With the aging of the population and changes in lifestyle, the number of people suffering from osteoporosis is increasing today. Although people are familiar with the term “osteoporosis”, their understanding of it is often “half-understood” and “mixed”, and many osteoporosis patients have taken many detours in prevention and treatment due to misconceptions. Many patients with osteoporosis have taken many detours in prevention and treatment due to misconceptions and misguidance. The following, the editorial on the most common clinical osteoporosis nine major misconceptions one by one to review, I hope to help the majority of patients.
1, “osteoporosis” and “osteopenia” is the same thing?
Although “osteoporosis” and “osteopenia” are only one word different, but the meaning is not the same. According to the definition of the World Health Organization (WHO), osteoporosis is a metabolic bone disease, and its bone density must be reduced by 2.5 standard deviations or more compared to the average of normal adult bone density to be called “osteoporosis”; a reduction of 1-2.5 standard deviations (SD) can only be called “Bone loss”. Many elderly people do have osteoporosis, but strictly speaking, they are in the category of “bone loss” and cannot be diagnosed as “osteoporosis” yet. Therefore, a formal bone density test is needed to confirm the final diagnosis.
2.Determination of osteoporosis based on conscious symptoms or blood calcium level
Firstly, in the early stage of osteoporosis, patients can have no symptoms or mild symptoms, which are difficult to detect; secondly, the calcium concentration in the blood can be maintained within a narrow normal range through the regulation of various hormones (such as parathyroid hormone, calcitonin, active vitamin D, etc.).
When calcium intake or loss is insufficient and blood calcium decreases, the body will increase osteoclast activity through hormonal regulation and mobilize calcium from the bones into the blood to maintain normal blood calcium; conversely, when dietary calcium intake is excessive, calcium-regulating hormones will stimulate osteoclast activity to deposit excess blood calcium in the bone. If the above balance is broken, it will lead to osteoporosis.
3, osteoporosis is caused by calcium deficiency, simple calcium supplementation can be cured
Calcium is the main component of bones, but osteoporosis is not simply due to calcium deficiency, but mostly due to the imbalance of calcium-regulating hormones (such as reduced secretion of estrogen, reduced synthesis and activation of vitamin D, etc.), osteoclast activity exceeds osteoblast activity, resulting in the rate of bone loss exceeding the rate of bone formation.
Therefore, it is far from enough to rely on calcium supplementation alone to treat osteoporosis, but also to correct the imbalance of bone metabolism, that is, calcium supplementation must be combined with anti-osteoporosis drugs (including drugs that inhibit bone resorption and promote bone formation) to effectively treat osteoporosis.
4, calcium is a nutrient for bones, more supplementation is beneficial and harmless
Calcium deficiency can lead to osteoporosis, but calcium supplementation is by no means more than necessary. Excessive calcium intake does not turn into bones, but also increases the burden on the digestive tract, stomach pain, constipation and other discomforts, and more seriously, can cause hypercalcemia, increasing the risk of kidney stones and cardiovascular disease.
According to the National Osteoporosis Foundation (NOF), the daily calcium requirement of the human body is related to age and gender: men under 70 years old and women under 50 years old need to supplement 1000 mg of calcium per day, and men over 71 years old and women over 51 years old need to increase the daily calcium requirement to 1200 mg. The recommended daily calcium intake for adults set by the Chinese Nutrition Society is 800 mg, and the recommended daily calcium intake for postmenopausal women and the elderly is 1000 mg.
5.Patients with osteoporosis are prone to fractures, and it is better to be still than to move
Maintaining normal bone density and bone strength requires constant exercise stimulation, lack of exercise will cause bone loss, physical exercise has a positive effect on the prevention of osteoporosis, especially in outdoor sunlight activities, can also increase the synthesis and absorption of vitamin D, and help the absorption and utilization of calcium in the body.
If the elderly do not pay attention to exercise because they are worried about falling and causing fractures, muscle strength decreases and coordination decreases, osteoporosis will only become more serious, but more likely to fall and cause fractures.
6, osteoporosis is a disease of the elderly, not related to young people
The latest research found that women in their twenties and thirties (especially those with a thin body type), may also suffer from this disease, which is closely related to the poor lifestyle habits of young people. Nowadays, many young people stay at home, go out to the car, lack of outdoor exercise, sunshine time is not enough; eat a partial diet, addicted to alcohol and tobacco, like to drink strong tea and coffee; some young fashionable women, in order to pursue a slim body and desperately dieting to lose weight. All the above-mentioned bad lifestyle, resulting in insufficient calcium intake, vitamin D synthesis is reduced, may suffer from osteoporosis at a young age.
7, osteoporosis is a minor disease, no big deal
Osteoporosis is not just a backache, it has the characteristics of “four highs and one low”, namely high morbidity, high disability, high mortality, high medical costs and low quality of life. Fracture is the most serious complication of osteoporosis, especially brittle fractures in the elderly hip, resulting in long-term bedridden patients, quality of life is seriously reduced, mortality rate of up to 10-20%.
8, people old brittle bones is a natural law, there is no need to intervene
Many people believe that osteoporosis is the inevitable result of aging of the body, neither avoidable nor reversible, so there is no need for treatment, this view is not correct. Osteoporosis is caused by a decline in the level of hormones (mainly sex hormones) in the body after old age, which accelerates bone resorption and delays bone formation, resulting in continuous loss of bone mass. Reasonable treatment, including estrogen, active vitamin D supplementation and bisphosphonates and other medication, can delay bone loss and prevent fractures.
9. With osteophytes, calcium cannot be supplemented
One of the reasons for osteophytes is the ectopic deposition of calcium in the compensatory process of the body after osteoporosis (calcium is often deposited on the surface of the cervical spine, lumbar spine and knee joints to form “bone spurs”), and calcium supplementation can precisely correct the state of calcium deficiency in the body, thus partially correcting this abnormal process and reducing the formation of “bone spurs”. Bone spur” formation, therefore, for patients with osteophytes, an appropriate amount of calcium supplementation will not cause and aggravate osteophytes, but can also play a role in improving bone metabolism, treatment and prevention of osteophytes.