Myths and Truths About Osteoporosis and Bone Health

When it comes to the health of our loved ones – particularly those who have passed the age of 65 – we are often faced with a wealth of contradictory information. Osteoporosis, the disease that weakens bones and dramatically increases the risk of fractures, is surrounded by numerous myths that can jeopardise the wellbeing of our elderly relatives. Each year, hundreds of thousands of Romanians are diagnosed with this condition, and the consequences of a hip or spinal fracture can be devastating – not only physically, but emotionally and socially as well.

As a family, our responsibility is to separate fact from fiction and make informed decisions about the care of our loved ones. A lack of accurate information can lead to the neglect of early symptoms, or to the adoption of practices that, far from helping, may worsen the situation. In this article, we will explore the most common myths about osteoporosis and discover together the truths that can make the difference between an active old age and one marked by suffering.

At Servicii Funerare Beelsamen in Bragadiru, alongside the comprehensive funeral services we provide to families in București with discretion and respect, we deeply understand the importance of proactive prevention and care for older people. Over the years, we have seen too many cases where a lack of awareness about bone health has led to tragic situations that could have been avoided.

Contents

1. What osteoporosis really is
2. The most common myths about osteoporosis
3. Real risk factors – beyond age
4. Warning signs you should not ignore
5. Correct diagnosis – when and how to act
6. Evidence-based prevention
7. Modern treatment options
8. Home adaptations for safety
9. Frequently asked questions

What osteoporosis really is

Osteoporosis is a systemic skeletal disease characterised by reduced bone mass and deterioration of the microarchitecture of bone tissue. Imagine bones as a structure similar to a honeycomb – in healthy individuals, the cells are dense and well connected, whereas in those with osteoporosis, the spaces between the cells become progressively larger, weakening the entire structure. The result is tragically simple: bones can fracture even following minor trauma, or sometimes with no apparent trauma at all.

This condition does not appear overnight. It is a slow process that can take years, during which the body loses more bone tissue than it can rebuild. The most dangerous characteristic of osteoporosis is that it remains silent until the first fracture occurs. There is no pain in the early stages, no clear warning signals – which is why many specialists refer to it as the "silent epidemic".

Types of osteoporosis

Understanding the types of osteoporosis can help you better identify the risks for your loved one:

• Primary osteoporosis – develops with age, most commonly after the menopause in women and after the age of 70 in men
• Secondary osteoporosis – caused by other conditions (endocrine, renal or digestive disorders) or by certain medications
• Juvenile osteoporosis – extremely rare, affecting children and adolescents
• Senile osteoporosis – directly linked to the ageing process, affecting both men and women over the age of 70

The most common myths about osteoporosis

Let us address, one by one, the most widespread myths that can jeopardise the bone health of our elderly relatives. These misconceptions are passed down from generation to generation and can delay diagnosis or lead to unhealthy lifestyle choices.

Myth 1: Osteoporosis only affects women

The truth: Whilst it is true that women are more susceptible – approximately one in three women over the age of 50 will suffer an osteoporotic fracture – men are not immune. Approximately one in five men faces the same problem. Moreover, fractures in men tend to be more severe and carry higher mortality rates, partly because diagnosis comes later, as men are less vigilant about bone health.

Myth 2: If you drink plenty of milk, you cannot develop osteoporosis

The truth: The calcium in milk is important, but it is not the only factor that determines bone health. Vitamin D is essential for calcium absorption, physical exercise stimulates the formation of new bone tissue, and genetic factors and lifestyle play crucial roles. A person may consume large amounts of calcium and still develop osteoporosis if other elements are missing from the equation. Additionally, calcium absorption decreases with age, and excess calcium can cause other health problems.

Myth 3: Osteoporosis is an inevitable part of ageing

The truth: Not all older people develop osteoporosis. Although bone density naturally decreases with age, many people maintain healthy bones well into very old age through an appropriate lifestyle, a balanced diet, and regular exercise. Osteoporosis is not inevitable – it is largely a disease that can be prevented, or whose effects can be minimised through early intervention.

Myth 4: If you have no pain, you do not have osteoporosis

The truth: This is perhaps the most dangerous myth of all. Osteoporosis is completely asymptomatic until the first fracture occurs. There is no pain, no discomfort, no visible signs. This is why regular screening from the age of 65 for women and 70 for men is essential. Many people only discover they have osteoporosis after suffering a "spontaneous" fracture or following a minor fall.

Other myths debunked

• Calcium supplements are sufficient – The reality: without vitamin D and physical exercise, supplements have limited effectiveness
• Exercise can worsen the disease – The reality: appropriate exercise strengthens bones and reduces the risk of falls
• Once diagnosed, nothing can be done – The reality: effective treatments exist that can slow or halt the progression of the disease
• Osteoporosis is inherited, so it cannot be avoided – The reality: although there is a genetic component, lifestyle choices can largely counterbalance hereditary predisposition

Real risk factors – beyond age

Understanding the risk factors helps you better assess your loved one's situation and take preventive measures. Some factors can be modified, others cannot – but knowing them allows for a proactive and informed approach.

Non-modifiable risk factors

• Advanced age – risk increases exponentially after the age of 65
• Female sex – particularly after the menopause, when oestrogen levels decline
• Ethnicity – people of Caucasian and Asian origin are at greater risk
• Family history – if parents have suffered hip fractures, the risk increases significantly
• Body build – people who are slim or have a small bone structure are more vulnerable

Modifiable risk factors

These are the factors we can influence through lifestyle changes, and their impact can be substantial:

• Sedentary lifestyle – lack of weight-bearing exercise accelerates the loss of bone mass
• Smoking – reduces calcium absorption and accelerates the loss of bone density
• Excessive alcohol consumption – interferes with calcium and vitamin D metabolism
• Calcium and vitamin D deficiency – fundamental to maintaining bone health
• Body weight that is too low – a body mass index below 19 increases risk
• Long-term use of certain medications – corticosteroids, anticonvulsants, some thyroid medications

Warning signs you should not ignore

Although osteoporosis itself is asymptomatic, there are several signs that should prompt you to consult a specialist. These signs may indicate either the presence of advanced osteoporosis or an increased risk of developing the disease.

One of the most subtle yet significant signs is loss of height. If your loved one has lost more than 3–4 centimetres in height, this may indicate vertebral compression fractures, even if they have been painless. Many older people attribute this loss of height simply to "old age", but it can be an important warning signal.

Full list of warning signs

1. Persistent pain in the lower back or mid-back – may indicate vertebral fractures
2. Changes in posture – the appearance of a hump (dorsal kyphosis) or a stooped back
3. Fractures following minor trauma – a fall from standing height should not cause fractures in healthy bones
4. Loss of height greater than 3 cm – signals possible asymptomatic vertebral fractures
5. Breathing difficulties – caused by compression of the ribcage in advanced cases

At Servicii Funerare Beelsamen, we have met many families who regret not having paid closer attention to these early signs. Prevention and early diagnosis can make the difference between maintaining independence and quality of life, and a rapid decline following a major fracture.

Correct diagnosis – when and how to act

A diagnosis of osteoporosis is established by measuring bone mineral density, most commonly using the DEXA method (dual-energy X-ray absorptiometry). This test is painless, non-invasive, and takes approximately 10–15 minutes. Results are expressed through T and Z scores, which indicate the level of bone density compared to that of a healthy young person or to people of the same age.

When screening should be carried out

• All women over 65 and men over 70, regardless of risk factors
• Women who reached the menopause before the age of 65 and who have risk factors
• People who have suffered fractures after the age of 50
• People taking long-term corticosteroids
• People with conditions associated with bone loss (thyroid, renal or digestive disorders)

Interpreting the results

The T score obtained from the DEXA test indicates the state of your loved one's bone health. A T score between -1 and +1 is considered normal. A score between -1 and -2.5 indicates osteopenia (reduced bone density, but not yet osteoporosis). A score below -2.5 confirms a diagnosis of osteoporosis. The more negative the score, the greater the risk of fracture.

Evidence-based prevention

The good news is that there are many concrete steps you can take to protect your loved one's bone health. Prevention is far more effective and less costly than treating the consequences of an osteoporotic fracture.

Nutrition for healthy bones

Calcium and vitamin D are fundamental, but they are not the only important nutrients. A balanced diet for bone health includes:

• Calcium – 1,200 mg daily for women over 50 and men over 70 (dairy products, broccoli, salmon, sardines, almonds)
• Vitamin D – 800–1,000 IU daily (sun exposure, oily fish, eggs, fortified foods or supplements)
• Protein – essential for maintaining muscle and bone mass (lean meat, fish, eggs, pulses)
• Vitamin K – helps to fix calcium in bones (green leafy vegetables)
• Magnesium – works alongside calcium for bone health (nuts, seeds, whole grains)

Physical exercises that protect bones

Not all exercises are equally beneficial for bone health. The most effective are weight-bearing and resistance exercises:

1. Brisk walking – at least 30 minutes daily, a minimum of 5 days per week
2. Climbing stairs – excellent for stimulating the formation of bone tissue
3. Dancing – combines impact with enjoyment and socialisation
4. Resistance exercises with light weights – 2–3 times per week
5. Tai chi or yoga – improve balance and reduce the risk of falls

Lifestyle changes

• Giving up smoking – benefits are seen even after years of smoking
• Limiting alcohol consumption – a maximum of one drink per day for women, two for men
• Maintaining a healthy body weight – neither too low, nor obese
• Limiting consumption of caffeine and fizzy drinks – these can interfere with calcium absorption

Modern treatment options

If your loved one has been diagnosed with osteoporosis, there are multiple therapeutic options that can slow or even halt the progression of the disease and significantly reduce the risk of fractures. The decision regarding treatment must be made together with a doctor, taking into account the severity of the disease, age, other conditions, and the individual's risk of fractures.

Main categories of medication

• Bisphosphonates – the most commonly prescribed medications; they slow bone loss
• Selective oestrogen receptor modulators (SERMs) – mimic the protective effects of oestrogen on bones
• Hormone replacement therapy – for women at the menopause, with benefits and risks that must be carefully evaluated
• Monoclonal antibodies – newer medications, highly effective in reducing fracture risk
• Parathyroid hormones – stimulate the formation of new bone tissue; reserved for severe cases

Monitoring treatment

Treatment for osteoporosis is long-term and requires regular monitoring. DEXA scans are usually repeated every 1–2 years to assess the effectiveness of treatment. It is essential that your loved one follows the treatment exactly as prescribed – many osteoporosis medications have specific administration instructions to maximise absorption and minimise side effects.

Home adaptations for safety

For people with osteoporosis or at increased risk, preventing falls becomes an absolute priority. A fall that might result in nothing more than a bruise for a younger person can lead to a hip or vertebral fracture in someone with weakened bones. The good news is that most falls can be prevented through simple adaptations to the home.

Essential modifications to the bathroom

The bathroom is where the majority of falls among older people occur. Wet and slippery surfaces pose a major risk:

• Installing grab rails next to the toilet and in the bath or shower
• Using non-slip mats in the bath and on the bathroom floor
• Fitting a shower seat if balance is poor
• Ensuring excellent lighting, including night lights
• Raising the toilet seat if it is too low

Safety in the bedroom and living room

1. Removing rugs and small mats that can slip
2. Clearing objects from the floor – cables, grandchildren's toys, pets that can get underfoot
3. Installing light switches at an accessible height and night lights along frequently used routes
4. Keeping walkways clear and wide
5. Checking the stability of furniture – chairs and tables that may be used for support

General adaptations

• Adequate lighting in all rooms, especially on stairs
• A sturdy handrail on both sides of the staircase
• Clearly marking the first and last step
• Securing rugs firmly or removing them altogether
• Keeping frequently used items at an accessible height, without the need to climb on chairs

Frequently asked questions

Can osteoporosis be completely cured?

Osteoporosis cannot be completely cured, but it can be managed very effectively. Modern treatments can halt the progression of the disease, increase bone density, and significantly reduce the risk of fractures. With appropriate treatment and lifestyle changes, many people lead active and independent lives.

How often should a bone density test be repeated?

For people undergoing treatment, the DEXA scan is usually repeated every 1–2 years to assess the effectiveness of therapy. For those without a diagnosis but with risk factors, a doctor may recommend testing every 2–5 years. The frequency depends on age, risk factors, and previous results.

Can calcium supplements cause kidney stones?

Studies show that the risk is higher in people who consume very high doses of calcium supplements, particularly without vitamin D. Calcium from food does not carry the same risk. If your loved one has a history of kidney stones, discuss with a doctor the optimal dose and type of supplement.

Do men need the same tests as women?

Yes – although the risk is lower, men can develop osteoporosis. Screening is recommended after the age of 70, or earlier if risk factors are present (long-term corticosteroid treatment, previous fractures, conditions affecting bone density). Men tend to be underdiagnosed and undertreated.

What happens after a hip fracture in older people?

Hip fractures are the most serious complication of osteoporosis. Approximately 20–30% of people who suffer a hip fracture die within the first year following the event, and more than half never regain their previous mobility. This is why prevention is crucial – a hip fracture can mark the transition from independence to complete dependence.

When should I seek specialist advice for a parent or grandparent?

Consult a specialist if your loved one has suffered a fracture after the age of 50, has lost more than 3 cm in height, has persistent back pain, has changes in posture, or has multiple risk factors. Do not wait for symptoms to appear – preventive screening saves lives. In the community of Bragadiru and București, Servicii Funerare Beelsamen has witnessed the devastating impact of osteoporotic fractures on families, and strongly recommends consulting a doctor for a preventive assessment.

Can I exercise if I already have osteoporosis?

Not only can you – you should! Appropriate exercise is essential in the management of osteoporosis. Avoid movements that involve sudden trunk rotation or pronounced forward bending, but walking, balance exercises, and light resistance training are all highly beneficial. A physiotherapist can create a personalised programme that is both safe and effective.

The bone health of our loved ones should not be left to chance. By understanding the truths about osteoporosis, dispelling the myths, and adopting a proactive approach, we can ensure that our older relatives enjoy an active, independent, and dignified old age. Every family has the power to make a difference through awareness, prevention, and timely action. If you have concerns about a loved one's bone health, speak to your GP or a specialist in metabolic bone disease today. Do not wait for the first warning sign – prevention starts now.

This article is intended for informational purposes only and does not replace medical advice. For specific situations, please consult a specialist in endocrinology, rheumatology, or internal medicine.