Osteoporosis, bone loss and calcium supplementation

  Patient: Description (onset time, main symptoms, hospital, etc.): female, now 39 years old, joint ringing, bone pain, weakness, easy fatigue for 10 years, today in August at the first hospital in Daqing, the diagnosis is written “bone loss” 10 years ago, blood tests: low blood calcium, a series of 2 years of calcium injection, the situation has improved. Today, I feel that my joints are ringing more than ever, and after half a month of calcium injection, there is no improvement. I went to Daqing First Hospital, and after examination by the instrument (I don’t know what instrument), I came to the conclusion: bone loss. Is osteoporosis the result of a decrease in bone mass? How should I treat it?  1, osteoporosis and bone loss. According to the consensus opinion of the International Society of Clinical Densitometry (ISCD), the diagnostic criteria for osteoporosis used at present are: ① T value >-1 for normal; ② T value >-2.5 for low bone mass (also called bone loss in the past); ③ T value ≤-2.5 for osteoporosis; ④ T value ≤-2.5 for osteoporosis with fragility fracture for severe osteoporosis. The equipment used was a dual-energy X-ray absorptiometry (i.e., dual-energy bone densitometry, abbreviated as DXA).  In fact, this criterion applies to postmenopausal women and men over 50 years of age. Perimenopausal women can refer to this criterion. However, young people are generally not diagnosed with osteoporosis unless a fragility fracture has occurred. Young people are diagnosed with reference to Z-value, if Z-value >-2 is within the range of BMD of the same age, if Z-value ≤-2, BMD is lower than that of the same age.  From the above, it is clear that reduced bone mass and osteoporosis are only different in degree. In addition, low bone mass is also seen in normal people, that is, the population itself has low bone density and has never experienced loss.  2, osteoporosis and calcium supplementation. The calcium intake of adults is about 1000mg, with different needs at different ages, mainly through dietary supplementation, if the dietary calcium intake is not enough, then calcium should be supplemented. Calcium supplementation does not mean that osteoporosis will not occur.  There are primary and secondary osteoporosis, therefore, after the diagnosis of osteoporosis, further examination and analysis are needed.  3.Treatment of osteoporosis. First, basic measures, including reasonable diet, appropriate exercise, calcium supplements, good lifestyle, etc.; second, drug therapy, according to the patient’s specific situation to choose anti-osteoporosis drugs.