Osteoporosis is a disease which causes bones to become fragile and easily broken. While it can affect anybody, the most susceptible to developing osteoporosis are women who are post-menopausal, this being considered Type I Osteoporosis.  This project will show how bone development is hormonally regulated, and when those hormones are not being produced the bones are not capable of developing correctly, causing porous and brittle bones.

When women go through menopause, they experience a severe drop in estrogen, one of the most important hormones associated with bone development in women. There are three primary types of estrogen: estrone, estradiol, and estriol. Before menopause, the primary type of estrogen is estradiol, while after menopause estrone becomes the most abundant. This is due to the fact that the ovaries are the production source of estradiol, so when the process of menopause begins, the ovaries are no longer creating that form of estrogen. Unfortunately, this is detrimental to bone health in women, as estradiol is essential in dictating osteoblastic activity.

Osteoblasts are the cells which are responsible for building new bones, while their counterparts, osteoclasts, are responsible for breaking down old bones. Where osteoblasts are influenced by the absorption rate of calcium, which is determined by estrogen levels, osteoclasts are controlled by the parathyroid hormone. During menopause, women experience a sharp decline in estrogen production, however, the parathyroid hormone continues to be produced at normal levels. This means that the osteoclasts will continue to break down bones, but without the estrogen present to increase the calcium absorption rate, osteoblasts will not continue building new bones at the rate necessary to keep up with the osteoclastic activity. Eventually, the osteoclasts will have broken down all of the old bone, and will start eating away at the new bones, causing them to be porous and fragile.

While post-menopausal women are the primary victims of osteoporosis, everyone has the possibility of developing the disease without proper care, especially those who are currently dealing with, or have previously dealt with an eating disorder. Malnutrition resulting from an eating disorder can result in a serious lack of calcium with which to build and strengthen bones. If this malnutrition begins at a young age when the bones are still in the process of being initially built, the long-term effects include early-onset osteoporosis possibly without the possibility of reversing the bone loss even after the eating disorder has been treated.

Treatment for osteoporosis includes hormone therapy as well as calcium and vitamin D supplements or changes in diet. Typically, a combination works best, however each person may experience better results choosing supplements over dietary changes, and some may find hormone therapy isn’t necessary if they increase their calcium and vitamin D intakes.

The cake below shows an example of a healthy bone versus a bone which is lacking in calcium (or butter in this case). The cake on the left shows a bone which has enough calcium: it is dense and strong enough to hold itself together, and capable of withstanding trauma. On the right, the cake is missing a critical ingredient which would stabilize the cake. Without the butter, the cake crumbles with minimal effort, just like a bone without calcium.

Sources:

Bone loss from eating disorders. Eating Disorder Hope. (2022, September 20). Retrieved November 23, 2022, from https://www.eatingdisorderhope.com/information/eating-disorder/osteoporosis-bone-density-loss

Cheng, C.-H., Chen, L.-R., & Chen, K.-H. (2022, January 25). Osteoporosis due to hormone imbalance: An overview of the effects of estrogen deficiency and glucocorticoid overuse on bone turnover. International journal of molecular sciences. Retrieved November 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836058/

Cui, J., Shen, Y., & Li, R. (2013, March). Estrogen synthesis and signaling pathways during aging: From periphery to brain. Trends in molecular medicine. Retrieved November 22, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3595330/

Gambacciani, M., & Levancini, M. (2014, September). Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Przeglad menopauzalny = Menopause review. Retrieved November 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520366/

Steinman, J., & Shibli-Rahhal, A. (2019, August). Anorexia nervosa and osteoporosis: Pathophysiology and treatment. Journal of bone metabolism. Retrieved November 22, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746661/

3 Comments

  1. This project addresses the objective: “Explain how bone development is hormonally regulated” by investigating the symptoms, causes, and treatments of osteoporosis, a disease that affects mainly post-menopausal women and malnourished individuals by causing their bones to be weak and fragile. The ultimate cause of osteoporosis is insufficient calcium to continue the construction of bone. Osteoporosis affects many older women whose bodies have stopped producing estradiol, a female sex hormone that regulates calcium absorption, because of menopause. Calcium controls osteoblasts, bone-building cells; if calcium is not being absorbed, osteoblasts are not actively forming new bone. This is bad, but it gets worse, osteoclasts, cells that break down old bone, remain active and attack healthy bone, causing destruction to outweigh construction.

    From the written statement, we learn that osteoporosis, although it is seen most in post-menopausal women, can happen to anyone, and thus, we must be careful. The author, Jessica Atwell supports this warning by emphasizing how a lack of calcium is the true cause of osteoporosis, this being the case, people who do not consume foods containing calcium are at risk of osteoporosis. We also are told that osteoporosis is not limited by age, young people with calcium deficiencies can get this group of diseases. The younger the patient, the more serious this can be, since the bones are not fully developed in children.

    Thankfully, there is hope, Jessica tells us. Post-menopausal women can take replacement estrogen, since their bodies are no longer producing it, to combat osteoporosis and bring osteoblasts back into the game. Other people can take vitamin D supplements and eat calcium-rich foods to try to build back strength in their bones. The success of either treatment has been seen in osteoporotic people.

    The visual representation of osteoporosis excellently displays the impact that a loss of calcium has on the bones. For her visual representation, Jessica Atwell baked two delicious-looking cakes, but left out a significant ingredient in one. While the first piece of cake is firm and dense, the second piece is a crumbly mess. What caused the difference between the two? The first cake was assembled and baked in a traditional manner; the second cake contained no butter. What is the point of this culinary creation? Butter gives structure to cake, enabling it to stand up, like how calcium influences osteoblasts to make strong bones that form the framework of the body. People with osteoporosis lead a frightening life, a minor fall or jar could break their brittle bones. A well-made cake can be shaken and pressed on a little bit in the process of removing it from the oven and cutting into it, and it will not be harmed. A butter-less cake that is jiggled and sliced, however, will not be unscathed.

    Overall, Jessica Atwell does a great job of explaining bone development using the illustration of osteoporosis. Her written statement is informative without wasting words and helps the reader to better understand the subject without becoming lost in the details. The visual representation is creative and effectively reinforces the point she is trying to make.

    Micah Hassen
  2. Jessica Atwell illustrates how bone density is regulated by hormones through a demonstration in which two cakes are prepared and their integrity compared. Of the two cakes, one of them is prepared without butter and the other is presumably prepared normally. The cake without the butter is dry, crumbled, and lacking structural support. This signifies how bones respond to a deficiency in calcium, (with the calcium representing the butter).
    The cake that was prepared with the butter is dense and homogenous. This is indicative of the structural property’s calcium and healthy bones in general provide. If external trauma were to be inflicted on both cakes, the cake that was prepared with the butter stands a much better chance at withholding its structural integrity. As Jessica explained, it is when the calcium (in this context, butter) levels drop that one may experience osteoporosis. Osteoblasts will not produce enough bone to keep on pace with the osteoclasts destruction rate.
    The treatment of osteoporosis in post-menopausal women, as Jessica points out, is often most successful when calcium and vitamin D supplements are paired with hormone therapy. This is because of the key role estrogen plays in regulating osteoblast and osteoclast activity. If estrogen levels drop, there are subsequent consequences on the level of calcium absorbed as the absorption rate is regulated by estrogen levels. The parathyroid hormone continues functioning normally, causing disproportionate levels in activity comparatively between osteoclast and osteoblasts. Jessica’s illustration of this concept through use of baking was a great way to conceptualize and visualize the ramifications of hormonal imbalances on bone health.

    Annelise Fullerton
  3. I learned that Osteoporosis is a disease which causes bones to become fragile and easily broken. The most susceptible women are those who are post-menopausal. During menopause, women experience a sharp decline in estrogen production. Without the estrogen present to increase the calcium absorption rate, osteoblasts will not continue building new bones. Eventually, the osteoclasts will start eating away at the new bones, causing them to be porous and fragile. Although post-menopausal women are the primary victims of osteoporosis, everyone has the possibility of developing the disease. Malnutrition resulting from an eating disorder can result in a serious lack of calcium with which to build and strengthen bones. Treatments include hormone therapy as well as calcium and vitamin D supplements or changes in diet.

    Jessica does a great job metaphorically using two cakes as her demonstration: The cake on the left shows a bone which has enough “butter” which acts as calcium to hold itself together, while the one on the right lacks it. A healthy bone is dense and strong, capable of withstanding trauma. Without butter, a cake crumbles with minimal effort, just like a bone without calcium.

    Amanda Scott

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