, racquet sports, etc.) stresses the bones encouraging thickness and strength.
2. Avoiding excess phosphorous intake. Phosphorous is an essential nutrient for human health, however excess intake has negative effects on bone and mineral metabolism in humans. The largest sources of dietary phosphorous are grains, dairy products, animal proteins and soft drinks. Cola intake in particular is associated with low bone density and fractures. (1)
3. Vitamin D allows the body to absorb much of the calcium that’s ingested. Without vitamin D, there is very little absorption of calcium. Calcium is of course the main mineral that creates the framework on which bones are made. Decades of low vitamin D and inadequate calcium absorption will lead to weak, thin bones.
4. Excessive use of cortisone - cortisone based hormones (prednisone) are used for many conditions. Typically this medication is meant for short term use, but there are autoimmune and other conditions in which these drugs are prescribed continually. Cortisone inhibits how calcium is absorbed and speeds up the breakdown of bone. 
5. Thyroid hormones - when prescribed in excess or when a patient’s thyroid labs aren’t monitored closely, too much thyroid hormone can also speed up bone turnover, leading to weak bones.
6. Excessive use of acid-blocking drugs: Long term use of proton pump inhibitor drugs translated to more fractures. People with osteoporotic fractures were twice as likely to have used a proton pump inhibitor for several years. These drugs limit the body’s ability to absorb minerals (like calcium), leading to weakened bones. Here's a video covering it all.
7. Inadequate calcium intake - calcium provides the mineral matrix upon which bones are built. Ongoing calcium intake is important to maintain bone integrity.
8. Essentially fatty acids (omega-3s) may also play a role in supporting bone health directly, and they may also assist with calcium absorption in the gut.
9. Low ranging estrogen - estrogen is a primarily female hormone that helps build bone by stimulating bone growth, repair and turnover. Lower estrogen levels over a lifetime can lead to weakened bones; at menopause estrogen levels decline rapidly bringing osteoporotic changes quickly. You can easily test your estrogen levels at home using this kit.
10. A healthy diet that favors the nutrients bone needs can be started at any time. Here's some good information on the best foods for healthy bones. 

(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693714/#R8