Osteoporosis & Anti-Aging

The term osteoporosis describes the fragility of bones that leads to fractures.

Osteoporotic fractures are fractures that result from poor bone quality rather than necessarily from the severity of a fall, as is the case with fractures caused by high-impact events such as car accidents.

The most common fractures related to osteoporosis are vertebral fractures, which lead to a reduction in a person’s height and the development of kyphosis. Loss of height and kyphosis significantly affect posture and movement and are often associated with the physical appearance of aging. Importantly, height loss due to osteoporotic fractures and kyphosis are irreversible condition. For this reason, early prevention and treatment are of crucial importance for an individual’s musculoskeletal health.

The maintenance and preservation of healthy bones, joints, and muscles are of tremendous importance. With advances in science and technology, significant new tools have been added in recent years to combat musculoskeletal aging. In the past, the diagnosis and management of musculoskeletal disorders were complex and time-consuming processes, and access to anti-osteoporotic medications was limited. Fortunately, today there are safe medications that can help bones regain up to five years of “youthfulness” within just three years of treatment.

The rapid progress of medical science has greatly strengthened the fight against osteoporosis. With current therapies, it is now possible to reduce the risk of fractures by up to 60% within just one year.

Osteoporosis—or osteopenia, which represents the often early aging of bones—is in many cases accompanied by sarcopenia. Sarcopenia refers to the parallel aging or decline of neuromuscular function, which affects a large percentage of individuals over the age of 80, significantly reducing their muscle mass.

As a result, there is a substantial decline in mobility, reduced ability to support the body, and pain that worsens over time. Indicatively, approximately 7% of our muscle mass is lost per decade after the age of 30. After the age of 70, this percentage increases to 15–25%. Muscle strength declines by approximately 12–15% per decade.

Hip fractures are also osteoporotic fractures. They carry a very poor prognosis and require specialized and timely treatment. There is extensive reference to hip fractures on the website, with detailed information provided. Other fractures caused by osteoporosis include fractures of the wrist (radius and ulna), shoulder fractures, and fractures of the pelvic bones.

In many cases of severe osteoporosis, bone quality becomes so poor that no fall is required for a hip fracture—or a fracture at another site—to occur. In such cases, these fractures are referred to in the medical literature as spontaneous fractures, meaning that no external factor contributed to their occurrence.

The study of osteoporosis and bone metabolism has, for many years, been at the epicenter of the specialized interest and expertise of Dr. K. Dretakis.

Osteoporosis is so common today that we now know that 1 in 3 women over the age of 60 may experience a vertebral fracture due to reduced bone strength, even without any traumatic event. In most cases, the patient is unaware of it, resulting in a slow but progressive loss of height, as well as changes in posture.

Following such a spontaneous—so-called compression—fracture, patients often report the sensation that a bone is “protruding” in the neck or back, or that the abdomen appears more prominent. In some cases, there may be mild lower back or upper back pain. Although the pain is usually subtle, it tends to persist and gradually worsen over time. In many instances, family members or close friends notice the change in posture or the reduction in height, but hesitate out of politeness to mention it to the patient.

The causes of osteoporosis and sarcopenia are multifactorial. Heredity is a very common contributing factor. Although one may believe that aging of the musculoskeletal system is not easily noticeable, osteoporosis and sarcopenia soon lead to visible changes in posture, shifts in the body’s center of gravity, and deterioration in the quality of gait and balance. Over time, the musculoskeletal system gradually weakens, causing the patient to lose part of their mobility.

All of the above, in turn, lead to an even greater increase in fractures resulting from falls, such as hip and pelvic fractures, which often require mandatory surgical treatment and involve significant physical strain until full recovery. Some of the main criteria by which we estimate a person’s age from a distance include trunk posture, ease of walking, and the ability to stand up and remain upright. All of these factors are directly related to osteoporosis, vitamin D levels, and sarcopenia.

Older individuals who maintain good bone and muscle health tend to be more active and are able to perform more activities, similar to those that younger individuals can carry out with ease.

Orthopedic Surgeon, PhD (University of Crete), Director of the 2nd Orthopedic Clinic at “HYGEIA” Hospital, and vitamin D researcher, Dr. Konstantinos Dretakis, has conducted extensive research in the field of musculoskeletal health and osteoporosis. He can assist you in diagnosing and managing complex musculoskeletal conditions, as well as provide answers and treatment options for all matters concerning your musculoskeletal health and its improvement.

Osteoporosis is managed by several medical specialties. Indicatively, orthopedic surgeons, endocrinologists, rheumatologists, internists, and general practitioners all possess a broad range of knowledge in this field. The appropriate physician for diagnosis is not determined solely by specialty, but rather by the level of training and in-depth expertise in osteoporosis and bone metabolism. A doctor of any of the above specialties may be suitable, provided they have received specialized education and have substantial experience in the diagnosis and management of osteoporosis.

Both women after menopause and men over the age of 60 are advised to undergo a bone mineral density (BMD) test. In women, the cessation of menstruation leads to significant hormonal changes—particularly a decline in estrogen levels—while in men, advancing age is associated with a reduction in testosterone, a hormone closely linked to bone health. The results of a bone density test can serve as a baseline reference, providing a clear comparison point for future evaluations.

If a patient is taking medications that negatively affect bone health, has a strong family history of osteoporosis, suffers from hormonal disorders, or experiences unexplained fractures without any preceding trauma, a bone density test should be performed regardless of age—even before the age of 60.

Blood tests play an extremely important role in the prevention of osteoporosis. Laboratory measurements of vitamin D, calcium, phosphorus, osteocalcin, and parathyroid hormone are essential—at least once in a person’s lifetime—so that their results can serve as a baseline reference for future comparison. Hormonal testing is also particularly important, especially in patients who experience unexplained fractures without any significant traumatic event. In such cases, identifying potential hormonal imbalances can help determine the underlying cause and guide appropriate preventive or therapeutic interventions.

Yes. Heredity is an extremely important factor in the development of osteoporosis. Genetic predisposition significantly increases the likelihood of obesity, elevated uric acid levels, cardiovascular disease, and other conditions, which, in turn, create a favorable background for the development of osteoporosis. When taking a medical history, the presence of osteoporotic fractures in parents—at any age—should be reported and recorded as significant information. A strong hereditary burden is a valid reason to screen individuals at a younger age, in order to prevent serious and potentially irreversible consequences in the future.

Osteoporosis in men is relatively common and often presents with more pronounced symptoms compared to women. It tends to appear somewhat later, usually after the age of 65, and unfortunately, the diagnosis is often made later than it should be. The treatment approach is the same for both men and women and includes anti-osteoporotic medications, as well as vitamin D and calcium supplementation. In men, osteoporosis is frequently associated with treatments for prostate conditions. It may also develop following serious gastrointestinal disorders or surgical procedures aimed at treating obesity.

Today, highly effective medications are available for both the treatment and prevention of osteoporosis. The drugs used for osteoporosis have been tested for more than 10 years and are considered reliable, as they rarely produce significant side effects. These therapies are regarded as highly effective, as they are capable of increasing bone mineral density by approximately 4% per year. As a result, they can reduce the risk of fractures by up to 60% within just one year.

A balanced diet and a healthy daily lifestyle are extremely important for maintaining musculoskeletal health. Prevention should begin early in life. A diet rich in calcium plays a key role in the fight against osteoporosis.

It is recommended to consume three servings of dairy products per day, such as milk, cheese, yogurt, etc. In addition, green leafy vegetables—such as spinach, arugula, and kale—various seeds, and almost all legumes provide significant amounts of calcium. In younger individuals in particular, daily calcium requirements can be fully covered through proper nutrition, without the need for supplementation.

It is recommended to consume three servings of dairy products per day, such as milk, cheese, yogurt, etc. In addition, green leafy vegetables—such as spinach, arugula, and kale—various seeds, and almost all legumes provide significant amounts of calcium. In younger individuals in particular, daily calcium requirements can be fully covered through proper nutrition, without the need for supplementation.

Special attention is required for individuals who are on anticoagulant or antidepressant therapy, as their calcium needs may be increased. The same applies to those taking corticosteroids.

Today, osteoporosis can be diagnosed, treated, and prevented. However, it is essential to consult a physician with specialized expertise and a reliable scientific team who can assist in addressing all underlying medical issues affecting the patient.