Bone Demineralization and Osteoporosis

Bone Demineralization and Osteoporosis

Aging is an important part of life. Many people dread it. But aging is a privilege and can be a positive experience given the correct mindset. With age comes experience, knowledge, and emotional resilience.

While our emotions may become more resilient, our bodies generally don't. Muscle loss, diminished skin elasticity, and low bone mass density (BMD) commonly occur with age.

Today, we will be focusing on the factors that can cause the progression of bone demineralization. We will also talk about its' connection to osteoporosis.

Finally, we will analyze the surprising results of a study on the link between topical corticosteroids (TCS) and the loss of bone mass. 

Read on to learn important information that may help you prevent osteoporosis and live a happier, healthier life!

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Understanding Bone Demineralization and Osteoporosis

In the intricate world of human health, bone demineralization is often overshadowed by more pressing conditions. Yet, understanding these phenomena is important. Especially because it can silently undermine the very framework of our body – our bones!

Bones can become demineralized due to the gradual loss of essential minerals, primarily calcium and phosphate. This results in weaker bone structure.

This process can stealthily progress, influenced by factors ranging from nutritional deficiencies to hormonal fluctuations and alcohol use. A vitamin D deficiency can also contribute to bone demineralization. This process can result in bone disease, osteopenia, and osteoporosis.

Osteopenia is a medical condition characterized by low bone mineral density (BMD), but not low enough to be classified as osteoporosis.

It can be thought of as a condition where bone density is reduced, but it has not reached the severity of bone loss seen in osteoporosis.

Osteoporosis is a condition that manifests as a reduction in bone mineral density. This leaves the bones alarmingly fragile and increases the risk of fracture. 

Hip fracture is an especially dangerous result; as a broken hip, back, or leg can cause immobilization. This can lead to an increase in bone loss due to lack of exercise.

Older men and women are predominately at risk for bone demineralization. The decrease in estrogen found in postmenopausal women plays a crucial role in accelerating bone loss.

The prevention of osteoporosis and the demineralization of bone hinges on a multi-faceted approach. This approach includes a diet rich in calcium, exercise, and the use of medications.

What is Osteoporosis?

Osteoporosis in the hip

Most of us have heard of osteoporosis. Many of us have family members who have experienced it. But not everybody understands this troubling condition. Let's explore what it is and what causes it.

The primary cause of osteoporosis is an imbalance in the bone remodeling process. This process involves the continuous formation and breakdown of skeletal tissue. Osteoporosis risk factors include the following:

  1. Aging. As people age, bone density tends to decrease, making bones more prone to becoming porous and fragile. Loss of muscle mass is another contributor that comes with age.

  2. Hormonal Changes. Hormonal changes occur naturally within all people. Women experience this during menopause while men see a decline in testosterone. Hormone replacement has been shown to restore bone.

  3. Nutritional Deficiencies. Low intake of calcium and vitamin D can contribute to osteoporosis.

  4. Lifestyle Factors. Lack of physical activity, particularly weight-bearing exercises, can cause osteoporosis. Smoking, excessive alcohol consumption, and a sedentary lifestyle has been associated with bone loss.

  5. Medical Conditions and Medications. Certain medical conditions like rheumatoid arthritis and vascular disease could cause you to lose bone density. Medications like corticosteroids can also negatively affect bone remodeling. Studies have shown that there is an association between potent TCSs and osteoporosis.

  6. Genetics. A family history of osteoporosis is associated with higher risk of developing the condition.

  7. Low Body Mass Index (BMI). Being underweight or having a small body frame can be associated with lower skeletal tissue density.

Often, a combination of these factors contributes to osteoporosis.

Prevention requires a combination of a balanced diet and regular weight-bearing exercise. Avoiding smoking, excessive alcohol intake, and addressing any underlying medical conditions is important.

Findings demonstrate an association of potent TCSs and the appearance of osteoporosis and fracture.

Symptoms of Osteoporosis: What to Look Out For 

Broken Foot in a cast

The symptoms of osteoporosis include back pain, increased bone fractures, and loss of height. Reduced mobility is also a symptom.

Losing the ability to engage in the common activities of daily living can impact mental health. 

The symptoms develop over time and often quietly. For this reason, osteoporosis is sometimes called a "silent disease."

A Quick Word About Bone Tissue

There are two primary types of bone tissue found in the human body. Knowing the types of bone tissue and their function will help us understand bone demineralization.

Trabecular bone--AKA spongy bone--is an important type of bone tissue.

Trabecular bone is characterized by its porous and lattice-like structure, which gives it a spongy appearance. It is typically found at the ends of long bones such as the femur and tibia.

Trabecular bone provides strength and flexibility to the bones. Its porous structure allows bones to withstand mechanical forces while being lighter than solid bone. This tissue is very responsive to bone metabolism.

This means it responds to changing in hormonal signals and nutritional factors. It can undergo remodeling, which involves the continuous process of bone resorption (breakdown) by osteoclasts and bone formation by osteoblasts.

The other type is cortical bone. Cortical bone is characterized by its dense and solid structure, forming the outer layer of bones and providing them with strength and durability.

Cortical bone is solid and dense, with a compact appearance. It forms the outer layer of bones, creating a protective shell around the internal trabecular bone.

Bone demineralization effects both types of bone tissue and can strike slowly over time.

How to Get Evaluated: Tests and Procedures

How do you get evaluated for osteoporosis?

Your healthcare team might recommend bone density tests. These tests include Dual-Energy X-ray Absorptiometry (DEXA).

A DEXA scan is a medical imaging procedure used to measure bone mineral density (BMD) in the body. It is the most widely used and accurate method for assessing bone health.

DEXA Scan for bone density

This type of scan differentiates between bone and soft tissue by measuring the attenuation of each energy beam as it passes through the body.

This is because bone and soft tissue each absorb the X-ray beams differently.

The resulting measurements are used to calculate the bone mineral density (BMD), which helps to estimate the strength of bones and the risk of fractures.

Here's how a DEXA scan procedure works and what it involves:

  1. Procedure: A machine passes a very low dose of X-ray energy through the body. The X-ray beams are typically of two different energies, which allows for more accurate measurement of BMD.

  2. Measurement Sites: DEXA scans are commonly performed at specific sites in the body. The most common sites are the lower back, hip, and sometimes the forearm. These areas are prone to breakage

  3. Results: The Dual-Energy X-ray Absorptiometry machine generates a T-score, which compares the patient's bone density to that of a healthy young adult. The T-score indicates whether bone density is within the normal range.

DEXA Bone density scan

Results are typically reported as:

  • Normal: T-score above -1.0
  • Osteopenia (low bone density): T-score between -1.0 and -2.5
  • Osteoporosis: T-score -2.5 or lower

Are Corticosteroid Creams Associated With Low Bone Density?

If you suffer from certain skin conditions, you may have used topical corticosteroids (TCS) to relieve itching.

But did you know that creams used to treat skin irritation can also affect your bone health?

Recent studies have shown that this may be true. Patients with high cumulative exposure to potent topical steroids have an increased risk of bone disease and osteoporosis

Academic research institutions have discovered that systemic corticosteroids may contribute to the development of osteoporosis.

Systemic corticosteroids are medications that are given by injection, swallowed, or inhaled. Once taken, this medication spreads throughout the entire body.

Common Forms of steroids

Oral corticosteroids are usually taken by swallowing a pill and are used to treat arthritis and allergies. Medical findings have revealed that these are often the medications that can affect bone remodeling.

Inhaled corticosteroids are used to treat asthma. Research has shown that use of inhaled corticosteroids is also associated with lower bone strength.

Systemic corticosteroid use is associated with increased risk of osteoporosis

There are many potential adverse effects to using topical corticosteroids, as well. These include dependence, increased chance of infections, and itching and redness.

Researchers in Taiwan recently published a study with alarming results. They found a clear connection between topical corticosteroid use and osteoporosis.

This means long-term TCS use can negatively affect bone formation and increase osteoporosis risk! 

What are Topical Corticosteroids?

Topical steroid hand cream

Topical corticosteroids (TCSs) have become a common fixture in dermatology. They offer relief for various skin conditions. There are many types of TCSs.

Let's start by defining what these medications are and exploring the different types available.

Topical corticosteroids are often referred to as topical steroids. They are applied to the skin to reduce inflammation and irritation.

These corticosteroids mimic the effects of cortisol, a natural hormone produced by the adrenal glands.

These medications come in different dosages, ranging from mild to high dose, and are classified into several classes. The potency and formulation depend on the specific skin condition being treated. 

There are many adverse effects of topical corticosteroids. Though many of these negative effects target the skin, we now know that bones are at risk, as well.

Long-term use of TCSs has been observed to show a risk increase for osteoporosis.

How Topical Coricosteroids Work

Understanding how topical corticosteroids work is important. This knowledge sheds light on their effectiveness in managing skin conditions.

When you have a skin condition, your body’s immune system sends signals to your skin cells to produce chemicals that cause inflammation.

This inflammation can cause redness, itching, and swelling.

Steroid creams work by blocking these signals and reducing inflammation in the skin. Steroids cause a chemical inhibition of these signals.

Think of it like this: when you have a cut or a scrape, your body sends white blood cells to the area to help fight off any germs that might cause an infection.

But sometimes, your body sends too many white blood cells to the area, which can cause inflammation.

TCSs help reduce this inflammation by telling your body to send fewer white blood cells to the area.

Common Uses for Topical Corticosteroids

Woman itching arm

Topical steroids are used to treat many conditions. These include eczema, psoriasis, and more. These medications play a pivotal role in managing various dermatological conditions.

Common Uses:

  • Eczema. The application of topical steroids can control the inflammatory response. This provides relief from itching and redness.

  • Psoriasis. The anti-inflammatory properties of these medications assist in managing excessive skin cell growth. This is a main characteristic of psoriasis.

  • Contact Dermatitis. Contact dermatitis results from contact with certain substances. It can cause redness, itching, and sometimes blistering of the affected area. TCSs can alleviate the inflammation associated with contact dermatitis.

Can Long-Term Use of Topical Corticosteroids Cause Osteoporosis?

Now that we understand the nature of osteoporosis and steroid creams, we can finally look at the question that started this all.

Is there a connection between the use of potent TCSs and the risk of developing osteoporosis?

What the Data Says About Topical Corticosteroids and the Risk of Osteoporosis

Artist's illustration of bone fibers being weakened by medications.

A recent study showed something quite alarming. It revealed that people who used very strong topical corticosteroids for prolonged periods see a loss of bone tissue.

What makes this all the more distressing is that topical steroids are well-known for how long it takes to see results.

In other words, the longer you use it, the most likely you are to see results, both positive and negative- including osteoporosis and bone demineralization!

While the results of this study still need to be reviewed, the findings demonstrate that use of TCSs can lead to osteoporosis.

How Topical Corticosteroids Affect Bone Health 

The exact science of how topical corticosteroids impact bone health is still under debate.

One theory is that high cumulative amounts of potent TCSs can be absorbed into the body.

Once these are present in the body, they can inhibit the natural process of bone remodeling and bone mineralization.

When to Consider Alternative Options: Making the Switch

Deciding when to explore alternative medications depends on various factor.

They include the nature of the skin condition, individual response to treatment, and the presence of side effects. It's advisable to consult with a healthcare professional when contemplating a switch.

Indicators for Consideration:

  • Inadequate Response. If the current treatment plan is not providing the desired results.

  • Side Effects. When side effects from topical corticosteroids become problematic.

  • Preventive Care. It is a good idea to explore alternatives for long-term preventive care. This is especially true in cases requiring extended treatment.

Being well-informed about alternative treatment options can help manage skin conditions.

Consultation with healthcare providers is crucial for personalized recommendations. Medical professionals base their recommendations on individual health considerations and treatment goals.

Dermeleve®: The #1 Rated Steroid Free Itch Cream

Dermeleve® is the best alternative to traditional steroid creams. It is a solution that's both effective and gentle on the skin.

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Dermeleve® provides lasting relief without the side effects associated with steroid-based creams. Dermeleve®'s proprietary topical formula does not contain steroids. It has been clinically shown to absorb quickly into the skin and reduce itch.

Dermeleve® is developed by dermatologists and can be applied to affected areas as needed. 

And, Dermeleve® does all of this without any potential for osteoporosis and major osteoporotic fracture!

Topical Steroids and Osteoporosis: What You Need to Remember 

Let's look back on what we've learned about the relationship between topical corticosteroids and osteoporosis. 

  • Systemic corticosteroid use is associated with osteoporosis.
  • Studies show an association between cumulative use of high potency TCSs and bone loss.
  • Bone demineralization may lead to osteoporosis.
  • It's important to speak with your doctor about the risks and benefits of steroid use.

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What You Can Do Today

Aging can be uncomfortable and even distressing. But understanding how to protect your bones and your skin makes aging easier. Finding alternatives to steroid creams can be a solution for itchy skin and osteoporosis prevention.

One option to consider is Dermeleve®. This is a fast-acting and safe alternative. It provides relief the risks of steroids. Always seek counsel on the best preventive measures, whether it's Dermeleve® or not.

In the grand tapestry of health and well-being, understanding the interactions between skin care and skeletal health is important. Consultation with healthcare professionals, considering alternative treatment options, and staying vigilant about bone health makes life better.

Studies on this subject are ongoing. There are continuous advancements in medical knowledge. Stay informed, prioritize your health, and, consult with your healthcare provider. Our skin and bones deserve the care and attention that keep them in harmony. 

So, go ahead and give Dermeleve® a try!