Myth 1: Only the elderly have osteoporosis usually people think that only the elderly have osteoporosis and need to take calcium tablets, but in fact, they do not. Osteoporosis is divided into three categories: primary osteoporosis, secondary osteoporosis and idiopathic osteoporosis. Primary osteoporosis mainly includes senile osteoporosis and post-menopausal osteoporosis, this type of osteoporosis is more frequent in the elderly and has nothing to do with young people. Secondary osteoporosis is caused by a variety of factors, such as long-term application of glucocorticoids, long-term alcohol consumption, hyperthyroidism, diabetes, myeloma, chronic kidney disease, long-term bed rest, etc. This type of osteoporosis can occur in all age groups, not only in the elderly. Idiopathic osteoporosis includes adolescent osteoporosis evidence, young adults, adult osteoporosis, pregnancy and lactation osteoporosis, this type is more common in young people. Han Shuhua, Department of Rheumatology and Immunology, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine Myth 2: Osteoporosis is a phenomenon of aging and does not require treatment Some people believe that the natural aging process of osteoporosis does not require treatment with drug intervention. In fact, there are still many symptoms caused by osteoporosis in clinical practice. The main signs and symptoms of osteoporosis include circumferential pain, shortening of height, humpback, fragility fracture and restricted breathing, among which circumferential pain is the most common and the main symptom. The cause is mainly due to high bone turnover, increased bone resorption, destruction and disappearance of bone trabeculae in the process of resorption, and destruction of subperiosteal cortical bone, which can cause generalized bone pain, with low back pain being the most common. Bones suffering from osteoporosis are very fragile, and some slight movements are often not perceived (i.e. no obvious history of trauma), but can cause fractures: such as coughing, sneezing, lifting heavy objects or holding children, or even breathing hard …… These slight fractures can bring serious consequences to the patient, greatly affecting the quality of life of the patient These minor fractures can have serious consequences for patients, greatly affecting their quality of life, and even shortening their life expectancy. The most common sites are the thoracolumbar vertebrae, proximal femur, distal radius, proximal humerus, and ankle joint. Some elderly people may say that they have shrunk in old age and are much shorter than before, but the shortening is actually caused by osteoporosis, which shortens their height silently, so osteoporosis is often called “the silent disease”. These signs and symptoms tell us that osteoporosis requires treatment, early examination, timely medication and lifestyle changes to prevent peripheral pain, fractures and other consequences. Myth 3: Normal blood calcium, even with osteoporosis, does not need calcium supplementation clinically many patients will pay attention to their blood calcium water, think that blood calcium is normal, no need for calcium supplementation. In fact, normal blood calcium is not the same as normal calcium in the bones. The calcium level in the blood needs to be regulated by a variety of hormones to maintain it within a narrow normal range, these hormones are: parathyroid hormone, calcitriol, active vitamin D. When calcium intake is insufficient or too much is lost and the body is deficient in calcium, it will be released into the blood through hormonal regulation of osteoclasts to reabsorb bone from this huge calcium reserve in the bone iliac to maintain the blood calcium within the normal range, when When dietary calcium intake increases, the calcium reserve is rebuilt by osteoblasts re-forming bone, and if the above balance is disrupted, osteoporosis will occur. It is important to emphasize that primary osteoporosis is still normal in terms of blood calcium levels even when severe fractures occur, so calcium supplementation should not be based on blood calcium levels alone. Myth 4: Calcium tablets are sufficient for osteoporosis Clinically, many patients who are found to have osteoporosis will say, “I am already taking calcium tablets for prevention, how can I still have osteoporosis?” Or “Why is my osteoporosis worsening even though I am taking calcium tablets?” . These two statements reflect the voice of many patients. First of all, patients who think that calcium supplementation can prevent osteoporosis generally think that the loss of bone calcium causes osteoporosis, but in fact, the loss of bone calcium is only one aspect of osteoporosis, other factors such as low sex hormones, smoking, excessive alcohol consumption, excessive coffee and carbonated beverages, lack of physical activity, lack of calcium and vitamin D in the diet (low light or low intake), etc. can lead to osteoporosis. Therefore, calcium supplementation alone cannot prevent the occurrence of osteoporosis; it is necessary to improve lifestyle and reduce other risk factors. After calcium is ingested into the body, it needs the assistance of vitamin D in order to be transported and absorbed. In patients with osteoporosis, the amount of calcium that can be absorbed by calcium supplements alone is very small and cannot fully compensate for the calcium loss in the body, so the phenomenon of osteoporosis worsens with calcium supplements. Therefore, in clinical practice, for patients with osteoporosis, calcium supplements should be supplemented with vitamin D preparations, currently available on the market are alfacalcidol and osteoporotic triol, both of which are active vitamin D components, but the former needs to be further transformed by the kidneys before it can take effect, while the latter can work directly. Therefore, in patients with renal insufficiency can directly choose osteotriol combined with calcium tablets to prevent osteoporosis. Myth 5: Drinking bone broth can prevent osteoporosis In fact, this is a dietary misconception. Most people know that calcium exists in the body mainly in the form of bones, so many people think that if you boil soup with bones, you can boil the calcium contained in the bones into the soup, and by drinking soup you can achieve the effect of calcium. In fact, the calcium inside the bones is not easily dissolved out, and the calcium content in bone broth is actually close to the calcium content in water, and its value is not high. Experiments have shown that after two hours of steaming in the pressure cooker, the fat inside the bone marrow has surfaced, but the calcium inside the soup is still minimal. If you want to use bone broth for calcium, you can consider adding half a bowl of vinegar when cooking the soup and slowly stewing it for an hour or two, the vinegar can effectively help dissolve the bone calcium. In fact, the best food for calcium is milk, on average 104mg of calcium per 100g of milk, the appropriate daily intake of calcium for adults is 800 to 1000mg, so drinking 500ml of milk every day can supplement a large amount of calcium. In addition, yogurt, soy products, seafood, etc. also contain more calcium, can be a balanced choice to eat. Misconception six: there is osteophytes can not be supplemented with calcium degenerative osteoarthrosis in the elderly often osteophytes and osteoporosis coexist, some people think that there is osteophytes (i.e. bone spurs) can not be supplemented with calcium. In fact, the root cause of osteophytes is calcium deficiency, which is caused by the ectopic deposition of calcium in the compensatory process of the body after osteoporosis. Calcium supplementation can correct the calcium deficiency of the body, thus partially correcting this abnormal process and reducing the formation of “bone spurs”, or even making the formed “bone spurs” smaller. Therefore, patients with osteophytes still need to be treated with calcium supplements. These are some of the common misconceptions about osteoporosis in clinical practice, which I hope will be helpful. In addition to calcium and vitamin D supplementation, we also need to add some osteoclast-inhibiting drugs, such as alendronate, for patients with severe osteoporosis, and 1-yearly bone density check is still necessary. In terms of life conditioning, patients will be advised to get more sunlight, eat a balanced diet, and exercise appropriately to prevent the occurrence of osteoporosis through their own conditioning and to prevent its aggravation if it has already appeared.