Overview of osteoporosis.

Overview of what causes osteoporosis, how it is diagnosed and treated.

Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. Osteoporosis is a common condition that affects many older adults. The following provides an overview of what’s going on in your body to weaken your bones, what causes osteoporosis, and how it is diagnosed and treated.

How bones get weaker.

You may not think of your bones as being active organs, but they are. They undergo a constant cycle of repair, renewal and mineral release, a process called remodeling. The remodeling cycle has two phases:

• Bone reabsorption (breakdown and renewal)
• Bone formation (generation of new bone)

During the reabsorption phase, cells on the surface of the bone called osteoclasts dissolve bone tissue and release it into the bloodstream. This leaves behind tiny pits. During the bone formation phase, cells called osteoblasts fill in the pits with new bone tissue. In a normal healthy bone, reabsorption and formation are balanced, meaning that the amount of bone that is formed matches the amount of bone that was dissolved.

In people with osteoporosis, the remodeling process becomes unbalanced. More bone tissue is dissolved than formed. This results in less dense, weaker bones that are more prone to breaking.

Causes.

Causes of osteoporosis include:

• Age
• Hormonal changes
• Prolonged inactivity
• Certain medications
• Calcium-poor diet
• Other diseases

Diagnosis of osteoporosis is made using a patient’s medical history, physical exam and a bone mineral density test, most commonly a central DXA scan. This DXA scan is a specialized x-ray that can measure the bone density of your hip and spine. This test can:

• Determine if you have osteoporosis before you break a bone
• Predict your likelihood of breaking a bone in the future
• Find out if your bone density is improving, worsening, or staying stable
• Determine whether a fracture was caused by osteoporosis

According to the National Osteoporosis Foundation¹, DXA scans are recommended for:

• Women age 65 or older
• Men age 70 or older
• Anyone who has broken a bone after age 50
• Women of menopausal age with risk factors
• Postmenopausal women under age 65 with risk factors
• Men age 50-69 with risk factors
• Some patients with back pain or loss of height

Your doctor will work with you to determine when and how often you should be tested.

Treatment.

Osteoporosis is typically treated with medications that help restore balance in the bone remodeling process. By either slowing the reabsorption process or increasing bone formation, these medications help to increase bone density and strength, and prevent fractures.

There are many different medications available to treat osteoporosis. Your doctor will choose the best medication for you based on a number of factors, including your medical history and test results. Because these medications vary in the ways you take them – some are infused and some are taken in pill form – your doctor will also take your lifestyle and personal preferences into account.

If you have any questions about your osteoporosis treatment, talk to your doctor or contact your CVS Specialty CareTeam.