When a patient tells me they have osteoporosis or osteopenia, I want them to physiologically understand what’s happening in their bones. Let’s quickly break down the underlying mechanism behind these conditions. The first concept to understand is that Osteoporosis is a severe form of Osteopenia. I’ve had patients try to separate them into two categories when they are in fact the same mechanism.
So, what exactly happens in these bones at the cellular level? Essentially the bones lose mass and become more porous. They almost look like Swiss cheese as demonstrated by the below image.
Here’s what is happening at the physiological level: As we’re aging, our bones are constantly remodeling – we have cells that build bones (osteoblasts) and cells that break bones down (osteoclasts). As we age, the bone builders start to decrease their activity, where the cells that break down bone do not. So, we get this completely normal trend where bones are being broken down faster than they are rebuilt. There are certainly other risk factors as well including being postmenopausal, prolonged steroid use, smoking, etc.
What can we do to prevent this from happening or to slow its progression? We’ll take a closer look in our next blog.
