What is Osteoporosis? Part 1

What is osteoporosis? Part 1

by Dr. John Klibanoff
Orthopedic Surgeon
Rochester, NY

 To understand this condition and how we treat it you need some background information. Osteoporosis is a condition of the bone. Bone is made up of living tissue, the cells, and nonliving tissue – primarily calcium and some phosphorus. It is the non-living tissue that gives bone its hard mechanical properties. Without adequate calcium in the bones, we are prone to fracture, or breakage, even with routine activities of daily life. To prevent such injury and to allow normal function it is important to maintain the level of calcium in our bones.

Now, to understand osteoporosis we use the analogy of a bathtub half filled with water. Both the faucet and the drain are half open. If the water runs more rapidly into the tub, than the drain, the tub will continue to fill. If the drain is opened wider, it will remove more water than the faucet delivers, the tub will slowly empty. Think of calcium in your body as being represented by the water level.  Over time, you will wish the tub to be as full as possible.

In the healthy human body, the faucet can never be on too much. But, the drain can be open so widely that we lose calcium over time.

The balance of these two processes – filling and emptying – create a NET GAIN or NET LOSS of calcium.

Continuing with our analogy, from the time we are born until about age 23 in women and age 35 in men the faucet is on more than the drain is open. A NET GAIN. This means that we accumulate calcium for about the first 25 years of our lives. Men continue to build up their store of calcium for about another decade. After this, men lose calcium at a fairly constant rate. Women start to lose calcium in their mid-20s. Unfortunately, it is not a constant loss. When women enter menopause the loss of calcium is accelerated for at least a decade.

Remember, this loss is a result of the filling process gradually being exceeded by the emptying process. Because this reversal happens later in life for men their “tub” is more full when the net loss begins. It also means that men lose calcium for a shorter number of years than women. In women, the increased RATE of loss in the mid-50s and 60s compounds the problem. This explains why women are more prone to bone breakage due to osteoporosis than are men.

Next month, in the second part of this article, I will discuss the types of treatments available to either prevent calcium loss and to increase calcium deposition in our adult lives.

Dr. John Klibanoff  Orthopedic Surgeon  2410 Ridgeway Ave Rochester, NY 14626